Development of Diabetic Foot Ulcer Care Model using Tele-Nursing System in Ubolratana Hospital, Khon Kaen Province

Abstract

This action research, which is applied to the ADAPTE Collaboration guideline, aims to develop and evaluate the effectiveness of a nursing model for diabetic foot ulcer care using a tele-nursing system. The sample was divided into two groups: tele-nursing system users and service recipients, which was obtained by simple random sampling. The data collection tools included a tele-nursing outcome recording form, a knowledge and foot care behavior assessment questionnaire, and a satisfaction assessment form. The IOC is 0.67 to 1.00, and the reliability coefficients of 0.76, 0.83, and 0.95, respectively. Data were analyzed using descriptive and inferential statistics such as the Paired Samples T-Test. The study found that the nursing model for diabetic foot ulcers using a tele-nursing system consists of the following components : 1) Input – Ensuring readiness of service providers, service recipients, necessary equipment, and online educational materials. 2) Tele-Nursing Process – Involving individualized patient assessments, nursing diagnosis, planning, implementation, and follow-up evaluations conducted through images and video calls over six sessions. 3) Outcomes Evaluation – Assessing ulcer severity, healing time, and recurrence rates. The model's effectiveness showed that the severity of ulcers decreased, with an average healing time of 5.86 weeks (SD 4.24). Recurrence was observed in 7.14% of the cases. The average comparison of foot care knowledge and behavior scores before and after tele-nursing services is statistically significant. (p<.001, p<.001 respectively) Overall satisfaction with the tele-nursing system was rated as high level. These findings indicate that tele-nursing provides effective guidance and follow-up care for diabetic foot ulcers.