Table of Contents

Introduction......................................................................................................................................1
Challenges faced by the affectees....................................................................................................2
Physical, social, psychological, and emotional challenges of affectees......................................2
Relationship between the health of the body and mind during COPD............................................3
Integrated care and patience experience..........................................................................................4
Laws and the ethical principle in nursing....................................................................................5
The local and international ratios of affected people.......................................................................6
International ratio and practices...................................................................................................6
Local ratios and practices.............................................................................................................8
Conclusion.....................................................................................................................................10
References......................................................................................................................................11
Introduction
Chronic obstructive pulmonary disease (COPD) is a group of diseases that eventually cause
breathing problems due to airflow obstruction. COPD affects millions of people, with the most
common conditions being chronic bronchitis and emphysema. Both of these conditions can
coexist in a person and worsen the disease's severity. It is a lung disease that causes a blockage in
the airflow, resulting in breathing difficulties (O’Donnell, 2014). COPD symptoms include
shortness of breath, coughing, mucus production, and wheezing. It is caused by long-term
exposure to poisonous gases such as cigarette smoke. COPD can get worst over time, if not
treated properly, although treatments are available. COPD is considered the third leading cause
of death worldwide, and it is increasing the number of death every year (Bhatt, 2013).
Countries that are underdeveloped and have high levels of air pollution are thought to have a
high number of COPD patients under the age of 70 (WHO, 2022). Underdeveloped or middle-
income countries suffer as a result of government mismanagement; additionally, giant
manufacturing companies locate there due to low labour costs. Such countries lack strict rules
and regulations governing air pollution and environmental exploitation. Because poisonous gas
exposure affects the lungs of people living in the surrounding area, people in underdeveloped
countries do not have better living standards. As a result, in such countries where 90% of the
population is affected, this has become one of the leading causes of COPD (WHO, 2022).
Smokers can easily get COPD but apart from people who are highly exposed to poisonous air
pollution, or work with chemicals, dust or fumes can be affected by COPD. A person with
genetic risk factors, or who has been facing respiratory infections since childhood can also get
COPD.
The first stage of COPD is mild COPD, in which the person feels out of breath only with light
exercise, such as walking up the stairs. People do not take it seriously at this stage, and another
symptom, cough with mucus, may appear. The second and third stages are moderate to severe,
with frequent shortness of breath after mild exercise, and the lungs are affected by pneumonia
and bronchitis. The fourth stage is the most severe stage and shortness of breath starts very
frequently after every short activity, the mobility of the person is limited. Based on every stage it
is treated differently, for the cough, various medications help to get it cured, and for shortness of
breath, the patient might need instant oxygen. Vaccination, antibiotics, supplemental oxygen, and
rehabilitation programs are some of the ways to cure COPD (Duffy, 2019).
Further, the report will deal with various sub-topics analyzing the international and national
(UK) ways of treatment if they differ or not, and the difference between the ratios of the
affectees. People face different challenges, especially those residing in underdeveloped
countries. The report will further discuss the mind and health of the body during this disease.
And different experiences of the patients, residing in the UK.
Challenges faced by the affectees
Based on the immune system every patient faces different challenges in COPD if the person
already has some disease like diabetes or high blood pressure, they are affected more severely
during COPD. It can lead to lung cancer due to multiple infections in the human body. Apart
from them, treatment can be another factor that is the biggest challenge for the patient. In the
UK, there are short-acting bronchodilator inhalers are the first treatment which is used by
patients. In the UK patients face fewer challenges in their treatment because of the availability of
resources in the country. They have better doctors and nurses who treat every stage with care and
full potential. Because the doctors and nurses trained staff patients to feel betterment during the
treatment of COPD (WHO, 2023). In the UK, several of the latest treatments have been
introduced to enhance the effect of treatment on the patients i.e. Bronchodilators, corticosteroids,
and other medications which are specifically made to get breathe easily by reducing
inflammation.
On the other hand, challenges faced by the patient who is residing in some underdeveloped
countries which do not have sufficient resources the situation for the patient is entirely different.
Because many underdeveloped countries are lacking in the professional staff like doctors, nurses
as all these people are shifting to developed countries of right better professional life and
personal life. Researchers have found gaps between the lower-income and middle-income
countries patient’s challenges (REPORTS, 2020). More than 42% of lower-income countries
people don’t even get treatment to cure COPD because they believe treatment is very expensive
and will end up in their deaths. In middle-income countries, there are some health programs
which are launched by their government which covers 40 to 50 per cent of expenses to cure any
treatment so this has reduced the number of death of COPD patients (MD, 2021). Due to this
patients are not checkup up properly, apart from that many medicines and vaccinations for
COPD are not afforded by these countries, which is why there is a 90% ratio of COPD patients.
In developed countries, there are different situations and different challenges that are being faced
by COPD patients. Based on the treatment, they have different physical, emotional, and social
challenges, which we will discuss in depth.

