Nurses' Knowledge about Diabetes Foot Ulcer Prevention and Treatment: An Integrative Review


  • Hasdi Hasdi Dinas Kesehatan Kota Parepare
  • Syahrul Syahrul Universitas Hasanuddin
  • Saldy Yusuf Universitas Hasanuddin


Diabetic Foot, Diabetic Foot Ulcer, Nurses’ Knowledge, Prevention and Treatment


Introduction: Diabetic Foot Ulcer (DFU) is a complication often experienced by patients with Diabetes Mellitus (DM). Evidence-based prevention and treatment in DM patients who are at risk of DFU can reduce the global economic burden. Nurses' knowledge plays an important role in screening, prevention, and proper treatment of DFU. This review identifies evidence of nurses' knowledge about the prevention and treatment of DFU and identify factors related to nurses' knowledge. Method: The study applied an integrative review design. The relevant literature were searched from PubMed, CINAHL (EBSCO), Wiley Online Library, ScienceDirect, and ProQuest. The inclusion criteria was articles published in English, peer-reviewed articles, and journals between January 2016 and May 2021, by using keywords; “nurs*”, “diabetic foot*” “knowledge”, "awareness" and "perception". Result: There are 10 articles met the inclusion criteria and eligible to review. Nurses have low knowledge about diabetic foot care and also have limited knowledge about the characteristics and complications of DFU. Factors related to nurses' knowledge about DFU prevention and treatment; training, educational qualifications, work experience, educational institutions, and age. Conclusion: This review revealed that nurses experienced a significant knowledge deficit in several aspects regarding the prevention and treatment of DFU. So that new effective education and training must be developed to address the knowledge gap, one of which is the online training method utilizing telenursing-based electronic learning (e-learning).


Download data is not yet available.

Abate, T. W., Enyew, A., Gebrie, F., & Bayuh, H. (2020). Nurses’ knowledge and attitude towards diabetes foot care in Bahir Dar, North West Ethiopia. Heliyon, 6(11), 1–7.

Abrar, E. A., Yusuf, S., Sjattar, E. L., & Rachmawaty, R. (2020). Development and evaluation educational videos of diabetic foot care in traditional languages to enhance knowledge of patients diagnosed with diabetes and risk for diabetic foot ulcers. Primary Care Diabetes, 14(2), 104–110.

Al-Busaidi, I. S., Abdulhadi, N. N., & Coppell, K. J. (2016). Care of patients with diabetic foot disease in Oman. Sultan Qaboos University Medical Journal, 16(3), e270–e276.

Alhaiti, A. H., Senitan, M., Shanmuganathan, S., Dacosta, C., Jones, L. K., & Lenon, G. B. (2019). Nurses’ attitudes towards diabetes in tertiary care: A cross-sectional study. Nursing Open, 6(4), 1381–1387.

Bilal, M., Haseeb, A., Rehman, A., Hussham Arshad, M., Aslam, A., Godil, S., Qamar, M. A., Husain, S. N., Polani, M. H., Ayaz, A., Ghazanfar, A. S., Ghazali, Z. M., Khoja, K. A., Malik, M., &

Ahmad, H. (2018). Knowledge, Attitudes, and Practices Among Nurses in Pakistan Towards Diabetic Foot. Cureus, 10(7), 1–13.

Bus, S. A., Lavery, L. A., Monteiro-Soares, M., Rasmussen, A., Raspovic, A., Sacco, I. C. N., & van Netten, J. J. (2020). Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes/Metabolism Research and Reviews, 36(S1), 1–18.

CEBMa. (2014). Critical Appraisal of a Cross-Sectional Study (Survey) Appraisal questions.

Fujii, K., Komoda, T., Maekawa, A., & Nishikawa, M. (2020). Foot care knowledge and practices among Japanese nurses and care workers in home care and adult service center: A cross sectional study. BMC Nursing, 19(1), 1–15.

Gaffar, A., Yusuf, S., & Hatta, M. (2019). Evaluasi Tingkat Pengetahuan Perawat Tentang Pencegahan Dan Perawatan Luka Diabetes Di Rumah Sakit Militer. Jurnal Ilmu Kesehatan, 8(1), 67–73.

Gribben, L., & Semple, C. J. (2021). Factors contributing to burnout and work-life balance in adult oncology nursing: An integrative review. European Journal of Oncology Nursing, 50, 1 14.

Hermawati, H., Tiranda, Y., & Sukron, S. (2021). Health service for diabetic foot ulcer patients during covid-19 pandemic. Media Keperawatan Indonesia, 4(4), 311.

Kassar, A. K., & Khudur, K. M. (2021). Evaluation of Nurses ’ Knowledge Regards Diabetic Foot Care Management at Teaching Hospital in Al- Nasiriya city. Annals of R.S.C.B, 25(4), 12500–12506.

