Nursing care for patients undergoing colonoscopy: A comparative case study of two cases, Kalasin Hospital.

Abstract

     Nursing care for patients undergoing colonoscopy:  A comparative case study of two cases, Kalasin Hospital. This study aimed to examine the nursing care of patients undergoing colonoscopy using a comparative case study approach of two cases conducted between June and October 2025. Data collection tools included questionnaires, interviews, observations, physical examinations, and medical record reviews, guided by Gordon's 11 Functional Health Patterns and Orem's Self-Care Deficit Nursing Theory, covering four phases: pre-colonoscopy, during colonoscopy, post-colonoscopy, and discharge with follow-up care.

     The findings revealed that Case Study 1 was a 65-year-old Thai female presenting with chronic mucoid bloody diarrhea, with underlying conditions including type 2 diabetes mellitus, gastroesophageal reflux disease, and generalized anxiety disorder. Colonoscopy findings showed a cauliflower mass measuring 7-8 centimeters in the sigmoid colon, 20 centimeters from the anal verge. Histopathological examination confirmed well-differentiated adenocarcinoma. Case Study 2 was a 75-year-old Thai male presenting with melena, hematemesis, a palpable left abdominal mass, and weight loss of 5-6 kilograms over six months, with underlying conditions including type 2 diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease stage 3A, with severe anemia (Hb 6.20 g/dL). Colonoscopy revealed an obstructing mass in the descending colon. Histopathological examination confirmed poorly differentiated adenocarcinoma. Both patients shared similarities including anxiety, good compliance with instructions, absence of colonoscopy complications, and strong family relationships. Differences included: Patient 1 had high anxiety levels, good bowel preparation quality, received moderate sedation, complete colonoscopy reaching the cecum, and shorter hospital stay, while Patient 2 had moderate anxiety levels, fair bowel preparation quality, received general anesthesia with endotracheal intubation, incomplete colonoscopy due to obstructing mass, required blood transfusions before and after the procedure, and longer hospital stay. The application of proper nursing processes resulted in both patients being safe from complications, able to appropriately care for themselves, and ready to receive further treatment.