Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.
Choi, Ki Bo;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Park, Mi Sun;Park, Yoo Kyoung;Cha, Jin A;Lyu, Eun Soon
Journal of the Korean Society of Food Science and Nutrition
/
v.46
no.2
/
pp.251-258
/
2017
The objective of this study was to analyze patient satisfaction and perception of nutritional counseling services quality. A patient satisfaction and perception survey was conducted for 1,095 patients from 43 tertiary hospitals and 20 general hospitals. The number of returned questionnaires was 656 (response rate: 60.0%). Data from 633 questionnaires were analyzed after the questionnaires with unanswered items were excluded. Five domains were identified from the result of the factor analysis using the maximum likelihood and oblique rotation. The five domains were named empathy, responsiveness, tangibles, reliability, and skill and specialty. Patient perception mean score of nutritional counseling was 4.54/5.00. Patient satisfaction scores were significantly higher in empathy (P<0.001), responsiveness, and skill and specialty (P<0.01) with a college or graduate school education than in patients with a middle school education. There was no statistically significant difference between satisfaction scores in tertiary hospitals and those in general hospitals, but patients in capital hospitals reported significantly higher scores than their local counterparts in empathy, responsiveness, reliability, skill and specialty (P<0.001), and tangibles (P<0.05). In responsiveness, significantly higher (P<0.01) scores were observed in patients who received nutritional counseling only once compared to patients who received counseling two times. Patients perception of nutritional counseling services was significantly correlated with their satisfaction of five domains, reliability (r=0.721), responsiveness (r=0.697), empathy (r=0.690), skill and specialty (r=0.678), and tangibles (r=0.622).
The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.
The purpose of this study was to analyze task performance and importance level of the dietitian who is working in the public health nutrition area. Work oriented job analysis methodology was employed for the study purpose. Subjects of 38 dietitians currently working at health centers in 2002 were recruited. Based on the focus group interview with 7 public health nutritionists and 7 professors, information about task elements was collected. Questionnaires measuring work performance and self-perception of importance of the selected task elements were administered. The results of this study can be summarized as follows; 1) The tasks with high performance and importance level among 20 tasks are developing nutrition education material (B1), nutrition services for adults and the elderly (C3), writing the proposal for nutrition services (A2), evaluating service effect (A4), improving professionalism (E1), and self management (E2). 2) The task elements with high performance and importance level among weekly task elements are nutrition education for diabetes (C56), nutrition counseling for adults (C47), nutrition for hypertension (C53), managing and keeping records (C80), nutrition education for kindergarten and nursery school children (C42), searching for nutrition education materials (B26), and searching for media (B27). 3) The number of task elements with high performance and importance level among monthly task elements are 13 in the planning and evaluation of public health nutrition service, and 5 in developing nutrition education materials. The tasks of a dietitian in the public health center show a very wide spectrum. However dietitians recognize most of the tasks are important even though they cannot perform those tasks adequately.
Objectives: To investigate the use frequency and amount of food sources of sodium and knowledge requirement, and job satisfaction with school food services according to the school types in Busan. Methods: A total of 98 schools were surveyed and knowledge requirement and job satisfaction were assessed using a questionnaire. In addition, the use frequency and amount of food sources of sodium for 10 school days were examined. Results: The response rate of the most difficult area among dietitians' tasks was significantly high in 'nutrition education and counseling' for elementary schools and 'hygiene management' for high schools (p < .05). The response rate of the factors to be considered in meal planning was significantly high in 'energy and nutrients requirement' for elementary schools and 'menu/taste preference of students' for middle and high schools (p < .05). The response rate of whether school food services affect health and eating habits of students or not was significant high in 'very helpful' for elementary schools (p < .001). The average sodium contents in the meals of elementary, middle and high schools was 1981.4 mg/meal/person/day, 1867.3 mg/meal/person/day and 1,329.9 mg/meal/person/day, respectively. For foods in highest sodium, Kimchi, Oribulgogi, and Kare rice were ranked 1st, 2nd and 3rd respectively. The main reason for not providing the fruits was 'price' among all groups. The knowledge requirement such as 'nutrition and menu management', 'nutrition education', and 'nutrition counseling' was significantly higher in elementary school compared with middle and high school (p < .001, p < .01, and p < .01 respectively). The dietitians and nutrition teachers of elementary schools have a higher job satisfaction compared with those of middle schools (p < .01). The job satisfaction was positively correlated with knowledge requirement of dietitians and nutrition teachers of elementary and middle schools. Conclusions: The results suggest that developing dietitians' education program about knowledge requirement contribute to increasing the school food service and job satisfaction in elementary and middle schools.
Background: The number of colorectal cancer (CRC) patients in Taiwan has increased in recent years; therefore, the effective dissemination of information related to symptom care has become especially important. Previous studies indicated that the physical and psychological status of cancer patients can be effectively improved by telephone counseling services (TCS). Thus, determining the most effective means of establishing a TCS to support the clinical practice of oncology has become a crucial goal for nursing. The purposes of this study were to analysis the content of the TCS for CRC and explore stratification of the TCS. Materials and Methods: The study design was retrospective. A total of 850 calls were made to CRC patients in the cancer center of Southern Taiwan during the period of January 2007- December 2011. A structure questionnaire was adopted to analysis satisfaction. Results: Responses provided by the TCS included information regarding nutrition, side effects resulting from chemotherapy and pain. Moreover, 28.7% of CRC patients needed advanced treatment. More than 90% satisfaction with all aspects of the calls was found. Conclusions: The TCS coulkd be shown to provide an effective means by which to expand the reach of nursing care to different times, places and patients, allowing for greater cost efficiency and more rapid service.
