• Journal of the Korean Dietetic Association
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• v.16 no.4
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• pp.378-396
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• 2010

The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

• Journal of the Korean Dietetic Association
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• v.13 no.4
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• pp.379-388
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• 2007

This study empirically examined the actual level of elementary school children's knowledge of nutrition and the extent of current nutrition education for the children through the use of textbooks. Two or three classes were sampled from each of six schools, respectively, in Gangneung; of the 562 questionnaires that were distributed, 537 were returned and used for analysis. Respondents were all sixth-graders, on average boys and girls were 153.02$\pm$8.19㎝ and 152.79$\pm$7.15㎝ in height and 45.27$\pm$10.32㎏ and 43.33$\pm$7.46㎏ in weight, respectively, which was consistent with others' research. Most children had two siblings and a working mother, considered that they were well off, and their mother prepared meals. Children regularly had breakfast and dinner, although more children had dinner than breakfast. As a whole, their knowledge of the main nutrients contained in foods was lower than their general knowledge of nutrition. There were significant differences in knowledge of the main nutrients contained in foods, with girls showing more knowledge than boys (p<0.01). Most of them learned about nutrition at school, followed by home. At school, Practical Technology classes taught them the most about nutrition. Although Physical Education classes were expected to teach about nutrition in a quantitative way, they accounted for just 4.7% of the overall knowledge. As for the children's understanding of nutrition education through use of a textbook at school, just 19% of the students gained a very good understanding. As for interest in nutrition education at school, 22.2% of the students had no interest, while girls were more likely to have their interest in nutrition education at school affected by knowledge of nutrition than boys. For both boys and girls, the most desired method of education was cooking practice. More research across subjects is necessary so that nutrition education concentrated on the curriculum for fifth-graders can be provided by stages from the lower grades. Since cooking practice or games were preferred, it is necessary to develop nutrition education methods to incite active interest rather than passive education.

• Journal of the Korean Dietetic Association
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• v.13 no.1
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• pp.61-72
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• 2007

In order to study milk preference and intake pattern of adolescents, the questionnaire survey was conducted with 929 middle and high school students residing in Chungnam cities through October and November 2004. Of the subjects, 56.3% liked milk or liked very much. They preferred chocolate and fruit-tasted milk to plain milk. Reasons for liking milk were for health and its taste, while the reasons of disliking were unpleasant smell and stomach upset. However those who disliked milk did like milk products such as ice-cream, yogurt or cheese. Of the students 35.1% drank milk 2 times or more a day, while 11.8% drank milk less than 2-3 times a month. As a whole they drank milk 8.6$\pm$6.7 times a week, of which 4.3$\pm$3.1 times for plain milk. Daily intake amount was estimated as 308$\pm$315mL. Middle-school students and boys drank more milk than high-school students and girls, respectively. Among the students 64.3% used to drink 1 cup of milk at a time, and 58.3% drank only milk without other foods. It was shown that 51.8% took milk school-serviced and their milk intake frequencies were higher than those of who were not given school milk service. Also milk intake frequencies was higher in students whose mother were housewives than in students whose mother had jobs. Milk preference, intake frequency, and one portion size showed significant and positive correlations each other. In conclusion, milk intake level of the subjects was insufficient and unpleasant smell and stomach upset were the main reasons which decreased milk preference and consumption. Students with low milk preference should be guided with how to drink milk deliciously, how to choose milk type and its products. It is also effective to go into school milk service and to provide milk at home anytime. As students like much fruit-tasted and chocolate milk, the milk processing industries should take their nutritional and health benefits into considerations importantly.

• Journal of the Korean Dietetic Association
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• v.13 no.1
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• pp.73-83
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• 2007

In order to investigate the ecological factors affecting milk intake frequency of adolescents, the questionnaire survey was conducted with 929 middle and high school students living in Chungnam urban area through October and November 2004. The subjects consumed milk 8.6$\pm$6.7 times per week, other beverages 4.4$\pm$4.1 times per week and drinking water 3.7$\pm$2.1 cups per day. Of the students 77.3% took balanced meals, 72.8% ate regularly and 36.2% ate adequate amount. About 61% had breakfast everyday and nearly a half students snacked once a day. Nutritional knowledge scores about milk was 7.2$\pm$1.7 and milk attitude scores was 28.1$\pm$6.5. The subjects spent daily 1.8$\pm$1.1, 1.9$\pm$1.1, and 1.0$\pm$0.5 hours for computer use, TV watching and exercise, respectively. Milk intake frequencies were positively correlated with excercise, snack frequency, meal balance and regularity, breakfast frequency, food attitude score and milk preference, while showed negative correlationships with TV watching and computer use. Intake frequency of fruit-tasted and chocolate milk showed inverse correlation with nutritional knowledge. Subjects without either school store or vending machine took milk more frequently than those with one or both did. Of the correlated variables, milk preference was the most important influencing factor to milk intake frequency according to the stepwise linear regression analysis, which presented other 5 important influencing factors as food attitude, school vending facilities, excercise, snacking frequency and watching TV. In conclusion, the improvement of milk preference is the most important and effective way to promote milk consumption in adolescents. The favorite ways of drinking milk, nutritional benefit of milk, healthy beverage and good snacking should be taught in nutrition education. Also physical activities should be recommended to students rather than watching TV, computer use and vending facilities selling soft drinks should be limited to be established inside school.

• Journal of the Korean Dietetic Association
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• v.21 no.2
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• pp.123-139
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• 2015

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

• Journal of the Korean Dietetic Association
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• v.21 no.2
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• pp.91-109
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• 2015

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

• Journal of the Korean Dietetic Association
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• v.13 no.2
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• pp.183-193
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• 2007

School foodservice employees are involved with every aspect of ensuring that high quality meals are prepared and they influence student satisfaction. The objective of this study was to identify whether job satisfaction of cooks is affected by their relationships with management. Survey forms that were developed for foodservice dietitians and employees were interviewed. Questionnaires to measure job satisfaction were distributed to 30 schools in the Gyeonggi province and completed by 30 dietitians and 323 cooks. Foodservice cooks' job satisfaction was evaluated by measuring attitudes towards aspects of their job using the modified Smith method(1969). All items in the scales were coded by 4 Likert scale(1: nerver satisfied, 4: very satisfied), then grouped by using factor analyses. Statistical methods used in this study were a $x^2$-test, t-test with SPSS software(version 12.0). The study results were as follows; 1) The demographic data showed that 65.3% of respondents were in their 40s, 96% were married, 68.8% were high school graduates, and 93.5% were contracted employees. Regarding overall experience in their current workplace, 27.9% had been in their position over 5 years and 25.7% said less than 2 years. 2) Most of the school lunches was served in the classroom(73.3%). The cook working was rotated among the employees(90%). Most employees did not use a day's leave of absence per month because they were averse to burdening their coworkers. 3) There were no significant differences in job satisfaction between the cooks' self-evaluation scores(2.92) and those of the dietitians(2.92). Among the factors influencing job satisfaction, dietitians(2.10) perceived that cooks(1.99) were more satisfied with their salaries than was actually the case. The cooks(3.19) rated their level of work satisfaction higher than the dietitians(3.03) perceived it to be. Employees rated their relationship satisfaction as 3.50, but dietitians on the other hand rated it 3.37. Most of the cook respondents want a higher salary and a some kind of employment guarantee. This study provides foodservice managers information useful for design positions that will increase productivity. Future study is needed to determine the factors that will improve job satisfaction and satisfy the employees' needs, which in turn will improve school food service quality.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.257-274
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• 2014

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.