Optimalisasi Peran Keluarga Melalui Program Skoci (Skrining Komplikasi dan Cegah Infeksi) Dalam Perawatan Paliatif Luka Kaki Diabetik di Daerah Pesisir
DOI:
https://doi.org/10.35870/jpmn.v6i2.7405Keywords:
Caregiver, Coastal Area, Diabetic Foot Ulcer, Palliative Care, SKOCI ProgramAbstract
The incidence of advanced-stage Diabetic Foot Ulcers (DFU) requiring a palliative care approach among patients with Type 2 Diabetes Mellitus has escalated significantly in coastal areas. Coastal environmental characteristics—such as high humidity, high water salinity, and limited geographical access to referral healthcare centers—serve as primary risk factors for secondary infections that often lead to amputation. During the palliative phase, optimizing the role of the family as the primary caregiver is crucial for maintaining the patient's quality of life through home-based self-care. This Community Service (PKM) initiative aims to optimize family roles and capacity by implementing the innovative SKOCI program (Complication Screening & Infection Prevention) within the context of palliative DFU care in coastal regions. The activity was conducted in person on May 18, 2026, at the Batu Ampar Community Health Center (Puskesmas) in Kubu Raya Regency, West Kalimantan. The 28 participants included family members acting as primary caregivers, community health volunteers, and practicing nurses from the health center. The intervention employed a comprehensive approach involving structured education, workshops on the early detection of systemic and local complications using the SKOCI assessment tool, training on palliative wound-cleansing techniques utilizing safe, locally sourced coastal materials, and psychosocial support. Program evaluation utilized knowledge-level questionnaires, a caregiver self-efficacy scale, and psychomotor observation sheets (pre-test and post-test). Evaluation results demonstrated a significant increase (p < 0.05) in the knowledge of diabetic patients' families regarding palliative care. Families' psychomotor skills in detecting clinical signs of infection improved by 58%, and their self-efficacy in ensuring physical comfort for palliative patients rose by 64%. The SKOCI program facilitates the early detection of critical wound conditions independently within coastal households. The SKOCI program has proven effective in enhancing family independence and self-efficacy, mitigating the risk of nosocomial or secondary infections, and improving the quality of life for patients with advanced chronic kidney disease (CKD) requiring palliative care in coastal areas with limited access to secondary healthcare.
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