The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: A case report

  • Annisa Wuri Kartika | School of Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.
  • Widyatuti Widyatuti Community Health Nursing Department, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
  • Etty Rekawati Community Health Nursing Department, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.


Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers.
Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit.
Results: Significant changes were reported in diabetes self-management practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5,62 to 8,54 and the Summary of Diabetes Self-Care Activities (SDSCA) score increased from 3,2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks.
Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education.



PlumX Metrics


Download data is not yet available.


Wu Y, Ding Y, Tanaka Y, et al. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci 2014;11:1185–200. DOI:

Ministry of Health Republic of Indonesia. Basic Health Research 2018. Jakarta: Ministry of Health Republic of Indonesia; 2018.

Jannoo Z, Mamode Khan N. Medication adherence and diabetes self-care activities among patients with type 2 diabetes mellitus. Value Heal Reg Issues 2019;18:30–5. DOI:

Yuan C, Lai CW, Chan LW, et al. The effect of diabetes self-management education on body weight, glycemic control, and other metabolic markers in patients with type 2 diabetes mellitus. J Diabetes Res 2014;2014:789761. DOI:

Trevisan DD, São-João T, Cornélio M, et al. Effect of an 'implementation intention' intervention on adherence to oral anti-diabetic medication in Brazilians with type 2 diabetes. Patient Educ Couns 2020;103:582-8. DOI:

Kirkman MS, Briscoe VJ, Clark N, et al. Diabetes in older adults. Diabetes Care 2012;35:2650-64. DOI:

García AA, Brown SA, Horner SD, et al. Home-based diabetes symptom self-management education for Mexican Americans with type 2 diabetes. Health Educ Res 2014;30:484–96. DOI:

Davis WA, Lewin G, Davis TME, et al. Determinants and costs of community nursing in patients with type 2 diabetes from a community-based observational study: The Fremantle Diabetes Study. Int J Nurs Stud 2013;50:1166–71. DOI:

Felix HC, Narcisse MR, Long CR, et al. The effect of family diabetes self-management education on self-care behaviors of Marshallese adults with type 2 diabetes. Am J Health Behav 2019;43:490–7. DOI:

Handayani E. Modern wound care application in diabetic wound management. Int J Res Med Sci 2017;5:702–6. DOI:

Gnanasundaram S, Ramalingam P, Nath B. Gait changes in persons with diabetes: early risk marker for diabetic foot ulcer. Foot Ankle Surg 2020;26:163-8. DOI:

Rosyid FN. Etiology, pathophysiology, diagnosis and management of diabetics’ foot ulcer. Int J Res Med Sci 2017;5:4206–13. DOI:

Tresierra-Ayala MÁ, García Rojas A. Association between peripheral arterial disease and diabetic foot ulcers in patients with diabetes mellitus type 2. Medicina Universitaria 2017;19:123–6. DOI:

Yazdanpanah L, Shahbazian H, Nazari I, et al. Diabetes & metabolic syndrome: Clinical research & reviews risk factors associated with diabetic foot ulcer-free survival in patients with diabetes. Diabetes Metab Syndr Clin Res Rev 2018;12:1039–43. DOI:

Gianino E, Miller C, Gilmore J. Smart wound dressings for diabetic chronic wounds. Bioengineering (Basel) 2018;5:51. DOI:

Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med 2017;376:2367–75. DOI:

Yu CH, Parsons JA, Mamdani M, et al. A web-based intervention to support self-management of patients with type 2 diabetes mellitus: Effect on self-efficacy, self-care and diabetes distress. BMC Med Inform Decis Mak 2014;14:117. DOI:

Nwankwo CU, Ezenwaka CE, Onuoha PC, et al. Implementing diabetes self-management education (DSME) in a Nigerian population: Perceptions of practice nurses and dieticians. Arch Physiol Biochem 2015;121:123–7. DOI:

Lavelle D, Zeitoun J, Stern M, et al. Diabetes self management education in the home. Atl Heal Syst 2016;8:1–8. DOI:

Abdulrahman M, Husain ZSM, Abdouli KA, et al. Association between knowledge, awareness, and practice of patients with type 2 diabetes with socio-economic status, adherence to medication and disease complications. Diabetes Res Clin Pract 2020;163:108124. DOI:

Lukman NA, Leibing A, Merry L. Self-care experiences of adults with chronic disease in Indonesia: An integrative review. Int J Chronic Dis 2020;2020:1–17. DOI:

Dube L, Van den Broucke S, Dhoore W, et al. An audit of diabetes self-management education programs in South Africa. J Public Health Res 2015;4:581. DOI:

Najafian A, Fallahi S, Khorgoei T, et al. Role of soap and water in the treatment of wound dehiscence compared to normal saline plus povidone-iodine: A randomized clinical trial. J Educ Health Promot 2015;4:86.

Evans J. A solution to cost-effective wound management in the community. J Comm Nurs 2014;28:46-51.

Vedhara K, Dawe K, Wetherell MA, et al. Illness beliefs predict self-care behaviours in patients with diabetic foot ulcers: a prospective study. Diabetes Res Clin Pract 2014;106:67-72. DOI:

Home-based intervention, self-care management, foot ulcer recurrence, DSME
  • Abstract views: 630

  • PDF: 94
How to Cite
Wuri Kartika, A., Widyatuti, W., & Rekawati, E. (2021). The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: A case report. Journal of Public Health Research, 10(2).