Jurnal NERS
Vol. 21 No. 3 (2026): VOLUME 21 ISSUE 3 (AUGUST 2026)

Development and feasibility evaluation of web-and mobile-based application for recurrent diabetic foot ulcer risk assessment in primary health center

Haryanto Haryanto (Department of Nursing, Institut Teknologi dan Kesehatan Muhammadiyah Kalimantan Barat, Pontianak, Indonesia)
Wien Fitrian Roshandi (Department of Nursing, Institut Teknologi dan Kesehatan Muhammadiyah Kalimantan Barat, Pontianak, Indonesia)
Kharisma Pratama (Department of Nursing, Institut Teknologi dan Kesehatan Muhammadiyah Kalimantan Barat, Pontianak, Indonesia)
Elvira Panjaitan (Sei Durian Primary Health Center, Sawahlunto, Indonesia)
Patimah Abdul Wahab (Department of Medical-Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Malaysia)



Article Info

Publish Date
31 Aug 2026

Abstract

Introduction: This study aimed to develop and evaluate the feasibility of a secure, reliable, and user-friendly web- and mobile-based application, the Indonesia Diabetic Foot Ulcer Recurrence Assessment Tool (INDIFURUTO), for assessing the risk of recurrent diabetic foot ulcers. Methods: A system development and feasibility evaluation study was performed. The INDIFURUTO web- and mobile-based application was developed based on validated clinical risk factors and expert opinions. The feasibility evaluation comprised three components: (1) inter-rater reliability testing among 30 patients with previously healed diabetic foot ulcers at the Sei Durian Primary Health Center, West Kalimantan, Indonesia, using Cohen's kappa between two independent raters; (2) an application-layer security (vulnerability) assessment performed by an accredited cybersecurity institution using OWASP ZAP; and (3) usability evaluation among 41 multidisciplinary healthcare professionals using the validated Post-Study System Usability Questionnaire (PSSUQ). Results: Inter-rater reliability testing demonstrated near-perfect agreement (Cohen’s kappa = 0.96), indicating a high assessment consistency. No high- or critical-severity vulnerabilities were observed. Three medium-severity and three low-severity vulnerabilities were identified during the security assessment; all were remediated and successfully rechecked. Usability testing showed favorable scores across all PSSUQ dimensions (System Usefulness: 1.74 ± 0.63, Information Quality: 1.91 ± 0.68, Interface Quality: 2.17 ± 0.79, and Overall: 1.90 ± 0.66), indicating high user satisfaction and good system usability. Conclusions: These findings support the potential to enhance standardized, nurse-led RDFU risk assessment in Primary Health Center settings and inform future large-scale implementation and effectiveness studies.

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Journal Info

Abbrev

JNERS

Publisher

Subject

Nursing

Description

The scope of this journal includes studies that intend to examine and understand nursing health care interventions and health policies which utilize advanced nursing research. The journal also committed to improve the high quality research by publishing analytic techniques, measures, and research ...