Physical, social, psychological, and emotional challenges of affectees.

In the UK, due to better healthcare resources and services, patients do not feel any physical or
psychological challenges. But, in terms of society, they feel challenges because it creates
boundaries between them and other people. As they have to remain in the hospital and avoid
going out in public places due to the shortness of breath and couch, doctors recommend they stay
in the house until and unless they get properly cured (Lim, 2017). A more social person might
feel challenged during COPD which on their emotions as well. A social person might get
irritated, and feel alone as it prevents the person to socialize much. But still, the challenges in the
UK are not that harsh because of the facilities and proper treatment against COPD. The lifestyle
is better in the UK in terms of pollution and awareness about the health importance. People are
much aware that smoking can cause many serious illnesses along with COPD. As per various
reports, the UK has a pulmonary rehabilitation program which is special design for people who
are living with COPD, which lasts about six to eight weeks. In this program breathing techniques
and exercises are taught to COPD patients, which ultimately affect positively the physical,
psychological, social, and emotional factors (Ntritsos, 2017).
Lower-income countries and middle-income countries have completely different situations,
because of the lack of better hospitals, and treatments the patients face challenges physically,
socially, psychologically, and emotionally. Insufficient treatment makes them physically weak
and they are unable to be socialized it impacts them psychologically and emotionally as well
(Lortet-Tieulent, 2019). The air pollution atmosphere makes their condition worse and the
challenges increase day by day and creating the fear of death among COPD patients. Nepal
which is also one of the undeveloped countries have a high death rate of COPD patients, the
death rate is 182.5 per 100,000 population. Similarly, the main reason which has been diagnosed
for such deaths in Nepal is smoking, air pollution and heat caused by cooking. Though these
symptoms are curable due to the lack of resources and availability of doctors in hospitals patients
are facing many challenges which affect their physical health, limit their social exposure, and
make them aggressive and irritated emotionally. Due to physical, psychological, emotional and
social challenges, people are losing their lives during COPD in Nepal and other undeveloped
countries (Troosters, 2013).

Relationship between the health of the body and mind during COPD
COPD has various stages which we have discussed already and each stage can cause different
types of healthy relationships between the body and mind as per the research it depends on age-
wise in the UK. People above 50 years old tend to have depression and anxiety attacks due to the
shortage of breath in COPD (Jiménez-Ruiz, 2015). 50-plus years old are weak in the body and
immune system as this disease can be more severe in such age brackets. So this impact on the
psychology of the patient which ultimately causes panic attacks. Studies further recognized that
these symptoms are very common in old patients but unfortunately it is mostly unknown and
caregivers could not try to overcome these during the treatment of COPD patients (Polverino,
2018). In this age bracket, patients can face clinical depression which creates deep sadness
among the patient due to the fear of death and it last more than a week. It affects the mind so
much that patients’ treatment does not become much affected whereas, hospitals in the UK are
trying to overcome this problem as well and introducing exercises for aged patients to keep them
relaxed. This shows that patients who are 50 plus have a parallel relationship between the health
of the body and mind, if the body becomes weak depression and panic attack increases (Lim,
2017).
Some health researchers argue that it is all about first and then the body, health people who are
20 to 50 years old are healthy enough to tackle COPD, as they set their minds to remain healthy.
If the mind has positive thinking, the body will respond similarly. Whereas, some believe that the
body makes the mind, if the patient is improving day by day from COPD and overcoming the
symptoms it will relax the mind of the patient, and treatment gets easier. COPD can cause
cognitive impairment which affects information processing, attention, concentration, memory
and control of the person which results in severe panic attacks in the patient (Pooler, 2014).

Figure 1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199319/

Figure 1, exhibits a visual understanding of the relationship between the health of the body and
mind during COPD, it affects the daily life of the person where the patient loses the locus of
control despite having proper treatment in the UK. These symptoms worsen the condition of
patients more and more, to overcome this issue doctors are finding out different programs to
remain them calm. All these arguments still prove the positive relationship between the health of
the body and mind, which needed to be taken care of more seriously (Pleasants, 2016). UK
government and health care sector should introduce some psychological programs and
consultancies for COPD patients which may help patients to remain positive during COPD. The
UK government should launch awareness sessions for the people that how COPD can be
eliminated which main reason being smoking and air pollution, and the government should
emphasize the reduction of smoking.

