Nursing care for colon and rectal cancer patients undergoing colostomy : a case study of two cases.

Abstract

      This study was a comparative study of two case studies to examine the nursing care of colon and rectal cancer patients undergoing colostomy surgery at the Surgery and Orthopaedic Surgery Building, Borabue Hospital, from preoperative, intraoperative, and postoperative stages, including discharge planning. Data were collected from patients, relatives, and medical records. Symptoms were assessed, medical histories taken, and physical examinations were performed. The data were used to determine nursing diagnoses, develop nursing care plans, and continuously evaluate nursing outcomes. This study compared the nursing care of colon and rectal cancer patients undergoing colostomy surgery at the Surgery and Orthopaedic Surgery Building, Borabue Hospital, from June 1 to November 30, 2025. Case 1 involved a 75-year-old Thai male who was relatively obese. He presented with general abdominal pain 1 day before the visit. For 4 days before the visit, the patient had not defecated, farted, or vomited.

      Results: The doctor diagnosed CA descending colon with complete colonic obstruction. An explore laparotomy with a loop transversal colostomy under GA was performed. During the admission, the patient had a gout attack and hypoglycemia. After receiving treatment, the patient's symptoms improved and the pain and blood sugar levels were controlled. The patient had a problem with an elderly caregiver who had slight blurred vision and could not remember the instructions. This made teaching the family about colostomy wound care and changing the colostomy bag quite difficult every time there was a teaching session on stoma care and colostomy bag changing. Case Study 2: A 77-year-old Thai man with a thin build presented with abdominal pain around the navel 1 day before the visit. The doctor diagnosed CA rectum with complete colonic obstruction. An explore laparotomy with a loop transversal colostomy under GA was performed. During the admission, the patient had hypokalemia and hypoglycemia. After treatment, the laboratory test results were normal. On the 8th day after the surgery, the surgeon considered colonoscopy and biopsy for further analysis. Patients and their relatives are still unable to accept the reality of their illness. Relatives who care for patients are unable to make decisions about surgery. Key nursing interventions include physical and psychological preparation for patients and relatives. This includes providing information about colostomy and ensuring that all patients are assigned the appropriate colostomy placement. Nursing interventions address and alleviate acute, life-threatening problems, pain management to reduce suffering, and preventing complications from colostomy. Nursing interventions include providing education, training, and skills development for patients and caregivers, as well as empowering them to care for themselves. Both patients had no complications and were discharged home.