Kaya, Z., & Karaca, A. (2018). Evaluation of Nurses’ Knowledge Levels of Diabetic Foot Care Management. Nursing Research and Practice, 1–12.

Kumarasinghe, S. A., Hettiarachchi, P., & Wasalathanthri, S. (2017). Nurses’ knowledge on diabetic foot ulcer disease and their attitudes towards patients affected: A cross-sectional institution-based study. Journal of Clinical Nursing, 1–10.

Lilly-West B. R, John, M. E., & I, C. (2018). Knowledge of diabetic foot care among nursing practitioners in Rivers State, Nigeria. Texila International Journal of Nursing, 4(2), 1–9.

Munawar, K., Kamran, A., & Ahmad, Z. (2019). Assessment Of Knowledge And Attitude Of Nurses Regarding Diabetic Foot Care. World Journal of Pharmaceutical and Medical Research, 5(5), 259–265.

Narmawan, N., Syahrul, S., & Erika, K. A. (2018). the Behavior of Foot Care in Patients With Type 2 Diabetes Mellitus: Applying the Theory of Planned Behaviour. Public Health of Indonesia, 4(3), 129–137.

Nurhidayah, Yusuf, S., & Malasari, S. (2018). Gambaran Pengetahuan Perawat Tentang Evidence Based Practice Pencegahan Dan Perawatan Luka. Jurnal Luka Indonesia, 4(September), 45–54.

Ramirez-Perdomo, C., Perdomo-Romero, A., & Rodríguez-Vélez, M. (2019). Knowledge and practices for the prevention of the diabetic foot. Revista Gaucha de Enfermagem, 40, 1–7.

Schaarup, C., Pape-Haugaard, L., Jensen, M. H., Laursen, A. C., Bermark, S., & Hejlesen, O. K. (2017). Probing community nurses’ professional basis: A situational case study in diabetic foot ulcer treatment. British Journal of Community Nursing, 22, S46–S52.

Schechter, M. C., Fayfman, M., Khan, L. S. M. F., Carr, K., Patterson, S., Ziemer, D. C., Umpierrez, G. E., Rajani, R., & Kempker, R. R. (2020). Evaluation of a comprehensive diabetic foot ulcer care quality model. Journal of Diabetes and Its Complications, 34, 1–7.

Schoen, D. E., Gausia, K., Glance, D. G., & Thompson, S. C. (2016). Improving rural and remote practitioners’ knowledge of the diabetic foot: Findings from an educational intervention. Journal of Foot and Ankle Research, 9(1), 1–11.

Sharmisthas, S., Wongchan, P., & Hathairat, S. (2014). A Survey of Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer in Bangladesh. BIRDEM Medical Journal, 4(1), 22–26.

Stolt, M., Suhonen, R., Puukka, P., Viitanen, M., Voutilainen, P., & Leino-Kilpi, H. (2015). Nurses’ knowledge of foot care in the context of home care: A cross-sectional correlational survey study. Journal of Clinical Nursing, 24(19–20), 2916–2925.

Toronto, C. E., & Remington, R. (2020). A Step-by-Step Guide to Conducting an Integrative Review. In Springer. Springer Nature Switzerland AG.

Wui, N. B., Bin Azhar, A. A., Bin Azman, M. H., Bin Sukri, M. S., Harbaksh Singh, A. S., & Wahid, A. M. B. A. (2020). Knowledge and attitude of nurses towards diabetic foot care in a secondary health care centre in Malaysia. Medical Journal of Malaysia, 75(4), 391–395.

Yamas, K. V. (2020). N ursing Nurses ’ Knowledge and Attitude towards Diabetic Foot Care in a Secondary Health Care Centre in Sudan. Nursing and Midwifery, 01(01), 15–18.

Yusuf, S., Okuwa, M., Irwan, M., Rassa, S., Laitung, B., Thalib, A., Kasim, S., Sanada, H., Nakatani, T., & Sugam, J. (2016). Prevalence and Risk Factor of Diabetic Foot Ulcers in a Regional Hospital, Eastern Indonesia. Open Journal of Nursing, 06, 1–10.

Zhang, P., Lu, J., Jing, Y., Tang, S., Zhu, D., & Bi, Y. (2017). Global epidemiology of diabetic foot ulceration : a systematic review and meta-analysis. Annals of Medicine, 49(2), 106–116.



How to Cite

Hasdi, H., Syahrul, S., & Yusuf, S. (2022). Nurses’ Knowledge about Diabetes Foot Ulcer Prevention and Treatment: An Integrative Review . Indonesian Contemporary Nursing Journal (ICON Journal), 7(1), 25-35.

Most read articles by the same author(s)