• 대한지역사회영양학회지
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• 제14권2호
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• pp.236-244
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• 2009

Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy(4.00) was higher than those who had not practiced diet therapy(P<0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education(3.59) was higher than those who had no nutrition education(P<0.05) and subjects who had practiced diet therapy showed higher score(3.59) than those who had not practiced diet therapy(P<0.05). 'Exercise behaviors score' of subjects who were over 60(3.59) was the lowest(P<0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores(3.38) than those who had no nutrition education(P<0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores(3.72) than those who had not practiced diet therapy(P<0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores(3.78) concerning BMI(P<0.05). In conclusion, this study expected that Nutrition educators(Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.

• 대한지역사회영양학회지
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• 제18권3호
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• pp.213-222
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• 2013

Few studies investigated the effects of nutrition education and exercises in women with osteopenia. This study examined the relationship between changes in dietary intakes and changes in indicators related to bone health in postmenopausal women with osteopenia (-2.5 ${\leq}$ T-score ${\leq}$ 1) after a 12-week intervention. Thirty-one postmenopausal women aged > 50 years residing in Seoul were recruited and participated in nutritional education regarding bone health and general nutrition practices and aerobic exercises (three times a week; 60 min per session). Twenty-five subjects completed the study and were eligible for the analysis. Bone mineral density (BMD) at femoral neck was measured by dual energy x-ray absorptiometry. Serum calcium, osteocalcin, and intact parathyroid hormone (PTH) were also measured. Dietary intake was estimated by using a one-day 24 recall by a clinical dietitian. After 12 weeks, meat consumption increased (P = 0.028) but vegetable intake decreased (P = 0.005). Intakes of animal protein (P = 0.024), vitamin B1 (P = 0.012) and vitamin $B_2$ (P = 0.047) increased, and sodium intake decreased (P = 0.033). Intact PTH (P = 0.002) decreased and osteocalcin (P = 0.000) increased, however, BMD decreased (P = 0.000). Changes in mushroom consumption were positively correlated with femoral neck BMD (r = 0.673, P = 0.003). Changes in animal iron intake were negatively correlated with intact PTH (r = -0.488, P = 0.013) but were positively correlated with osteocalcin (r = 0.541, P = 0.005). These results suggested that the association between animal iron intake and biochemical markers of bone turnover may play an important role in bone metabolism. Further studies are needed to shed light on complicated mechanisms of diet, hormonal levels of bone metabolism, and bone density.

• 한국식생활문화학회지
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• 제14권4호
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• pp.431-446
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• 1999

The purpose of this study is to examine current foodservice management practices at free congregate meal service for elderly people. Forty seven meal service centers as well as randomly selected Seoul and Kyunggido area were surveyed and interviewed and results were summarized as follows: The cost of each meal(lunch) was ranged from 1,300 won to 1,500 won and 68% of target centers were severed over 100 meals per day. Meal time for lunch begins from 10:30 am to 12:00 because great portion of elderly didn't take breakfast frequently. 52.3% of centers severed meal 5 times per week, just weekdays. 21.3% of centers employeed dietitian, 63.8% of center employeed cook. 95.7% of center were supported labor force by volunteers. Volunteer was important contribution to free meal service. Utilizing the labor force more effectively is thus a major challenge facing manager in each center. Ideal supporting system of free foodstuff, foodbank was still minor source of securing foodstuff. Most of centers(46 centers)served lunch, only one of them served breakfast and lunch. Government was the major financial sponsor, the second of them was religious organization. The large portions of financial support provided only food cost of total meal service budget. Most of center adapted self-service system. Standardized recipes were not developed and meal preparation was controlled under the experience of volunteers. Recording system of nutrition management, production control, storage and inventory control was not adapted by most of sites. It is suggested that in order to meet the change of the patterns of social and family structure, the service of the center should be offended in urban area and it is necessary to develop systematic management models for the center. It was suggested that not only financial support but also systematical support on management by the local government may be necessary to meet the goal of supply nutritionally balanced food at center.

