• Journal of Nutrition and Health
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• v.28 no.7
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• pp.675-687
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• 1995

The purpose of this study were to analyze work patterns of clinical dietitians by time study, to investigate labor time used in each clinical dietetic activity, and to develop standardized indices of clinical dietetic staffing needs. Two general hospitals(A & B) in Seoul were selected for study. The results of this study can be summarized as follows. 1) For the A hospital, the percentage of clinical dietetic activities such as attending meeting, professional research, foodservicemanagement, clerical activity for the foodservice, administrative activity and delay were 17.5%, 1.3%, 14.5%, 23.4%, 21.3%, 4.6%, and 17.3% respectively, while 22.4% 3.5%, 23.7%, 10.9%, 15.8%, 4.2%, and 19.5% respectively for the B hospital. 2) For the A hospital, the percentage of direct patient care like outpatient nutrition education, group nutrition education, and patient meal planning were 69.5%, 10.5%, 7.6%, and 12.4% respectively while 78.9%, 7.3%, 8.9%, and 5.1% respectively for the B hospital. 3) Time spent for performing direct patient care such as basic care, intermediate care, and indepth care per patient were 28.0min, 73.1min, and 53.0 min respectively for the A hospital, while 45.3 min, 76.2 min, and 52.6 min respectively for the B hospital. 4) Full time clinical dietitian staffing needs were calculated for the three parts ; basic care, intermediate care, and in-depth care. For A hspital, the appropriate numbers of full time clinical dietitian were 3.5 persons in basic care, 3.6 persons in intermediate care, and 1.3 persons in in-depth care, while 6.1 persons, 6.3 persons, 3.2 persons respectively for B hospital.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.11-23
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• 2023

Objectives: This study aimed to determine the nutritional status of residents, to examine the perception and needs of community nutrition care service, and to compare and analyze the results of females and males living in Daejeon, Korea. Methods: The subjects were 592 adults and elderly (278 men and 314 women) residents of Daejeon. The dietary quality was assessed using the nutrition quotient (NQ), and data of the perception and needs for community nutrition care service were obtained by a questionnaire survey. Descriptive analysis was applied to analyze the demographic characteristics, perception and needs of the respondents, and independent t-test and chi-square test were performed to analyze and compare the differences between female and male participants. Results: A nutritional status that required monitoring was established in 78.9% of the respondents in this study. The balance factor (29.1 points) was much lower than the national average. In the diversity factor, the NQ score of the female group was 47.6 points, which was 8 points lower than that of males; the NQ grade was 43.9%, showing a significant difference between females and males (P < 0.001). The respondents answered that those who needed community nutrition care services were residents experiencing health care difficulties. Additionally, dietitians (35.6%) were pointed out as the most suitable service providers. The most important factor of community nutrition care service operation was securing the budget (47.0%). Conclusions: The results of the present study show that Daejeon residents need overall nutrition support, and a demand for community nutrition care services exists. Our findings provide basic data and can serve as a foundation for the development and establishment of a community nutrition care service model.

• Korean journal of food and cookery science
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• v.12 no.2
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• pp.178-185
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• 1996

Investigation of foodservices was carried out in 7 different day care centers in Gyeongnam area and no trition survey of their 481 children were undertaken between October 5 and November 3, 1994. The results were summarized as follows: Conditions of most equipments and facilities used in the kitchen were very defective especially in dishwashing and sterilizing step. Number of cooks and assistant cooks in foodservices was 1 or 2. Purchasing of foods and planning of menu were mainly done by the manager or the secretary. Menu was cycled weekly. None of the day care centers has empolyed a dietitian. Mean values of height and weight of children showed slightly over the standard of Korean children. Mean intakes of energy and all the nutrients from the lunch, which was served by day care centers, were below 30% of the Korean RDAs. Mean value of protein, thiamine and niacin were above 25％ of the RDAs. Intakes of Ca, Fe and Riboflavin were lower than the ones of other nutrients. It is suggested that dietitians should be empolyed to take care of meal services and nutrition education for the children.

• Preventive Nutrition and Food Science
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• v.18 no.2
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• pp.117-123
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• 2013

This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

• The Korean Journal of Food And Nutrition
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• v.24 no.4
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• pp.639-648
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• 2011

The purpose of this study was to investigate foodservice management practices in the child care centers and kindergartens. Interviews were held from May to July 2008 to understand the current situation concerning foodservices in Seoul and Gyeonggi provinces. Surveys were sent out from August 2008 to April 2009 to 1,478 child care centers and 299 kindergartens via the postal service. Among them, 203 child care centers(13.7%) and 64 kindergartens(21.4%) responded. One of the largest concerns while preparing the food was nutrition(68.7%, 69.8%, respectively) followed by sanitation(24.4%, 27.0%, respectively). The most frequently referred sources for planning the menu were the Seoul child care information center(55.4%) for child care centers and kindergarten related internet sites(39.0%) for the kindergartens. In general, the child care center principal was in charge of planning the menu(40.1%). Child care centers and kindergartens purchased ingredients mostly from large retailers(55.3% and 44.7%, respectively), whereas 46.0% and 56.3% of those did through foodservice suppliers. Dietitians were rarely employed at these facilities, and this may cause unprofessional foodservice management.

• Journal of the Korean Dietetic Association
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• v.28 no.2
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• pp.67-84
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• 2022

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

• Journal of the Korean Society of Food Culture
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• v.12 no.3
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• pp.331-339
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• 1997

With increases in senior citizens and changes in family structure, the need for long-term care system for elderly is increasing, however, the capacity and environment of Korean facilities are very limited. Health and nutritional status of long-term care residents are worse than free-living elderly. In this study, general food service management and health care practices in long-term care systems were investigated. Questionnaire were sent to the directors of all 162 long-term care facilities in Korea and 81 returned the complete answers. The results showed 1) There are slow but steady increase in long-term care systems in Korea, however, the capacity is far from adequate. Less than 10,000 elderly were resided in the facilities. Most of the systems were free-nursing homes and supported by the goverment. Staffing structure revealed that most of the facilities had a director, a secretary, nurses, but only 21% of the systerm hired a dietitian. It showed the shortage of nurses, physical therapists, and dietitians. Therefore, food purchasing, menu planning, food delivery, and the other food service management processes are handled by non-professionals, such as director, secretary, or cooks. Modified fool frequency questionnaire were used to get the frequencies of each food items used in menu and a menu-analysis was made on the one-day menu provided by the facilities. The results showed relatively satisfactory in nutrients content and food frequencies., however, this was about what was used in menu, not what was eaten by the residents. Therefore this results did not tell that the food intake status of individuals. In most facilities general health checkup was done on a regular basis, and had residents with various chronic degenerative diseases, such as hypertension, neuralgia, stroke, arthritis, diabetes. But the items checked on health checkup included weight, height, blood and urine tests, X-ray test, which suggested that the checkup lists should be revised to accomodate the health problem of the aged today.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.99-115
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• 2023

Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.

• Journal of the Korean Dietetic Association
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• v.22 no.1
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.