Community Nursing Care for Diabetic Patients with Complications : A Comparative Study of Two Cases

Abstract

This comparative case study examined nursing care for two diabetic patients with complications in the community. The purpose was to compare nursing interventions and develop practical nursing guidelines. Case 1 was a 65-year-old female, former teacher with 30,000 baht monthly pension, cared for by her husband and daughter. She had a left foot ulcer, 18-year diabetes history with kidney and eye complications, and poor glucose control due to stress from caring for her husband. Case 2 was a 63-year-old male laborer earning 5,000 baht monthly, cared for by his 17-year-old granddaughter. He had an infected right foot wound, 20-year diabetes history with multiple complications, including COPD and depression. Results showed that socioeconomic factors significantly impacted care outcomes. Case 1 had better outcomes due to higher education, income, strong family support, and better healthcare access. Case 2 faced economic constraints, limited healthcare access, and lack of capable caregivers, leading to higher risk of recurrent complications.Recommendations include developing community care systems addressing socioeconomic factors, establishing support systems for economically disadvantaged patients, enhancing caregiver and volunteer capabilities, and creating integrated care networks linking hospitals, communities, and support organizations for effective and sustainable care.