• Journal of Nutrition and Health
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• 제39권4호
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• pp.403-416
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• 2006

The purpose of this study was to investigate the practice of nutrition education and perceptions for implementing nutrition education in elementary schools. In this survey, 833 dietitians, 808 principals and 3,141 teachers across the country were asked about the present status and problems as well as necessity, methods, education time, education subjects and the proper nutrition educator ratio. The results of the survey showed that only 4.2% of dietitians implemented nutrition education during regular school hours or through special activities. Many subjects responded that the reasons for not practicing nutrition education were systematic problems of lack of time due to too much food service work. Especially, many rural area dietitians responded that the reason was lack of time due to joint management and cooking. Many dietitians, principals and teachers responded that the placement of one nutrition teacher in every school is needed to resolve these problems. Other solutions suggested were the introduction of a dietitian internship, and the modernization of foodservice facilities for principals and teachers. Of those surveyed 98.4 percent of principals and 95.5 percent of teachers responded that nutrition education is urgently needed. Many subjects also responded that the first three years of elementary school are the most proper time for nutrition education and it is best that these lessons are reinforced at least once a month through discretional or special activities. Survey participants responded that the proper ratio for nutrition educators is 400-800 persons for dietitians compared to less than 400 persons for principals. In conclusion, it is hoped that this study will be able to provide a foundation of data for implementing a systematic nutrition education program by nutrition teachers in elementary school.

• Journal of Nutrition and Health
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• 제39권4호
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• pp.417-425
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• 2006

The purpose of this study were to a) investigate operation of human resource in contract foodservice management company (CFMC), b) identify the staffing indices for the establishment an labor productivity for CFMC, and c) develop standardized model of staffing demand as foodservice's scale in CFMC. The data was collected using FS intra-net system from 138 contract-managed foodservice operations in A CFMC and statistical analysis was completed using the SAS/win package (ver. 8.0) for description analysis, ANOVA, Duncan multiple comparison, pearson correlation analysis, and regression analysis. The types of operation were included factory (45%), small scale operation (26%), office (11%), department store (10%), training institute (4%), and hospital (3%). The distribution of foodservice scale was classified by meal served was as follows; 'less than 500 meals (47%)', 'from 500 to 1500 meals (25%)', 'from 1500 to 2500 meals (17%)', and 'more than 2500 meals (12%)'. There was two types of contract method, fee-contract (53%) and profit-and-loss contract (46%) Some variables were significantly high operation indices such as selling price, food cost, monthly sales, net profit and others were significantly low operation indices such as labor, meal time a day in the small foodservice on meal scale (p<.001). The more foodservice was large, the more human resource was disposed on dietitian, cook, cooking employee altogether (p<.001). Foodservice in A CFMC was divided into 2 groups by 500 meals a day, according to comparative analysis of labor productivity as meal scale per working hour, meal scale a day and operation indices as meal per foodservice employee, meal per cooking employee (p<.001). The regression equation model was developed as 'the number of employees=1.82+0.014 ${\times}$ meal served' in the operation of less than 500 meals, 'the number of employees=9.42+0.013 ${\times}$ meal scale a day -0.94 ${\times}$ meal scale per working hour' in the operation over 500 meal scale using labor productivity indices and operation indices. Therefore, CFMC could be enhanced efficiency of human resource arrangement using the standardized model of staffing demand and would be increased effectiveness of profit.

• 대한영양사협회학술지
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• 제20권4호
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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.

• 대한영양사협회학술지
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• 제20권4호
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• pp.257-274
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• 2014

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

• 대한영양사협회학술지
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• 제3권1호
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• pp.9-22
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• 1997

