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92 From at-risk to multimorbidity – options for diagnostic reviews and de-diagnosing? The interplay between medical technology, the social and cultural context and women’s bodily experiences
  1. Susanne Reventlow
  1. Center of General Practice (Research Unit of general practice Copenhagen and Zeeland and Section of General Practice), Department of Public Health, University of Copenhagen, Copenhagen, Denmark


Aim To explore the categorization of risk and disease experienced over time and to discuss possibilities of diagnostic reviews and de-diagnosing?.

Introduction There is an increased attention to the body, which stems from both the society and the biomedical need to find risk factors, detect disease early, and monitor health. As a result, an increasing proportion of the population is classified as multimorbid. However, how is the categorization of the body experienced over time and are the diagnosis still relevant?.

Methods This presentation is based on a longitudinal qualitative study that included interviews with women followed in two rounds from 1997 to 2000 (when they were in their 60s) and again in 2012 (when they were in their 70s). The study draw on theory of ‘social technology’ and Merleau-Ponty and Csordas’ theory of embodiment. The body is seen as a dynamic synthesis shaped by the social-cultural context.

Results The first round of interviews revealed how medical technology (a bone scan) affected behaviour and symptom interpretation among those who were told they had low bone density. The findings of the next round revealed that all participants were classified as having multimorbidity. The participants were primarily afflicted by the health issues that hindered their everyday activities, including mental problems such as depression. Exceptions were concerns about unanticipated and potentially life-threatening illnesses. For the most, osteoporosis and comparable health issues were no longer a concern.

Discussion and Conclusion The longitudinal approach showed that medical technology and the connected solutions, the interpretation of health, health risk, and diseases is a dynamic process in which new experiences are incorporated.

There is a need to continually review if a diagnostic category could be a reason for overdiagnosis and whether the diagnosis still is relevant to the patient. This should be done also integrating a life-course perspective. There is furthermore a need to reconsider diseases classifications, the concept of multimorbidity, and the options for de-diagnosis.

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