Caregiver knowledge and attitudes toward holistic family support in diabetic foot ulcer care: A cross-sectional study in Indonesia.
5 affiliations
- 1Department of Nursing, Nursing Study Program, Institut Kesehatan Mitra Bunda, Batam, Indonesia.
- 2Doctoral Program of Public Health Science, Faculty of Medicine, Universitas Andalas, Padang, Indonesia.
- 3Faculty of Medicine, Department of Public Health, Universitas Andalas, Padang, Indonesia.
- 4Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic, Universitas Andalas, Padang, Indonesia.
- 5Faculty of Medicine, Department of Psychology, Universitas Andalas, Padang, Indonesia.
Abstract
Background
Family caregivers are central to home-based care for diabetic foot ulcers (DFUs), but domain-specific knowledge gaps may shape attitudes toward holistic family support.Objective
To examine caregivers' knowledge and attitudes across physical, psychological, social, and spiritual domains of DFU support and identified predictors of total attitude.Methods
A cross-sectional study was conducted among 274 family caregivers at a tertiary referral hospital in Batam City, Indonesia, from March to July 2024. Data were analyzed using descriptive statistics, Friedman tests, Spearman correlations, and multiple regression with robust standard errors. All statistical analyses were conducted in R version 4.5.0.Results
The mean total knowledge score was 15.42 (SD = 1.44), and the mean total attitude score was 62.13 (SD = 8.51). Knowledge was highest in the physical domain (M = 86.34%, SD = 3.17) and lowest in the psychological domain (M = 17.82%, SD = 6.67). Friedman tests showed significant differences across knowledge domains, chi-square(3) = 783.668, p < 0.001, and attitude domains, chi-square(3) = 435.191, p < 0.001. Significant correlations included total knowledge with physical attitude (rho = 0.565, p < 0.001) and spiritual knowledge with total attitude (rho = 0.564, p < 0.001). The adjusted regression model explained 38.1% of the variance in total attitude score. Spiritual knowledge (B = 0.416, 95% CI [0.312, 0.520], p < 0.001), physical knowledge (B = 0.722, 95% CI [0.393, 1.052], p < 0.001), and psychological knowledge (B = 0.180, 95% CI [0.056, 0.304], p = 0.005) were significant predictors; social knowledge was not significant.Conclusion
Caregiver attitudes toward holistic DFU support were strongly associated with domain-specific knowledge. Family-centered education could usefully address the physical, psychological, social, and spiritual needs of caregivers. Nurses could consider screening for domain-specific knowledge gaps, particularly in psychological support, and offering culturally sensitive family education to strengthen caregiver readiness for home-based DFU care.
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BibTeX
@article{eltrikanawati2026caregiver,
title = {{Caregiver knowledge and attitudes toward holistic family support in diabetic foot ulcer care: A cross-sectional study in Indonesia.}},
author = {Tengku Eltrikanawati and Rizanda Machmud and Eva Decroli and Rozi Sastra Purna},
journal = {Belitung nursing journal},
year = {2026},
month = oct,
doi = {10.33546/bnj.4932},
url = {https://europepmc.org/article/MED/42909955},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Caregiver knowledge and attitudes toward holistic family support in diabetic foot ulcer care: A cross-sectional study in Indonesia.
AU - Tengku Eltrikanawati
AU - Rizanda Machmud
AU - Eva Decroli
AU - Rozi Sastra Purna
PY - 2026
DA - 2026/10/21
JO - Belitung nursing journal
DO - 10.33546/bnj.4932
UR - https://europepmc.org/article/MED/42909955
AB - Background Family caregivers are central to home-based care for diabetic foot ulcers (DFUs), but domain-specific knowledge gaps may shape attitudes toward holistic family support.Objective To examine caregivers' knowledge and attitudes across physical, psychological, social, and spiritual domains of DFU support and identified predictors of total attitude.Methods A cross-sectional study was conducted among 274 family caregivers at a tertiary referral hospital in Batam City, Indonesia, from March to July 2024. Data were analyzed using descriptive statistics, Friedman tests, Spearman correlations, and multiple regression with robust standard errors. All statistical analyses were conducted in R version 4.5.0.Results The mean total knowledge score was 15.42 (SD = 1.44), and the mean total attitude score was 62.13 (SD = 8.51). Knowledge was highest in the physical domain (M = 86.34%, SD = 3.17) and lowest in the psychological domain (M = 17.82%, SD = 6.67). Friedman tests showed significant differences across knowledge domains, chi-square(3) = 783.668, p < 0.001, and attitude domains, chi-square(3) = 435.191, p < 0.001. Significant correlations included total knowledge with physical attitude (rho = 0.565, p < 0.001) and spiritual knowledge with total attitude (rho = 0.564, p < 0.001). The adjusted regression model explained 38.1% of the variance in total attitude score. Spiritual knowledge (B = 0.416, 95% CI [0.312, 0.520], p < 0.001), physical knowledge (B = 0.722, 95% CI [0.393, 1.052], p < 0.001), and psychological knowledge (B = 0.180, 95% CI [0.056, 0.304], p = 0.005) were significant predictors; social knowledge was not significant.Conclusion Caregiver attitudes toward holistic DFU support were strongly associated with domain-specific knowledge. Family-centered education could usefully address the physical, psychological, social, and spiritual needs of caregivers. Nurses could consider screening for domain-specific knowledge gaps, particularly in psychological support, and offering culturally sensitive family education to strengthen caregiver readiness for home-based DFU care.
SN - 2528-181X
SN - 2477-4073
ER -