Explain what chronic obstructive pulmonary disease is and outline its antecedents and progression.provided with a case study of George (detailed below) as well as a number of questions that need to be answered pertaining to the case.

Explain what chronic obstructive pulmonary disease is and outline its antecedents and progression.provided with a case study of George (detailed below) as well as a number of questions that need to be answered pertaining to the case.

provided with a case study of George (detailed below) as well as a number of questions that need to be answered pertaining to the case. required to draw on evidence
(primary research) that relates directly to the case when providing answers.
The report will be based on the case of George and should draw on relevant psychological research and theory.

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Summative Case Study
George is a 68 year old man who suffers from Chronic Obstructive Pulmonary Disease (COPD). He was diagnosed when he was 57 after he had become increasingly breathless
and tired and could not shift a cough he had been struggling with for months. He had been very active but had started to struggle to keep up with working on his
allotment. He was a builder by trade and retired when he was 65, although he took on more administrative duties towards the end of his career due to the symptoms of
his COPD.
He went to see his GP who referred him to a respiratory nurse at his local practice. She performed a simple breath test (spirometry) and confirmed his diagnosis as
moderate COPD. He had an FEV1 of 69%. During his initial assessment George confessed that whilst he had smoked for as long as he could remember but had always planned
to stop “one day” and determined to stop smoking to help manage his condition. At this time he was smoking 20 a day.
George found quitting much more difficult than he had anticipated. He tried using nicotine replacement patches but these irritated his skin so he stopped using them
and tried to reduce the number of cigarettes he smoked each day. This worked for a time and he managed to reduce his smoking to five a day, which he maintained for
over a year. However his smoking slowly increased and he is now smoking 10-15 a day again. He does not feel that he is able to stop on his own and doesn’t have
confidence that nicotine replacement helps.
George is married to Jane who is 59. They have just celebrated their 39th wedding anniversary and she is planning a break for their 40th wedding anniversary next year,
with the rest of the family. They have three grown-up children and two grandchildren who are due to start school next year. They are also expecting a third grandchild
in a couple of months’ time. Jane is an ex-smoker who gave up a few years before George’s diagnosis. She wasn’t a heavy smoker and found it relatively easy to stop.
She is supportive of his attempts to quit but is frustrated that his smoking has increased, especially as his health seems to be deteriorating. This is starting to
cause tension in the relationship.
At George’s recent annual review his FEV1 had decreased to 52% and he was recently admitted to hospital for an exacerbation of his COPD. He went to see his GP and
respiratory nurse following this as he felt low about his disease and the symptoms he has been suffering. He is anxious about experiencing further exacerbations and is
struggling to sleep due to excessive coughing. His GP told him that unless he stops smoking the condition will continue to deteriorate. His GP and nurse have been
advising him about his smoking since his diagnosis and know that this is the best way for him to manage his condition. Whilst they know George has reduced his smoking
overall, they also find it frustrating that he has continued to smoke. He is taking regular inhaled medication and has a management plan in place in case of further
exacerbations, including rescue medication. He has used his rescue medications a few times as he was worried his condition was worsening, although these perceived
exacerbations were due to breathlessness and panic, rather than exacerbations of COPD. George has been impressed with his care at the practice but feels unsupported
with his attempts to reduce his smoking. He does not know how to address this as his own attempts did not work in the past.

Areas To Include for this case study:
A 200 word summary of the case report

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