• Journal of Nutrition and Health
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• 제51권3호
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• pp.264-274
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• 2018

본 연구는 경기도 소재 초등돌봄교실의 돌봄전담사를 대상으로 집단면담조사 및 설문조사를 실시하여 도시와 농촌의 급 간식관리 현황을 비교 분석하였으며, 그 결과를 요약하면 다음과 같다. 첫째, 돌봄전담사 7명을 대상으로 한 집단면담조사 결과, 관련 지침이나 전문가의 도움 없이 돌봄전담사가 급 간식 운영을 전담하고 있었으며, 예산 부족으로 인한 질적 저하가 문제점으로 나타났다. 또한 초등돌봄교실의 급 간식을 공동관리할 수 있는 전문기관의 필요성이 도출되었다. 둘째, 돌봄전담사 101명을 대상으로 한 설문조사 결과, 학기 중 간식비는 평균 1,463원, 방학 중 급식비는 평균 4,062원이었으며, 학기 중 간식비 (p = 0.015)와 방학 중 급식비 (p = 0.039)는 농촌이 도시보다 유의적으로 적었다. 학기 중, 방학 중 급 간식 모두 완제품을 구매해서 제공하는 학교가 가장 많았으며 도시와 농촌 간 차이는 없었다. 셋째, 급식 영양관리기준이 있는 학교는 10% 미만에 불과하였다. 급식식단을 별도로 작성하고 있는 학교는 101개교 중 47개교였으며, 이 중 30개교 (63.8%)는 도시락공급업체로부터 식단을 제공받고 있었고, 17개 (19.3%)에서는 돌봄전담사가 식단을 작성하고 있었다. 간식식단을 작성하는 학교는 80개교로, 이 중 45개교 (44.6%)에서는 돌봄전담사가 식단을 작성하고 있었다. 농촌은 도시에 비해 돌봄전담사가 급식식단을 작성하는 비율이 높은 경향이 있었다 (p = 0.054). 넷째, 위생관리 기준이 있는 학교는 101개교 중 34개교 (33.7%)에 불과하였으며, 31개교는 급 간식 제공 전 검식을 하지 않고 있었고 정기적인 건강검진을 하지 않는 돌봄전담사도 56.4%에 달했다. 급 간식 위생관리 현황은 지역에 따른 차이가 나타나지 않았다. 다섯째, 돌봄전담사가 응답한 적정 1회 간식비는 1,924원으로 실제 간식비보다 높아 적정 간식비에 대한 검토가 필요해 보였다. 바람직한 급 간식의 운영형태에 대한 의견에서는 초등돌봄교실 전문 급 간식지원센터 설치가 바람직하다는 응답이 48개교로 가장 많았다. 본 연구결과, 초등돌봄교실의 급 간식 운영에서는 지역구분과 관계없이 식단관리 및 위생관리 등에서 문제점이 나타났다. 초등돌봄교실에 참여하는 어린이들에게 위생적이며 영양이 풍부한 급 간식을 제공하기 위해서는 돌봄전담사가 식단작성 등 관련 업무를 담당하고 있는 현실을 고려하여 현장에서 효율적으로 활용할 수 있는 구체적인 급 간식 운영지침 마련이 시급하며, 돌봄전담사를 대상으로 한 영양 위생 교육 프로그램 개발이 필요하다. 또한 초등돌봄교실 급 간식 권장패턴 및 참고식단 개발이 필요하며, 정부 차원의 효율적인 제도 마련과 지원이 요구된다. 특히 농촌은 도시에 비해 급 간식의 단가가 낮고 돌봄전담사가 식단을 작성하는 경우가 많아 급 간식 단가의 상승을 우선적으로 고려할 필요가 있으며, 체계적인 급 간식 관리를 위한 제도 도입이 선행되어야 할 것이다.

• 대한영양사협회학술지
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• 제14권3호
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• pp.229-242
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• 2008

This study examined foodservice management performance in child-care centers and suggests ways in which meal service quality can be improved. Questionnaires were distributed to 51 child-care facilities. The majority of respondents were facility directors (dietitians) and their facility type was tax-paid (92.2%). The dietitian response rate was 51.0%, and the majority (96.2%) were hired with co-management status, visiting a facility once a week (76.0%). Only 52.1% of the facilities had menu planning by a dietitian, and improvements were needed in terms of planning menus with standardized recipes, especially for infant meals. The monthly food cost per child was 47,394 won, and the labor cost for a co-management dietitian was 3,670 won per child, indicating 21.8% and 1.8% of the tuition fee, respectively. Other necessary improvements included: more reliable food purchasing management, securing additional foodservice equipment, and better sanitation management. In addition, respondents rated the following as requirements to ensure high quality meal service: 'modernized foodservice equipment and facilities', 'government financial support', and 'information on nutrition and foodservice management provided by dietitians'. Based on the study results, the following are recommendations for improving meal service quality in child-care centers: Dietitian placement should be extended to facilities of over 50-capacity in addition to their current placement in facilities of over 100-capacity, and co-management dietitians should have their control span restricted to two facilities instead of five. Finally, nationwide nutrition support plans and nutrition education programs should be developed and implemented by dietitians, and their roles should be extended to foodservice mangers as well as nutrition teachers.

• 대한지역사회영양학회지
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• 제25권3호
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• pp.214-225
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• 2020

Objectives: This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods: The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30~60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapy-related items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results: All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions: These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.

