Nursing Care for Adolescent Patients with Uncontrolled Type 1 Diabetes: 2 Case Study

Abstract

Nursing Care for Adolescent Patients with Uncontrolled Type 1 Diabetes: 2 Case Study
Wallapa Daechasatain. M.N.S*

Abstract Diabetes mellitus is a metabolic disorder that is a major health problem. In Thailand, 75% of childhood and adolescent diabetes is type 1 diabetes. Type 1 diabetes often has a severe high blood sugar condition that leads to diabetic ketoacidosis (DKA), which is the cause of hospitalization and the first diagnosis. Only 17% of patients achieve treatment goals. Objectives: 1. To apply the theory and nursing process in the care of adolescent patients with type 1 diabetes. 2. To apply the concept self-management theory to the care of adolescent patients with type 1 diabetes. Method: This study is a case study of two adolescent patients with type 1 diabetes who could not control their blood sugar levels. Data were collected from medical records, observation, interviews with patients and caregivers, and nursing interventions using the concept of self-management (Creer, 2000) and analyzed using the nursing process. The study was conducted between March and September 2023. Results: The findings of this study suggest that both patients received comprehensive and appropriate assessments and needs based on their health conditions. The common issue was lack of self-confidence in self-care. In case study 1, the patient was more prepared for self-care when provided with review and support for self-care knowledge as the adolescent patient desired. This allowed the patient to adjust selfcare to daily life well, and the HbA1c level decreased to normal range. The patient's stress and anxiety about self-care decreased, and the patient's confidence in life increased. In case study 2, the patient understood the disease and was determined to inject insulin and count carbohydrates. However, the patient was still worried that they would not be able to care for themselves as well as they should. Sometimes they could not choose what to eat, and they could not see a doctor every time due to economic constraints. Although they received support for equipment and travel costs, the HbA1c level in the blood tended to decrease. Therefore, it is necessary to continue monitoring.



Keywords: Nursing care for adolescent patients with diabetes, type 1 diabetes, childhood diabetes
*Registered Nurse, Professional Level, Khon Kaen Hospital.