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Table 1 Interpretation of symptoms: a summary

From: Multiple perspectives on symptom interpretation in primary care research

The interpretation of symptoms within individual research disciplines
Biomedical perspective • Focus is on interpretation of signs and symptoms as indicators of disease according to certain symptom characteristics such as: symptom nature, symptom severity, impact, and temporal aspects.
Psychological perspective • Focus is on factors affecting the interpretation of sensations such as: internal frame of reference, attention to sensations, illness perception and susceptibility to suggestion.
Anthropological perspective • Anthropologically situated research suggests that experiences and culture are in a continuous feedback relationship, where historical, political and/or social context contributes to different expectations and experiences. This influences when and how sensations are understood and acted upon as symptoms of disease. Moreover, it suggests that social and cultural structures may cause symptoms to manifest.
Taking a broader view
General issues • Symptom experiences are embedded within a complex interplay of biological, psychological and cultural factors.
• Symptom interpretation in general practice is preceded by particular biomedical conceptualisations.
• Research in symptoms as part of classifiable diseases cannot stand alone; symptom research should include symptoms as a generic phenomenon.
Interpretation of prevalence • Surveys of symptom prevalence in the general population or in primary care reflect a variety of interpretations of sensations, which are not equivalent to expressions of underlying disease. We should be cautious and explicit when interpreting the findings.
Diagnoses • If diagnosis of disease is based on the presence of specific symptom characteristics only, we may reinforce a dualistic approach (including medicalisation of normal phenomena and devaluation of medically unexplained symptoms).