• Title/Summary/Keyword: clinical nutrition support

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Analysis of the Prevalence and Risk Factors of Malnutrition among Hospitalized Patients in Busan

  • Lee, Ha-Kyung;Choi, Hee-Sun;Son, Eun-Joo;Lyu, Eun-Soon
    • Preventive Nutrition and Food Science
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    • v.18 no.2
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    • pp.117-123
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    • 2013
  • This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

The Medical Staffs' Perception about Nutrition Care (의료진의 병원영양관리에 대한 인식조사)

  • Ryu, Eun-Sun;Lee, Song-Mi;Eom, Yeong-Ram
    • Journal of the Korean Dietetic Association
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    • v.4 no.1
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    • pp.40-52
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    • 1998
  • This study was undertaken to identify medical staffs’ perception about nutrition care and dietitian's role in hospitals. Questionnaires were sent to 874 medical staffs at 50 general hospials size over 100 beds, located in Seoul and Pusan, A total of 649(74.3%) of medical staffs returned questionnaries from 47 general hospitals. The results of this study can be summarized as follows. 1. 89.6% of medical staffs responded that they required the help of the dietitian when the patients needed the nutrition acre and also most of them(87.0%) held positive perceptions about the necessity of the nutrition support team. 2. When the medical staffs prescribed the special diet of the patients' nutrition care, 90.0% of them preferred that diet would be order after consulting with dietitian. 3. Half of the medical staffs(52.1%) responded that they were scarced of the knowledge about the clinical nutrition and then 66.4% of them recognized the need of nutrition education at the medical school. 4. The medical staffs responded that dietitian must have the knowledge about food, nutrition and medical science(52.5%) and the competence of discussion with medical staffs about nutrition the patients(30.8%).

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Enteral nutrition of the premature infant

  • Cho, Su Jin
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.7-13
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    • 2010
  • Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

Validation of initial nutrition screening tool for hospitalized patients (입원 환자용 초기 영양검색도구의 타당도 검증)

  • Kim, Hye-Suk;Lee, Seonheui;Kim, Hyesook;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.52 no.4
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    • pp.332-341
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    • 2019
  • Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

A Comparison of Clinical Nutrition Knowledge and Nutritional Behavior of College Students Majoring in Korean Oriental Medicine vs. College Students Majoring in Food and Nutrition (한의학 전공 대학생과 식품영양학 전공 대학생의 임상 영양지식과 영양 실천도 비교)

  • 원향례;박미원
    • The Korean Journal of Community Living Science
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    • v.15 no.2
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    • pp.151-157
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    • 2004
  • This study examined two groups of students Korean Oriental Medicine majors and Food and Nutrition majors and compared their knowledge of clinical nutrition as well as their tendency to follow healthy lifestyles. In all, 204 college juniors and seniors majoring in Food & Nutrition, and 324 sophomores majoring in General Korean Oriental Medicine were given a questionnaire. Overall, knowledge of clinical nutrition(out of twenty questions) was significantly higher among the students majoring in food and nutrition (p<0.01). Specifically, these students obtained a higher score in the questions pertaining to the following topics: nutritional support(p<0.05), the relationship between menopause and blood cholesterol(p<0.01), the relationship between weight control and carbohydrates(p<0.01), the relationship between gout and protein(p<0.10), the relationship between hyperlipidemia and carbohydrates(p<0.01), the relationship between trans fatty acids and atherosclerosis(p<0.01), the relationship between blood potassium levels and kidney disease(p<0.01), and the relationship between weight control and diet and water(p<0.05). Conversely, students studying General Korean Oriental Medicine had a better knowledge of the relationship between malnutrition and the mortality rate and health complications(p<0.01). The questions relating to a healthy diet and lifestyle indicated that students majoring in Food and Nutrition had higher incidences of diet irregularity and a higher missing rate (p<0.01); they were more interested in calorie content and nutrients in their diet(p<0.05); and they were more likely to study about nutritional knowledge during their leisure time (p<0.01). The results also indicated, however, Korean Oriental Medicine students consumed proportionally more vegetables(p<0.05); and they were more likely to take the stairs than the elevator(p<0.01).

