ArticleInternational journal of nursing studies advances2026
Development of a supportive-educative nursing model based on health promotion for independent wound care in diabetic foot ulcer patients: A cross-sectional study.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Diabetic foot ulcers are a chronic complications of diabetes associated with substantial morbidity, amputation risk, and reduced quality of life. Promoting the patients' capacity for independent wound care is a key component of long-term management. Although health promotion and supportive-educative nursing approaches are widely advocated in nursing, empirically informed models specifically addressing independent wound care in diabetic foot ulcer patients remain limited, particularly in low-income and middle-income countries. Objective: To develop a supportive-educative nursing model based on health promotion for independent wound care in patients with diabetic foot ulcers. Design: A cross-sectional study was conducted during the model development phases. Settings: Twenty-two community health centers in Bandar Lampung, Indonesia. Participants: A total of 130 patients with grade 1-2 diabetic foot ulcers were recruited using purposive sampling, based on predefined inclusion and exclusion criteria. Methods: This study represents the development phase of this model. Quantitative data were collected using validated questionnaires assessing individual factors, support and facilities factors, nursing factors, supportive-educative nursing, patient commitment, and independent wound care behaviors. Structural equation modeling using partial least squares was applied to examine associations among constructs and inform model development. Results: Individual (β = 0.399, Conclusions: This study proposes a health promotion-based supportive-educative nursing model in which patient commitment functions as a key mediating pathway linking nursing support to independent wound care. These findings provide an empirically informed framework to guide nursing practice and support future longitudinal and interventional research. Registration: The Health Research Ethics Committee of Universitas Airlangga (Ref. No. 3664-KEPK), Investment and One-Stop Integrated Services Agency (Reference number 1871/070/06354/SKP/III.16/II/2025), and Bandar Lampung City Health Agency (Reference number B/400.7.22/III.02.V/02/2025).
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