This study was performed to assess the nutritional status, frequency of visiting and necessity of nutrition programs for 157 elderly(male:49, female:108) visiting public health centers in Puchon. The purpose of the study was to provide the basic data for developing a nutrition service model. The subject were investigated by interviews with a questionnaire to obtain dietary data and other information related to public health center. Blood tests for analyzing biochemical status were also carried out. The elderly showed low income status. Ninety two percent of them showed their monthly income was less than 400,000 won and 72.6% was observed as having 30,000 won/month as their pocket money. The most frequent disease reported as having or being treated were hypertension(32.6%), rheumatic arthritis(28.5%), diabetes(10.2%), and stomach disease(8.2%) for males and hypertension(33.1%), diabetes(19.4%), rheumatic arthritis(16.7%), anemia(11.1%) for females. The nutrients whose daily intakes were less than 2/3 of RDA were calcium(37.5% RDA),vitamin A(49.9% RDA), iron(60.0% of RDA) and protein(62.0% RDA) for males and vitamin A(27.7% RDA), vitamin B$_2$(33.3% RDA), calcium(44.1% RDA), iron(53.3% RDA), and niacin(60.0% RDA) for females, respectively. Prevalence of anemia, assessed by hemogloben using WHO definition, were 4.1% for males and 18.5% for females. The percentage of males with hypercholesterolemia( 220 mg/dl) was 2.1% and 19.4% fir females, Two percent of males and 12.0% of females were observed as having a LDL-C higher than 165 mg/dl. The mean fasting blood glucose(FBG) level of males and female was 84.2 mg/dl and 101.7 mg/dl respectively. Two percent of males and 8.3% of females were found with a FBG higher than 140 mg/dl. Seventy one percent of elderly reported they were visiting public health centers at least once per week or more frequently. They were satisfied most with the low medical bills but showed the lowest satisfaction for the facilities of the public health centers. What the nutrition service programs wanted most was nutrition counseling and guidance.
This study examined students' menu preferences as well as the job satisfaction and specific considerations concerning foodservice operation of dieticians and nutrition teachers at special schools for the disabled. Semi-structured interview questionnaires were sent to all of the 21 special schools with direct school food service in Gyeonggi-do, and 16 dieticians and nutrition teachers agreed to participate in this study. Among the various menu groups, the subjects perceived the meat group as the most preferred and the vegetable group the least preferred. They were generally satisfactory with their job and duty, and had a strong sense of belonging to the school. However, most of them answered that they needed more time for nutritional education and counseling. While most had pride and pleasure in their job, they expressed a desire to change the system to better fit with their roles as professional nutritionists. The content analysis revealed that the subjects mainly focused on safety issues in planning the food menu and were thus limited in selecting menu items. They also felt difficulty in menu planning due to various tastes and preferences, since special schools tend to consist of a wider grade range. However, most subjects reported little trouble in food distribution and food leftovers owing to practical support from teachers and parents. The necessity for education concerning table manners and obesity prevention was generally a shared opinion, and education programs for parents were also perceived as necessary to better understand the special considerations for developing proper eating habits in their child. The study findings provide useful basic data to improve the foodservice system at special schools.
The purposes of this study were to identify the significance of a nutrition teacher, to analyze the importance of competence as a nutrition teacher and to evaluate the importance and difficulty for duties of nutrition teachers. The questionnaire was distributed to 554 preliminary teachers and a total of 468 usable data were collected with 84.5% of response rate from August to October 2006. The statistical data analysis was completed by using SPSS Win (ver. 10.0) for descriptive analysis, t-test, ANOVA and ${\chi}^2-test$. The results were as follows: Preliminary nutrition teachers expected that conversion of a school dietitian into a nutrition teacher could lead to systematic and constant nutrition education and come into synergic effect by doing meal service with nutrition education. For a teacher's competence, all three paradigms were perceived as important. It was evaluated to be high for a knowledge factor in the empirical analytic paradigm, a personality factor in the practical interpretive paradigm and an attitude factor in the critical emancipatory paradigm. And 'a knowledge for nutrition and sanitation (4.59)' and 'an ability to raise a self-management capacity for right food habit and dietary life (4.59)' were showed as most important in a nutrition teacher. It appeared that both important and difficult duties of nutrition teachers were nutrition education, nutrition counseling and sanitation quality of nutrition education; the most necessary solution was to develop a reference and program for nutrition education (37.4%). In conclusion, the systematic supports of district offices of education and associated institutions as well as sustained efforts of preliminary nutrition teachers for themselves should lead to establish a successful system of nutrition teachers.
The elderly population in Korea is growing rapidly and their needs for long-term care has also increased. By the year 2018, our society will be approaching aged society and by 2026 it will be a super-aged society. The purpose of this study was to employ conjoint analysis to establish the relative importance of foodservice encounters in terms of determining the utility values of hospital foodservice for elderly patients. According to the results pearson's R(0.420) and Kendall's tau(0.402) statistics showed that the model fits the data well(p<0.05). The relative importance scores of hospital foodservice encounters were as follows: dietary counseling with dietetics(51.2%), foodservice personnel(48.7%), and food(0.1%). A soft cooking method(0.001) was preferred to a general cooking method(0.001), and kind foodservice personnel(0.086) were preferred to quick service(-0.086). Finally, counseling with a dietitian once a week(-0.138) was preferred to counseling twice a week (-0.276). Based on this conjoint analysis, the most preferable model for foodservice at a long-term care facility would be; soft cooking methods, kind service by foodservice personnel, and dietetic counseling once a week. Overall, a better understanding of the specific needs of our institutionalized elderly is one of the key elements that can help our long-term care system develop improved foodservice programs.
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