• Journal of the Korean Dietetic Association
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• v.21 no.1
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• pp.37-56
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• 2015

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

• Journal of the Korean Society of Food Science and Nutrition
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• v.25 no.3
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• pp.415-422
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• 1996

This study was conducted to evaluate the necessity of clinical nutrition education in the medical school curriculum. One hundred and eighty five medical school students, residents, nurses, and forty undergraduate students majoring in food science and nutrition were involved in this study. The survey included questions about nutritional knowledge, necessity of nutrition counseling, necessity of clinical nutrition and nutritional attitudes. The nutritional knowledge scores of the subjects in medical school and residents were significantly lower than those of the students majoring in food science and nutrition. Subjects of 91.3% strongly agreed to the necessity of nutrition counseling for patients ; 78.9% agreed that the present nutrition education in medical schools was inadequate. Most subjects (94.1%) agreed that clinical nutrition was an important field in the treatment of diseases. The medical profession is facing the challenges of the 1990s with the shift to outpatient care and preventative services. Clinical nutrition is an essential element in the process of curriculum change. The nutrition educator will be expected to take a leading role in integrating clinical nutrition into medical school curriculum.

• 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.

• Journal of the Korean Dietetic Association
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• v.18 no.3
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• pp.266-275
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• 2012

The purpose of this study was to evaluate the perception and needs of doctors on clinical nutrition services. A cross-sectional survey design was used. The doctors' perception and needs were assessed by questionnaires that had been specifically designed for the study. The research was conducted from February 14 to March 15, 2011 for 544 doctors at 42 large hospitals (with over 400 beds). Ninety-eight percent of doctors responded that clinical nutrition service was important. The mean scores of importance on clinical nutrition service were 4.45 for 'nutrition screening at admission', 4.50 for 'treatment of malnutrition', and 4.43 for 'nutrition education and counseling'. The mean scores of needs for clinical nutrition service were 4.42 for 'individual nutrition counseling & education' 4.39 for 'nutrition management for malnourished patients' and 'nutrition management for tube fed patients'. The medical specialists showed significantly (P<0.01) higher scores than the residents on the importance and needs for clinical nutrition services. Eighty-five percent of the doctors recognized the necessity of the specialized dietitians classified by diseases. The medical specialists (93.8%) showed significantly (P<0.01) higher recognition of this necessity than the residents (77.7%). The low residents' perceptions of the importance and needs for clinical nutrition services will necessitate clinical nutrition education plans. The departments of clinical nutrition in universities should improve the ability and skills of the clinical dietitians.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• Journal of the Korean Dietetic Association
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• v.21 no.2
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• pp.91-109
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• 2015

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

• Journal of Nutrition and Health
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• v.50 no.5
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• pp.519-529
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• 2017

Purpose: The purpose of this study was to explore whether or not there is a relationship between doctor's awareness of clinical nutrition service and needs for a clinical dietitian. Methods: A cross-sectional survey design was used. The research was carried out by using questionnaires that had been specifically designed for the study. The research was conducted from September to October, 2013 for 311 doctors at 43 hospitals (with over 400 beds). Frequency analysis, factor analysis, reliability analysis, confirmatory factor analysis, and bootstrapping analysis were conducted using SPSS 21.0. Results: 'Implementation of clinical nutritional service' (p < 0.001) and 'usefulness on clinical nutrition service' (p < 0.001) were found to be correlated with 'importance of clinical nutrition service' as an independent variable. The correlation between 'importance of clinical nutrition service' as a mediating variable and 'needs for clinical dietitian' as a dependent variable was also confirmed (p < 0.001). The results of the bootstrapping test showed that the mediating effect of 'importance of clinical nutrition service' was significant. The indirect effect value between 'implementation of clinical nutrition service' and 'needs for clinical dietitian' was 0.040, indirect effect value between 'usefulness on clinical nutrition service' and 'needs for clinical dietitian' was 0.095. Conclusion: The frequency of providing clinical nutritional services, the quality of clinical nutritional services, and the degree of implementation of clinical nutritional services were found to be important for positive perception of clinical nutrition services by doctors. Therefore, proper provision of clinical nutrition services and effective therapeutic effects will be continuously highlighted, which will increase the awareness of the physician and ultimately increase the demand for clinical nutrition service.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.235-246
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• 2014

The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

• Journal of the Korean Dietetic Association
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• v.22 no.1
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• pp.26-40
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• 2016

This study aimed to compare perception of job importance, job performance, and job difficulty between clinical dietitians working at small and medium hospitals in Busan. The survey was conducted from July 15 to August 31, 2014, and data were analyzed using the SPSS program. The mean scores for perception of job importance, job performance, and job difficulty of clinical dietitian's task elements were 3.88, 2.87, and 3.18 out of 5.0, respectively. Perception of job importance had a positive relationship with job performance. However, job performance showed a negative relationship with job difficulty. There were strong positive relationships among nutrition assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring & evaluation, nutrition research in perception of job importance (P<0.05, P<0.01). Nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition research showed positive relationships with job performance (P<0.05, P<0.01). There was also a positive relationship among clinical dietitian's task with job difficulty (P<0.05, P<0.01). These results suggest that it would be effective to adopt training programs for appropriate nutrition service and to provide continuous education programs for professional development.