Integrated care and patience experience

UK is trying to emerge a different integrated care system for the patients of COPD, coping with
breathing issues, and lung infections. Some care system has been launched by the UK themselves
where smoking cessation therapies are been given to COPD patient who is addicted to smoking,
under this program patients are given such environment which leads them to quit smoking,
protect young people to get into smoking, and those people who are already addicted, this
includes some kind of exercises, activities, and medications to prevent the patients from smoking
(Doiron, 2019). Doctors have also strategy different consultant agencies where awareness has
been spread for healthy lifestyles and to enhance the body exercises for this. Collaborative self-
management strategies are also being launched by the UK government in the hospitals so that
people can take care of themselves and their families to avoid COPD, the government has also
some strict rules for air pollution by reducing the greenhouse emission by 100% by 2050 (Hobbs,
2017), which indirectly will have a positive impact on the lifestyles of the people. World health
organization has also introduced some integrated systems for the patients like inhaled
corticosteroid medicine which helps to overcome breathing problems at the initial stage and
reduces the chances of death.
Several inhalers and corticosteroid medicines have been very helpful for the instant relief of the
patients which are increased the overall experience of the patients in the UK. On the initial level
when they do not have any idea about COPD, at that time patients have very worst experience
because the shortness of breath and severe cough makes their health worst day by day. But after
2016 when the UK started to launch several awareness programs for COPD, and inhalers for
treatment it started to relieve patience very much. Now overall 2% of the population is getting
COPD, which is stated by some researchers that it has decreased since 2011 because of the
awareness sessions, and the availability of instant medicines (Shrine, 2019). Whereas some of
the patients have stated that their experience in terms of food during COPD is not that good,
because of the specific food selection by the doctors during the treatment, patients have to eat
food which is not deep fried and spice. Because oily and spicy things can worsen lung infection
and cough, patients also have to avoid fizzy drinks, as they only need to have filtered water.

Laws and the ethical principle in nursing

In the UK there are various laws and ethics principles that nurses have to follow while treating
any patient. For nursing itself, section 60 of the health act 1999 in which the key functions are
about the training, education, and standard practice of the nurses to gain professional experience
(Kangasniemi, 2015). Similarly, 4 basic ethical principles are autonomy, beneficence, justice,
and no maleficence. As every patient has the right to choose a hospital for the treatment which is
autonomy given to the patients by the UK government. But, it created conflict as well because
patients sometimes go wrong as per the guidelines of nurses and doctors, because patients are not
aware of the health care guidelines. Because this autonomy ethical principle also gives the right
patient to refuse medication, injection, treatment, surgery, or any other medical treatment, this
leads to conflict because doctors know better what has to be given as the best on the severity of
COPD or any other diseases (Ventura, 2021).
Moreover, healthcare workers are also responsible to promote good towards patients, minimize
harm and refrain from maltreatment. And this is particularly beneficence healthcare professionals
demonstrate this ethical principle by providing a balance of benefits against risks to the patient.
Giving timely treatments and quick medication is an example of beneficence by health workers.
This principle enhances the trust between the patients and the healthcare professionals and makes
treatment much easier and curable. The third ethical principle is based on justice: providing fair
and equal treatment to patients. UK government emphasize very much on human rights and
that’s how they are expressing it by making ethical principles to avoid deaths (Jones, 2015).
Justice ethical principle exhibits that no matter what colour, age, caste, designation, or gender a
person is they will get equal treatment during any disease. Similarly based on these differences
patients do not have any right to get harmed by the nurses or health care protections. But this
principle is controversial because if the patient refused to get any specific medication as per the
right to autonomy, it leads to death, and at last, nurses got into a challenging situation (Hobbs,
2017). Overall, nurses in the UK are given training, and education related to these ethical
principles, and a code of ethics within their profession. UK government also emphasize that
nurses should remain true during the treatment of the patient, and no harm shall be made from
their end.