• 가정간호학회지
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• 제15권2호
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• pp.106-114
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• 2008

Purpose: We analyzed the self-care behavior and metabolic control rates in diabetic patients based on the National Health and Nutrition Examination Survey in Korea (2005). Methods: The study group included 311 patients who were over 126 mg/dL on the FBS test. Data were analyzed using SPSS PC WIN 12.0. Results: The average score of self-care behavior was $12.08{\pm}1.05$ points, and significantly different according to DM treatment status, disease duration (years), admission experiences (within 1 year) and education about DM. Glucose, total cholesterol, triglycerides were decreased in self care subjects, but not significantly. Conclusion: An educational program for diabetic patients would help maintain metabolic control rates to improve self-care behavior.

• 한국식품영양학회지
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• 제23권4호
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• pp.470-477
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• 2010

The purposes of this study were to identify the evaluation categories, areas, attributes of the hospital food service and to define the relative importance of the evaluation categories, areas, attributes of the hospital food service using analytic hierarchy process. A survey was conducted from January 8th to 25th in 2007. Questionnaires were mailed to the 310 directors of dietetic departments of hospitals that included 160 primary hospitals, 107 secondary hospitals, and 43 tertiary hospitals. The result of the analytic hierarchy process indicated that relative importance of evaluation category was 0.5259 for food service management and 0.3407 for nutrition care. The food service management consisted of four subcategories, which are equipment standard, sanitation, production, and delivery service. Sanitation(relative importance: 0.2652) was the most important area among the subcategories and it was followed by equipment standard(0.2067), delivery service(0.1864) and production(0.1848). The nutrition care has two subcategories, menu management and meal management. The relative importance of menu management(0.4174) was higher than that of meal management(0.3555). The quality of food service and nutrition care to inpatients can be improved by the evaluation system based on appropriate applications of the developed evaluation indicators for hospital food service systems.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.321-328
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• 2018

Purpose: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. Methods: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. Results: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. Conclusion: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권6호
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• pp.521-530
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• 2020

Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

• 대한지역사회영양학회지
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• 제11권3호
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• pp.327-337
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• 2006

The major purpose of this study was to develop the nutrition education contents and material through the basic data from the service provider and the consumer. And also, to find out the differences of attitude and needs between the service provider (SP breastfeeding specialist), present consumer (PC, pregnant or lactating women) and future consumer (FC, college women). There were types of questionnaires, which consisted of needs and attitudes toward child and maternal nutrition, as well as the personal characteristics of the study subjects. The subjects consisted of 113 breastfeeding specialists who served at medical related institutions, 197 pregnant or lactating women and 309 college women. The self-administered questionnaires from subjects were collected from October to November 2005 in Seoul and Kyunggi Province. The data was analysed by SPSS Win 12.0, ANOVA and Kruskal-Wallis test. The results of this study were as following: 1) The most Important determining factors on breastfeeding was 'medical specialist's support' (3.51) and the next one was 'knowledge of maternity care practice' (3.39). And the importance score of determinating factors on breastfeeding was significantly different between each group (p < 0.001). The groups of consumer (3.50 at PC and 3.59 at FC) considered the service provider (3.32) more important. The service providers considered a more effective determining factor to be 'husband and family support' and 'peer support' than the others (p <0.001). 2) To compare the effective factors of breastfeeding practices between the three groups, the service providers were more significantly considered than the otters such as 'attendance of intervention program' (p < 0.001). But the PC group considered the most effective factors wis 'mother's job after delivery'. 3) The self-evaluated score of the breastfeeding knowledge was the most high in SP; the score was significantly different between groups. The knowledge score of nutritional aspects in human milk was most highly evaluated. But maternity care practice and public acceptance marked the lower evaluation score than other issues. 4) The desirable types of educational material was mass media, and the next was printed matter such as booklets. Two kinds if consumers preferred DVD or VCR tapes than and the service provider group (p < 0.001). 5) The priority contents of nutrition service PC group wanted the information about infant care more than maternal care (p < 0.05), but FC group's priority was significantly different compared with PC group (p < 0.001). The priority of SP group pointed out the information of practical child care methods. The results showed the needs of nutrition service, education channels, and perception toward effective factors on consumer behavior changes were significantly different between each group. Thus the result of this study may suggest that consumer oriented nutrition service programs must be developed.

• 한국영양학회:학술대회논문집
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• 한국영양학회 2004년도 추계학술대회
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• pp.37-37
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• 2004

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권2호
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• pp.79-84
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• 2012

Pediatric patients in hospital are at risk of malnutrition at admission and even during their hospitalization. Although the concept of nutritional support team (NST) was introduced to hospitals for optimal nutritional care since 1960s and the benefits of pediatric NST have been proven by many studies and reports in terms of patient clinical outcome and cost saving, the pediatric NST is not widespread yet. The pediatric NST composed of pediatricians, dieticians, pharmacist, and nutrition support nurses as core members dedicated to nutritional care in children should be independent of central NST or other disciplines, but closely cooperate with other teams in hospitals. There is no doubt that a multidisciplinary NST is an effective way to provide appropriate nutritional support to an individual patient. Therefore, the implementation of the pediatric NST in hospitals should be recommended to provide optimum nutritional support including enteral tube feeding and parenteral nutrition and to assess pediatric patients at risk of malnutrition.