SJ is a 52-year-old while male who comes to the hospital with the complaints of the whistling sounds in his chest and a growing fatigue. He has recently developed a cough which he ignored for several days (he does not remember how many) but which has worsened over time. He confirms that coughing is accompanied by a large amount of mucus. He also reports the loss of stamina and shortness of breath which hampers his productivity in the workplace. He has been a smoker for 24 years. His respiratory rate is 29 per minute, and his heart rate is 114/min. The blood pressure is 132/86.
All of his symptoms, including the physical examination results, are consistent with COPD (Russel, Ford, Barnes, & Russel, 2013). Smoking has been conclusively tied to the development of the disease. In addition to the direct adverse effects of the tobacco smoke on the lungs, multiple effects are observed in other organs, such as the inflammatory agents detected in the bloodstream and the antioxidant imbalance (Fischer, Voynow, & Ghio, 2015). Thus, while other causes may be contributing to the patient’s condition, the COPD is the main diagnosis.
COPD has been associated with certain barriers to treatment. First, the patients diagnosed with COPD are commonly hospitalized because of the symptoms which discourage and complicate physical activities. At the same time, physical activity has been shown to result in better outcomes and decrease both mortality and morbidity rates associated with the disease (Thorpe, Kumar, & Johnston, 2014).
COPD is also regularly misdiagnosed for several factors, such as misattribution of the fatigue and shortness of breath to aging, the low awareness of the symptoms of the disease, and the underestimation of its consequences (Fromer, 2011). A factor that is often ignored but presents a significant barrier to the successful treatment is the anxiety and depression associated with COPD. As the disease is linked to smoking, many patients get a false impression that it is reversible once they quit, which in itself is a difficult task.
As a result, the mounting pressure discourages patient’s involvement and alters the course of treatment (Coelho et al., 2014). Finally, some studies have conclusively tied the COPD severity and the COPD helplessness to lower health literacy (Omachi, Sarkar, Yelin, Blanc, & Katz, 2013). In other words, low awareness is itself rooted in the ability to process healthcare information. For instance, certain cultural groups have inherently low literacy across the population. Cultural diversity also leaves the possibility of the groups which are traditionally biased against the clinical treatment and prefer folk medicine.
While some barriers, such as the restrictions of physical activity, are organizational and can be alleviated by introducing alternative policies, the majority of the recounted problems are rooted in the poor understanding of the disease. Raising awareness can decrease the number of misdiagnosed cases and allow the patients to properly react during the initial phase of the disease and participate in the treatment process.
It can also alleviate a psychological pressure and create a more favorable climate for a patient. At the same time, emphasizing serious consequences behind the symptoms is important to address negligence demonstrated by some individuals. The two latter points are conflicting, so a careful balance must be sought. Finally, a separate approach must be created to address the less literate population, such as the creation of more accessible visual and informational aids explaining the symptoms and treatments.
References
Coelho, R., Santos, A. S., Maia, D., Rosa, R., Caldeira, V., Sá, T.,…Cardoso, J. (2014). Symptoms for anxiety and depression in COPD patients. European Respiratory Journal, 44(8), 981-984.
Fischer, B. M., Voynow, J. A., & Ghio, A. J. (2015). COPD: balancing oxidants and antioxidants. International journal of chronic obstructive pulmonary disease, 10(1), 261-269.
Fromer, L. (2011). Diagnosing and treating COPD: understanding the challenges and finding solutions. International Journal of General Medicine, 4(2), 729-739.
Omachi, T. A., Sarkar, U., Yelin, E. H., Blanc, P. D., & Katz, P. P. (2013). Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. Journal of General Internal Medicine, 28(1), 74-81.
Russel, R., Ford, P., Barnes, P., & Russel, S. (2013). Managing COPD. London, England: Springer Science & Business Media.
Thorpe, O., Kumar, S., & Johnston, K. (2014). Barriers to and enablers of physical activity in patients with COPD following a hospital admission: a qualitative study. International Journal of Chronic Obstructive Pulmonary Disease, 9(4), 115-121.