The local and international ratios of affected people

As we have already studied the lower-income and middle-income countries, why there are
COPD patients and what are the reasons and differences between the treatment? This report will
further study the ratios of affected people internationally, and locally (UK). Also will discuss the
difference in why such differences in COPD affectees occur. Similarly, we will empathize with
the world health organization’s steps to overcome COPD internationally, and what various
programs and medications are being followed to reduce the number of death due to COPD.
International ratio and practices

Figure 2https://www.gov.uk/search/research-and-statistics

The figure shows the visual evidence of the prevalence of COPD where Denmark which is
4299.5, Myanmar (3963.7), and Belgium (3927.7) have the highest prevalence, with Fiji (668.5),
Guam (1010.0), and Kiribati (1019.4) the lowest number of prevalence of COPD. In 2019, the
highest number of death due to COPD is in Nepal (182.5), Papua New Guinea (145.0), and the
Democratic People’s Republic of Korea (105.2), whereas the lowest rates were found in Japan
(7.4), Barbados (8.3), and Kuwait (8.3). Due to the high prevalence in some of the countries
world health organization launch some rehabilitation programs to strengthen and overcome
chronic disease and its symptoms. Also, some programs to reduce exposure to tobacco which has
been the main reason for COPD prevalence in different countries.
Figure 3https://www.gov.uk/search/research-and-statistics

In figure 3 we can first see the affectees of COPD age-wise, where people who are between 65-
74 are highly affected by COPD, in women who are more than 95 years old are affected highly
and reported main causes of death. Similarly, after the age, of 80 years women are more highly
affected by COPD than men some of the researchers stated that it is because of the immune
system, of women and they are more tend to catch lung infections and then COPD, whereas,
some researchers argue that men should be highly infected after 70 years because they are more
towards the smoking.
Figure 4https://www.gov.uk/search/research-and-statistics

This is the sociodemographic index which exhibits the age-standardized DALY rate of COPD
from 1990 to 2019. With the increase of the sociodemographic index, the DALY rate also
increases which is up to 0.4. From 1990 to 2019, burdens in Western Sub-Saharan Africa, North
Africa and the Middle East, tropical Latin America, central Latin America, Andean Latin
America, southern Latin America, the Caribbean, central Europe, and high-income Asia Pacific
were lower than projected. South Asia, Oceania, East Asia, and high-income North America, on
the other hand, experienced higher-than-expected DALY rates from 1990 to 2019.

Local ratios and practices

Now if we discussed the ratio of patients in the UK below:
Figure 5https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/adhocs/
009649deathsfromasthmaandchronicobstructivepulmonarydiseasebyagegroupenglandandwales2010to2017

The above figure exhibits the data from 2010 to 2017, which age group has the maximum
number of COPD patients in the UK, hence in 2010 people who are between 80-84 are highly
affected by COPD (Gilkes, 2016), keep going till 2017 we have the same 80-84 age group people
who are again highly affected. This was revealed that people who are between the ages of 80-84
are highly reported COPD patients in the UK, because of their weak immune systems.

Figure 6https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/adhocs/
009649deathsfromasthmaandchronicobstructivepulmonarydiseasebyagegroupenglandandwales2010to2017

Similarly, we can see the number of death in age groups. Whereas, people between the ages of
80-84 are more towards die due to COPD. And the lowest death occurs in the age group 5-14
(Rothnie, 2016). The ratio of COPD in the UK is less than 10-15% because of the programs that
the government has introduced to overcome the smoking and pollution problems in the UK this
overall has increased the better lifestyle in the UK decreasing COPD among people. Whereas,
based on the age and immune system of the person people are still diagnosed with COPD. Instant
availability of medicines is also reducing the number of deaths of COPD patients because it
reduces the severity of the disease and eliminates infections in the lungs. Moreover, different
physical exercises and awareness programs have also decreased the number of affectees because
people are now enough awareness of health, and how to deal with lung infections and coughs.
If we compare the ratio of the UK and other countries we can conclude with the study that
Bangladesh, and Nepal where exposure to pollution and poisonous gas very has a high ratio of
COPD, along with the ratio of death. As there are underdeveloped countries and do not have
many resources they are unable to instantly fight with them. Whereas world health organization
is also providing financial aid for such countries to over with these diseases in order to save the
lives of people (De Matteis, 2016).

Conclusion
This report comprises different facts and figures about COPD in the UK and on an international
level also. The report concluded the symptoms and treatments in the UK and different
developing countries. We analyzed some of the patient’s relationships between the body and
mind during COPD, and how the UK government and healthcare industry trying to overcome
different symptoms of COPD, at every stage of the COPD stages. Moreover, discuss the
international and national ratio of COPD patients what ages are being diagnosed highly with
COPD, and also the ratio of death.
The report contains the different awareness sessions, and programs introduced by the UK
government to overcome the COPD ratio now. Different instant medications have also been
covered in this report which exhibits the reduction of severity of COPD.
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