• 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.

• Korean Journal of Community Nutrition
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• v.10 no.3
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• pp.331-340
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• 2005

The purpose of this study was to provide basic data to improve college food service satisfaction with sanitary, environment and service by comparing 2 contract-managed and 2 self-operated college food services in Daejeon and Chungnam area. According to the results, sanitation and environment satisfaction degrees of contract-managed college food services were higher than those of self-operated food services. The satisfaction degrees with service were also higher in contract-managed food services than self-operated food services except the category of quick food delivery. In all categories comprising the food service satisfaction, the satisfaction degrees were lower in female students than in male students. There were more negative self-perceived clinical symptoms in female students than male students. The higher the negative self-perceived clinical symptoms scores were, the lower the satisfaction degrees with food service were, which suggests that かe health state of students was one of the factors that influenced college food service satisfaction. There was no difference between contract-managed and self-operated food services in terms of satisfaction with overall food taste and overall satisfaction degree. The average satisfaction degree for the contractmanaged food services in terms of price relative to food quality was lower than that for self-operated food services. According to stepwise multiple regression analysis, 'overall food taste', 'price relative to quality', 'kindness of employees', 'coping with proposed opinions' and 'quicknless of food delivery' in decreasing order, were the most relatively important attributes for overall satisfaction. There should be further studies on important management factors to improve satisfaction with sanitary, environment and service by self-operated college food service.

• Korean Journal of Community Nutrition
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• v.20 no.3
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• pp.220-235
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• 2015

Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

• Clinical Nutrition Research
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• v.12 no.3
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• pp.177-183
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• 2023

Bariatric surgery is the most effective treatment for sustained weight reduction, and it can result in substantial improvements in the severity of type 2 diabetes, metabolic syndrome, nonalcoholic fatty liver disease, and quality of life. However, sleeve gastrectomy, a weight loss surgery that removes two-thirds of the stomach, reduces appetite and nutrient absorption, impairing digestion and the absorption of nutrients like iron, vitamin B₁₂, and protein-bound nutrients. This case study aims to demonstrate that patients undergoing sleeve gastrectomy require long-term and periodic monitoring of biochemical data, weight changes, and caloric and protein intake by a professional nutritionist to prevent malnutrition and nutritional deficiencies. In this case study, a 48-year-old woman was diagnosed with morbid obesity, hypertension, sleep apnea syndrome, and chronic gastritis. At initial evaluation, she was 160 cm tall and weighed 89 kg, with a body mass index of 34.8 kg/m². At 1 postoperative year, she consumed 650 kcal and 25 g of protein per day, the percentage of excess weight loss was 141.1%, and body mass index was 21 kg/m². Compared to preoperative levels, calcium and folic acid levels did not decrease after 1 postoperative year, but hemoglobin, ferritin, and vitamin B₁₂ levels decreased. In conclusion, when patients experience rapid weight loss after sleeve gastrectomy, follow-up should be frequent and long. Dietary education should be conducted according to digestive symptoms, and oral nutritional supplements, including vitamins and minerals.

• Journal of the Korean Dietetic Association
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• v.19 no.3
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• pp.265-286
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• 2013

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

• Journal of the Korean Dietetic Association
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• v.7 no.1
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• pp.38-49
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• 2001

This study was designed to analyze the dietetic practitioner's job in the over 600-ed hospitals in korea and to assess their labor time spent and staffing need indices. The actual time spent and expected labor time spent on dietitians' activities were investigated and the proper dietic staffing needs in the hospitals was also calculated. A job analysis questionnaires were developed and mailed to 20 hospitals. Completed questionnaires were received form 12 hospitals for a response rate of 60%. The followings are summary of the results. 1. The jobs dietitians at the hospitals were classified into the following 7 areas, direct patient care, indirect patient care, therapeutic patient care, education & counseling, meeting & research, delay & movement, and administration & food services. 2. The actual time spent on dietetic practice was 48.6 hours and expected labor time spent was 99.2 hours, Therefore, the proper time required to conduct classified jobs was 2.1 times higher than the time spent. Especially, the time required for performing clinical nutrition services including direct patient care, indirect patient care, therapeutic patient care was significantly higher than the time needed. 3. The average times required for the direct patient care was 1334.6min, for the indirect patient care was 796.3min, for the therapeutic patient care was 1634.5min, for the education & counseling was 265.2min, for the meeting & research was 366.7min, for the delay & movement was 327.3min, and for the administration & food services was 1170min. The staffing need indices was 12.3. As a conclusion, the standardized job descriptions for the dietitian to carry out their job at the hospital should be established. And the clinical dietitians as nutrition professionals have to be recruited to provide systematically hospitalized patients with medical nutrition therapy at each hospital.

• Korean Journal of Community Nutrition
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• v.24 no.6
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• pp.512-524
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• 2019

Objectives: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate. Methods: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification. Results: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, 'needs to provide nutrition counseling in children's hospitals', 'providing nutrition counseling services in working hospitals', and 'whether there is a nutrition counseling room' scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, 'self-assessment of food allergy knowledge understanding level', 'awareness of open oral food challenge (OFC)', 'recognition of the need for education and counseling on food allergy for patients / guardians', and 'food allergy related educational experience' scored higher among holders of clinical dietitians certificates than in non-holders. Conclusions: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.

• Journal of the Korean Dietetic Association
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• v.18 no.1
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• pp.59-71
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• 2012

The purpose of this study was to evaluate the patient perception of clinical nutrition service. The research was performed by using questionnaires and conducted from February 14 to March 15 at 42 hospitals (over 400 beds). 41.7% of patients experienced nutritional education and counseling. The mean score of the patients' perception on clinical nutritional service was 4.62/5.00 for "nutrition care is important for treatment of the disease", 4.49/5.00 for "diet therapy is necessary for treatment of the disease", 4.16/5.00 for "nutritional counseling call-centers are necessary", 4.13/5.00 for "nutritional consultation fee is required to apply insurance benefits", 4.12/5.00 for "one-to-one nutrition system is necessary", and 3.56/5.00 for "nutrition services I am willing to pay". The patients who had no past experience in nutritional education and counseling showed significantly higher scores for "nutrition care is important for treatment of the disease", "one-to-one nutritional care system is necessary", and "nutritional counseling call-centers are necessary" (P<0.05). The mean scores for the importance (4.26/5.00) and performance (3.88/5.00) of nutrition counseling service were significantly different (P<0.01). "Nutritional counseling is available whenever I want" had the highest gap score between performance and importance among nutrition counseling service items. The importance and performance grid showed that highly important items had high performance (doing great area) and less important items have low performance (low priority).

• Korean Journal of Clinical Pharmacy
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• v.8 no.1
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• pp.35-46
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• 1998

A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.

• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.183-198
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• 2014

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.