Challenges of Neuropathy Screening for Preventing Diabetic Foot Ulcers: Perspectives of Public Health Nurses in Indonesia

Abstract

Foot ulcers are a complication of diabetes which reduce quality of life. This study aimed to explore the perspectives of public health nurses regarding obstacles to carrying out effective neuropathy screening practices to prevent diabetic foot ulcers in public health centers. A qualitative study with a phenomenological approach was carried out using in-depth interviews and focus group discussions. The results of this study indicated five key themes of challenges: 1) inadequate knowledge and lack of skills in neuropathy screening; 2) insufficiency of health facilities in primary health care services; 3) high workload and job demands; 4) lack of human resources; and 5) inaccessibility of health care services. The findings provided important information regarding the challenges and constraints of implementing neuropathy screening practices in community health centers. The public health nurses need to improve their capabilities in implementing neuropathy screening and need to negotiate with stakeholders for the implementation of this screening policy to prevent foot ulcers in patients with diabetes mellitus at the community level. Keywords: challenges in neuropathy screening practice, foot ulcer, public health nurses, diabetes mellitus, qualitative study