THE RELATIONSHIP BETWEEN PRACTICES FOOT CARE AND THE SEVERITY OF DIABETIC ULCERS AT KARANG SAMBUNG COMMUNITY HEALTH CENTER, KEDUNGWARINGIN DISTRICT, BEKASI REGENCY

Abstract

Introduction: Diabetes Mellitus (DM) is a chronic metabolic disease marked by hyperglycemia. Diabetic foot ulcer is one of the major microvascular complications, with a risk of 30% and a mortality rate of 32% in Indonesia. Objective: This study aimed to determine the association between foot care practices among DM patients and the severity of diabetic ulcers. Methods: This analytical observational study used a cross-sectional design involving 93 patients at Karang Sambung Public Health Center, Kedung Waringin. Wound severity was assessed using the Bates-Jensen Wound Assessment Tool (BWAT), and foot care practices were measured using the Nottingham Assessment of Functional Footcare (NAFF). Data were analyzed using the Chi-square test. Results: Among patients with good foot care practices, 52% had mild ulcers. Conversely, among patients with poor foot care practices, only 1% had mild ulcers while 47% had severe ulcers. Diabetic ulcers are difficult to heal due to impaired blood circulation, particularly in the distal lower extremities. Besides glycemic control, improving foot circulation through routine foot care is essential. Irregular foot care may worsen ulcer severity, potentially leading to tissue necrosis and amputation. Nurses play a vital role in educating patients on proper foot care techniques. Patient understanding and motivation significantly influence the accuracy and frequency of foot care practices. The Chi-square test showed p=0.001 (p<0.05), indicating a significant association. Conclusion: Foot care practices are significantly associated with the severity of diabetic foot ulcers. Regular and proper foot care is crucial to prevent progression and reduce ulcer severity.