• Title/Summary/Keyword: Nutrition care

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Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit

  • Bae, Eunjoo;Kim, Jiyoon;Jang, Jinyoung;Kim, Junghyun;Kim, Suyeon;Chang, Youngeun;KIM, MI YEON;Jeon, Mira;Kang, Seongsuk;Lee, Jung Keun;Kim, Tae Gon
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.703-714
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    • 2021
  • BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.

Nutrition and Health Status of Day-Care Center Children (영유아 보육시설 어린이들의 영양, 건강상태)

  • Cho, Mi-Sook
    • Journal of the Korean Society of Food Culture
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    • v.15 no.4
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    • pp.313-323
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    • 2000
  • Although it is rapidly increasing the number of day-care centers in Korea, the quality of food and nutrition services is not improved sufficiently. The purpose of this study was to investigate the nutrition and health status of children in day-care center. Menus for lunch of 253 centers were collected and the content of nutrients was analyzed. Nutrient intakes from lunch and snacks of 90 children were investigated using weighing method and those from breakfast and dinner by 24-hour recall method surrogated from their mothers. Anthropometric indices of height, weight, skinfold thickness, the ratio of fat were measured. The lunch menus for children contained $437.0{\pm}138.9\;Kcal$, $17.6{\pm}6.7gr$ protein, $153.9{\pm}87.7mg\;Ca$, $3.63{\pm}1.6mg\;Fe$, $164.5{\pm}158.2RE\;Vit\;A$. and $4.46{\pm}3.04mg\;Vit\;B_1$. Energy, Ca and Fe supplied were below one third of RDAs. Mean daily calorie intake of children aged 3 years was $1303.0{\pm}474.0Kcal/day$, $1322.3{\pm}442.4Kcal$ in aged four, $1307.0{\pm}545.9Kcal$ in aged five and $1497.1{\pm}93.5kcal$ in six year of age. Intake of iron, vitamin A and vitamin $B_1$ were below RDAs.

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Categorization of Nursing Diagnosis and Nursing Interventions Used in Home Care (가정간호에서 사용된 간호진단과 간호중재 분류)

  • Suh, Mi-Hae;Hur, Hae-Kung
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.47-60
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    • 1998
  • This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.

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Beyond the clinical walls: registered dietitian nutritionists providing medical nutrition therapy in the home setting

  • Hicks-Roof, Kristen;Xu, Jing;Fults, Amanda K.;Latortue, Krista Yoder
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.789-797
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    • 2021
  • BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

A Study on the Development of the Goals and Contents System of Healthy Dietary Education Program for After-School Care in Lower Grade in Elementary School (초등 저학년 돌봄 교실 건강식생활 교육프로그램의 목표 및 내용체계 개발 연구)

  • Kim, Jung-Hyun;Lee, Myoung Hee;Park, Okjin;Choi, Kyung Sook
    • Korean Journal of Community Nutrition
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    • v.24 no.1
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    • pp.24-37
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    • 2019
  • Objectives: The study purpose is to develop a content system for a healthy dietary education program for after-school care in lower grade in elementary school. Methods: The contents of healthy dietary education in the 2015 revised curriculum and textbooks and the major education programs related to dietary life that are currently used in elementary school education were analyzed. Focus group interviews were held with field experts related to lower grade in elementary care class. Accordingly, the structuring of the education area and the detailed education contents were systematized. Results: From the analysis results, the contents of curriculum, textbook, and administrative department were classified as hygiene safety, health, and culture. The goal of the educational content system was divided into three areas: nutritional dietary life, food hygiene and health, and food culture. The subjects consisted of dietary balance, healthy body weight, digestion and absorption, food hygiene, Korean agricultural products, traditional food, and table manners. The curriculum was composed of 12 content elements. Conclusions: In order to ensure that after-school care students can grow into healthy, growth-oriented and creative talents, the role of the caring guide is important, and associated guidelines are needed in the future.

Management of Food Service and Health Care in Long-Term Care in Korea - Food Service and Health Care - (노인복지시설의 급식관리 및 영양 건강 증진에 관한 연구 - 급식과 건강관리 -)

  • Kim, Wha-Young;Yang, Eun-Ju;Won, Hye-Suk
    • 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.

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Influence of care practices on nutritional status of Ghanaian children

  • Nti, Christina Antwiwaa;Lartey, Anna
    • Nutrition Research and Practice
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    • v.2 no.2
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    • pp.93-99
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    • 2008
  • A community-based longitudinal study was conducted in the Manya Krobo District of the Eastern Region of Ghana with the objective of assessing how caregiving practices influence nutritional status of young children in Ghana. The study subjects were one hundred mothers with infants between the ages of 6 and 12 months. Each child was visited at home monthly for a period of six months. On each visit, information was collected on caregiver household and personal hygiene, child's immunization status, child's dietary diversity, caregiver responsiveness during feeding, caregiver hygienic practices related to feeding and child's weight and length. At the end of the study, summary scores were generated for each variable and quality of care practice determined based on their distribution. Classification of child nutritional status was based on z-scores for both weight-for-age and length-for-age. The results revealed that caregivers who exhibited better quality of care practice had well-nourished children. Such caregivers were more likely to practice good household and personal hygiene than those of poorly nourished children (97.1% vs 31.8%, p<0.001). They were also more likely to complete their children's immunization schedules (88.2% vs 62.2%, p<0.001), provide good quality diets from highly diversified sources (79% vs 23%, p<0.001), exhibit high responsiveness during feeding (100% vs 22.7%, p<0.001) and feed under hygienic conditions (100% vs 22.7%, p<0.001). Based on the findings it was concluded that good caregiving practices are associated with improved child nutritional status.

Nutritional Assessment of Snacks Consumed in Child Care Centers in Tean-Gun (태안군 어린이집에서 제공하는 간식의 영양 평가)

  • Kim, Ae-Jung;Park, Sang-Hyun;Lee, Gun-Soon
    • Journal of the East Asian Society of Dietary Life
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    • v.16 no.5
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    • pp.523-532
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    • 2006
  • This study evaluated the evaluate nutrient knowledge of child care teachers and assessed the nutritional level of snacks served in 18 child care centers in Tean-Gun. The survey sample was 18 child care teachers working in 18 child care centers of Tean-Gun. The questionnaire requested information about demographic factors, nutritional knowledge, management status of snacks, and the kinds and serving size of snacks served for 1 week. Data were analyzed using SPSS for windows(version 12.0) and nutritional values were assessed using Can-pro 2.0. The mean score of teachers' nutritional knowledge was 22 out of 30 points. The scores were low in the questions regarding the ease with which Ca and re deficiencies can be developed in infants. The contents of most nutrients supplied from the snacks exceeded 15% of RI(Recommended Intake) but there were significant differences in the contents of energy (p<0.05), protein (p<0.05), fat (p<0.05), carbohydrate (p<0.05) and calcium (p<0.001) between the child care centers. Especially, the difference of calcium between the child care centers was 344.84 mg. These results indicate that a program of relevant nutritional education focusing on snacks needs to be developed for child care teachers, with a special recognition on correct calcium level.

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Factors Affecting Patient Experience with Outpatient Care (외래 환자경험에 영향을 주는 요인)

  • Kim, Kyoung-Hoon
    • Health Policy and Management
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    • v.31 no.2
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    • pp.207-216
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    • 2021
  • Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.