The principal objective of this study was to assess the demands of the development program of silver health care professionals for elderly individuals residing in the Northern Gyeonggi-do area. To this end, a survey was conducted to investigate college students and employees related with elderly individuals in the area regarding their recognition, interest, and involvement in the labor training program. In the case of college students, the health education they had received was only 1 to 2 hours, from a school lecture(35%). The content of health education they desired was exercise(34%) and stress management skills(28%). The sources of health information they received included mass media(77%) and the internet(12%), and they trusted the information they received from health professionals(45%), and the mass media(34%). In the case of health professionals who were working at silver care facilities, the sources of health information to which they had access were mass media(51%), internet(14%), reliable health professionals(56%), mass media(22%), and books related to health (18%). The principal issues they reported as being relevant to the elderly were dementia(39%), hypertension(14%), arthritis (11%), and they reported that the most important personnel for elderly in the future would be care managers(44%), and care helpers(21%). 88% of subjects believed that there was a need for a silver welfare integrated information system. 43% of subjects used the internet, 77% of them required in-service training programs for the welfare of the elderly. Via this developmental program of silver health care professionals, a variety of new job opportunities can be provided in the future, and a program related to the silver service industry must be established as soon as possible.
Objectives: The purpose of the study was to develop dietary change program items that could be used to improve dietary life of the elderly and investigate their validity. Methods: The survey was were analyzed by SPSS program (Ver. 21) and descriptive statistics was performed; a t-test, ${\chi}^2$ test, One-way ANOVA and Friedman test were used to determine the priority. Results: Programs for feeding senior citizens that need to be newly established are largely divided into two fields, namely, application of welfare facilities and application of home care, classified into large, medium and sub-classes. The large class was divided into nutrition management, sanitary control, and other health management. The medium class of nutrition management was divided into nutrition education, nutrition intervention, and menu management and supply. The sub-class was composed of division into application of welfare facilities for the elderly and application of home care for the same age group. Responses showed high rate saying that all the categorized items were necessary and valid. With respect to expectation effect on a community program for old people feeding, 'yes' was 65 people (55.6%) showing very high expectation toward the question whether a community program for old people feeding are newly set up. Conclusions: It is believed that nutrition for the aged will be improved and it will be a help not only to a small facilities without obligation of employing a dietician but also to the aged at home if a community program for old people feeding are newly established.
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.
The purpose of this study was to investigate the status of children's breakfast skipping and their mothers' needs for breakfast service at child care centers. A survey was conducted with mothers of children aged 3 to 5 years and attending child care centers in Gwanak-gu, Seoul. Out of 960 questionnaires distributed to the caregivers at 32 child care centers, 633 were returned (66% response rate), and 449 were analyzed (47% analysis rate) after excluding data from the respondents not meeting the selection criteria for this study: mothers of children aged 3 to 5 years. Over 2/3 (69%) of children ate breakfast every weekday (Breakfast Eaters) and almost 1/3 (31%) of children skipped breakfast one time or more often on weekdays (Breakfast Skippers). The collected data were compared between Breakfast Eaters and Breakfast Skippers. The average Good Dietary Practice Score of Breakfast Skippers was significantly lower than that of Breakfast Eaters, implying poorer dietary habits. A higher percentage of mothers of Breakfast Skippers (62%) responded that breakfast service was 'necessary' or 'very necessary' at child care centers than those of Breakfast Eaters (27%). A multiple logistic regression analysis was conducted to determine factors affecting mothers' needs for breakfast service at child care centers. The result showed that the children's ages, mothers' occupational status, household monthly income, frequencies of eating breakfast on weekdays and satisfaction level with morning snack provided at child care centers affected mothers' needs for breakfast service at child care centers. In particular, mothers who had a full-time job (OR = 2.06) than housewives, mothers whose children did not eat breakfast at al (OR = 3.54), ate $1{\sim}2$ times (OR = 5.50) or ate $3{\sim}4$ times (OR = 3.80) on weekdays than those whose children ate breakfast every weekday were more likely to have needs for breakfast service at child care centers than housewives. In conclusion, Breakfast Skippers tended to have poorer dietary habits than Breakfast Eaters and Full-time working mothers had higher needs for breakfast service at child care centers. This study results suggest that child care centers consider serving breakfast to children as the number of working mothers increases.
Journal of Korean Academy of Fundamentals of Nursing
/
v.26
no.4
/
pp.221-230
/
2019
Purpose: This study was done to examine incidence of diarrhea and explore factors influencing occurrence of diarrhea in patients admitted to intensive care units (ICU). Methods: For this retrospective research, data based on inclusion criteria were collected from the electronic medical records for 142 patients admitted to a university hospital ICU from September 2014 to August 2015. Statistical analysis was conducted using SPSS/WIN 22.0 program. Results: Incidence of diarrhea was 53.5% during the 12-month study period. Diarrhea occurred at 4.54 days and continued for 1.79 days on average. Average total frequency of diarrhea was 5.56 times. Increased ICU stay, enteral nutrition, and infection state were significant predictors of the occurrence of diarrhea. Infection increased risk of diarrhea 3.4 times and enteral nutrition increased risk of diarrhea to 2.2 times greater than patients not receivng enteral nutrition. Conclusion: Diarrhea in ICU patients is associated with multiple factors that should be considered to implement preventive strategies. Infection control should be emphasized, and close monitoring of diarrhea should be provided for those with enteral nutrition. Further studies are warranted to determine standardized clinical definition of diarrhea and diarrhea risk factors in ICU patients with different levels of severity and comorbidity.
BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.
The objectives of this study were to assign reasonability to importance of weight selection issue in key performance indicator for performance evaluation of Centers for Child-care Foodservice Management (CCFSM) developed by using Balanced Scorecard (BSC), to draw key performance indicator (KPI) by perspective and to analyze differences in recognition on importance. From September 25 to October 9, 2012, we conducted a questionnaire-based study via e-mail, targeting chiefs and team leaders of nationwide 21 CCFSMs (43 persons), officials of local governments where CCFSM was established (21 persons), officials of Korea Food and Drug Administration (2 persons) and foodservice management experts (27 persons) in order to estimate the relative importance on 4 perspectives and 14 KPIs and analyzed its results by using 61 collected data. The results showed that relative importance of perspectives was estimated in order of importance as follows: business performance (0.3519), customer (0.3393), resource (0.1557), learning and growth (0.1531). Relative importance of KPIs was in order of importance as follows: Evaluation of sanitary management level in child-care foodservice facilities (0.1327), Level of customer recognition and behavior improvement (0.1153), performances of round visiting inspection on foodservice, sanitary, safety management, and foodservice consulting (0.0913). Our results showed that the recognition differences exist on the relative importance of perspectives and KPIs between officials of CCFSM, KFDA, local government and foodservice management experts. These observations will form the basis for developing evaluation systems, and it is considered that performance indicators developed on this basis will suggest direction of operation which CCFSM will have to perform.
Purpose : This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients. Methods : From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared. Results : The study found a higher rate of the use of enteral nutrition in the NST group (${\chi}^2=45.60$, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (${\chi}^2=3.33$, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p=.004), and higher proportion of discharge with survival rates (${\chi}^2=18.26$, p < .001) in the NST group. Conclusions : Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.
Dayeong Yeo;Hae Jin Kang;Hyejin Ahn;Yoo Kyoung Park
Clinical Nutrition Research
/
v.13
no.2
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pp.108-120
/
2024
The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.
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