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New Role and Implications of Japanese Clinical Laboratory Technologists through Team Medical Care (팀 의료에서 일본 임상병리사의 새로운 역할과 시사점)

  • Bon-Kyeong KOO;Min Woo LEE;Sang Hee LEE;Byoung Ho CHOI
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.3
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    • pp.213-218
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    • 2023
  • When it comes to 'Team Medical Care' in Japan, clinical laboratory technologists have actively engaged in various kinds of teams, such as a diabetes team, a nutrition support team, an infection control team and a medical practice support team. Overall, with continual changes in the medical environment, clinical laboratory technologists are recently being required to not only conduct phlebotomy, specimen collection, laboratory testing, and electrocardiography, but also get actively involved in 'medical practice assistance or support' in collaboration with medical doctors and nurses. Therefore, it is anticipated that resident clinical laboratory technologists in wards or emergency rooms in Korea will be better able to contribute to improving medical quality and securing medical safety by functioning as a link to the clinical laboratory, while medical doctors and nurses will have a reduced burden of work and can dedicate themselves to better patient care.

Different Perceptions of Clinical Nutrition Services between Doctors and Dietitians in the Busan-Gyeongnam Area (임상영양서비스에 대한 부산.경남지역 의료진과 영양사의 인식 차이)

  • Choi, Jiyoung;Park, Eunju
    • Journal of the Korean Dietetic Association
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    • v.19 no.1
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    • pp.69-81
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    • 2013
  • 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.

Nutritional Support for Neurocritically Ill Patients (신경계 중환자의 영양 집중 치료)

  • Jeong, Hae-Bong;Park, Soo-Hyun;Ryu, Ho Geol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.71-80
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    • 2018
  • Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

Exploring the Impact of Appetite Alteration on Self-Management and Malnutrition in Maintenance Hemodialysis Patients: A Mixed Methods Research Using the International Classification of Functioning, Disability and Health (ICF) Framework

  • Wonsun Hwang;Ji-hyun Lee;Se Eun Ahn;Jiewon Guak;Jieun Oh;Inwhee Park;Mi Sook Cho
    • Clinical Nutrition Research
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    • v.12 no.2
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    • pp.126-137
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    • 2023
  • Hemodialysis (HD) patients face a common problem of malnutrition due to poor appetite. This study aims to verify the appetite alteration model for malnutrition in HD patients through quantitative data and the International Classification of Functioning, Disability, and Health (ICF) framework. This study uses the Mixed Method-Grounded Theory (MMGT) method to explore various factors and processes affecting malnutrition in HD patients, create a suitable treatment model, and validate it systematically by combining qualitative and quantitative data and procedures. The demographics and medical histories of 14 patients were collected. Based on the theory, the research design is based on expansion and confirmation sequence. The usefulness and cut-off points of the creatinine index (CI) guidelines for malnutrition in HD patients were linked to significant categories of GT and the domain of ICF. The retrospective CIs for 3 months revealed patients with 3 different levels of appetite status at nutrition assessment and 2 levels of uremic removal. In the same way, different levels of dry mouth, functional support, self-efficacy, and self-management were analyzed. Poor appetite, degree of dryness, and degree of taste change negatively affected CI, while self-management, uremic removal, functional support, and self-efficacy positively affected CI. This study identified and validated the essential components of appetite alteration in HD patients. These MM-GT methods can guide the selection of outcome measurements and facilitate the perspective of a holistic approach to self-management and intervention.

The iron status, clinical symptom and anthropometry between normal and anemic groups of middle school girls

  • Hong, Soon-Myung;Cho, Jee-Ye;Chung, Hea-Jung
    • Nutrition Research and Practice
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    • v.1 no.1
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    • pp.52-56
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    • 2007
  • This research analyzed the iron status, clinical symptoms and physical characteristics between normal and anemic group of middle school girls in the Ulsan metropolitan area. It was carried out with 237 subjects (normal 190, anemic subject 47). They were evaluated with a questionnaire and measurement of hematological indices. BMI $(kg/m^2)$ of the two groups were $19.54{\pm}2.44$ (normal girls) and $19.22{\pm}2.27$ (anemic girls). The hemoglobin concentration of the anemic girls were $10.84{\pm}1.17g/dl$ and the serum iron of the anemic girls represent $35.15{\pm}27.47{\mu}g/100ml$. The TIBC (Total Iron Binding Capacity) of the anemic girls showed significantly high to $449.30{\pm}64.87{\mu}g/100ml$. The serum ferritin of the anemic girls was $20.53{\pm}42.29{\mu}g\ell$, it represented significantly low. The symptom of 'pale face' of the anemic girls were higher than the normal girls. Hemoglobin and serum iron were negatively correlated with 'pale face'. The TIBC was negatively correlated with 'Get a cold easily'. The duration and amount of menstruation were correlated with iron status. This research is to be utilized as basic data for dietary support and nutritional education to improve their iron status.