Ralphie Role Play Hypothetico-Deductive Model

Ralphie role play Hypothetico-deductive model

You have returned to the doctors as she/he had asked you to return for your CXR results. You didn’t really want a CXR. You are not worried about your cough; it has always been your wife who has made you come about that. You still think antibiotics might help. If the doctor tries to push it, you play down your symptoms. You know it is your smoking, but you just don’t want to give up at the moment. You haven’t coughed any more blood.

You are more worried that you have been feeling so tired for months. You are starting to struggle with work. Your work is very physical as a builder and you are really worried that you might not be able to keep it up. Your wife lost her job at the council last year and hasn’t found anything yet. In fact you think she may be depressed.

Systems review – positive findings (other systems normal if asked)

• If asked what you mean by tired you struggle with the level of physical activity required by your job. You need regular breaks to recover. You can get short of breath.
• You were ok until about a year ago, now you are gradually finding it harder
• You often fall asleep in the chair in front of the television. This doesn’t bother you, but does bother your wife more. Probably because she is on her own all day
• You need to go to for a wee regularly and need to get there quickly; this can be embarrassing with work if the doctor asks as your mates see you. It has been going on for at least a year. You also get up 2-3 times at night to go
• If asked, you often struggle to get back to sleep once up for the toilet as you are worrying about things at home but you don’t think you are depressed
• You know you are a bit overweight, but your job is very active
• You used to go out with your mates for several beers at the weekend, but cannot afford to. You may have one or two at home

You don’t have any ideas about what is making you tired. You are hoping the doctor can give you something to stop you weeing so frequently as then you will probably sleep better and that may help.

If the doctor asks, you haven’t thought of the possible link between the CXR findings of COPD and your tiredness or SOB. If it could be linked you would consider tests if they would help make you feel better.