Purposes of the study were to : (a) measure the levels of job satisfaction, (b) investigate the degree of job characteristics, (c) determine the levels of organizational commitment, (d) investigate relationships between demographic variables and job satisfaction, and (e) examine the relationship between organizational commitment, job characteristics and job satisfaction. Questionnaire was developed and mailed to 300 dietitians who are currently working in school, hospital and industry foodservices. A total of 177 questionnaires were usuable : resulting in a 59% response rate. Results of this study were summarized follows : 1. Approximately half of the respondents(46.9%) indicated that the were 26 to 30 years old. A total of 112 respondents(63.3%) were unmarried. A bachelor's degree was reported as the most common education level(46.9%) while 6.2% of the participants reported a master's degree. Years of employment in professional practices were ranged from 2 to 5. Approximately 40% of the respondents had earned over \900,000 per month. 2. Work itself of the JDI was with the highest job satisfaction mean score followed by supervision, co-workers, wage and promotion. 3. In total job satisfaction score, dietitians in school foodservices were a significant lower than dietitians in industry foodservices and hospital foodservices. 4. A significant relationship was found for demographic factors and four job facets in terms of job itself, co-workers, and promotion. 5. A work itself was the most improtant facet th the dietitian followed by wage and promotion. 6. Task identity of the JCI facets was the most prevalent job characteristics followed by variety, dealing with others, feedback and friendship. 7. Three groups of dietitians had no significant difference in total job characteristics score. 8. A group of dietitians with a higher job satisfaction score had a significant higher score in job variety and job autonomy. 9. Organizational commitment mean score with dietitians was 1.88. 10. Job satisfaction score for five facets and total job satisfaction were significantly correlated with organizational commitment score.11. Job charateristics with job variety, job autonomy, feedback, task identity, friendship were positively correlated with organizational commitment.

• 대한지역사회영양학회지
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• 제7권6호
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• pp.852-862
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• 2002

The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

• 한국식품영양과학회지
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• 제41권7호
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• pp.1020-1027
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• 2012

본 연구는 학교급식 영양(교)사들이 인식하는 메뉴 속성별 중요도와 수행도를 분석함으로써 학교급식 메뉴 운영 현황을 파악하여 향후 학교급식에서의 효율적 메뉴 운영을 위한 기초자료를 제공하고자 실시되었다. 2010년 9월 29일부터 10월 19일까지 전국의 학교급식 영양(교)사 448명을 대상으로 설문조사를 실시하였고, 총 292부가 통계분석에 이용되었다. 먼저 총 21개 메뉴속성 항목에 대해 탐색적 요인분석을 실시한 결과, '영양', '교육적 효과', '생산 능력', '품질관리 용이성', '효율성', '선호도' 등 6개 요인이 도출되었다. 메뉴속성 중요도와 수행도에 있어 영양교사들이 영양사들에 비해 메뉴의 영양적 부분에 대한 중요도를 높게 평가하고 있었고(p<0.01), 학생선호도의 경우 영양교사에 비해 영양사들이 인지한 중요도가 유의적으로 높게 나타났다(p<0.05). 수행도의 경우 영양 요인(p<0.05)과 교육적 효과 요인(p<0.001)에서 영양교사의 수행도가 유의적으로 높게 나타났고, 전체적인 수행도 역시 영양교사 집단에서 유의적으로 높았다(p<0.01). 학교급에 따라서는 초등학교 영양(교)사의 영양에 대한 중요도 인식 수준이 고등학교 영양(교)사에 비해 유의적으로 높게 나타났고(p<0.001), 수행도의 경우 영양과 교육적 효과 요인에서 초등학교 영양(교)사의 수행 수준이 중학교와 고등학교에 비해 유의적으로 높게 나타났다(p<0.001). 영양(교)사가 평가한 학교급식 메뉴속성에 대한 중요도 수행도 분석 결과에서는 전통적인 방법으로 분석한 결과 영양사, 영양교사 모두 시급한 개선이 필요한 영역과 과잉 수행되고 있다고 평가되는 영역에 아무 요인도 포함되지 않아 전반적으로 급식 운영이 효율적으로 이루어지고 있는 것으로 나타났다. 하지만 gap 분석방법으로 중요도 수행도 분석을 실시한 결과 영양사와 영양교사 집단 모두 효율성 요인만이 중요도에 비해 수행도가 높은 오른쪽 영역에 위치하고 나머지 항목 모두 수행도가 낮은 왼쪽 영역에 위치하여 개선이 필요한 것으로 평가되었다. 추가적인 분석에서 영양사 집단은 영양, 교육적 효과, 학생 선호도 요인에서, 영양교사 집단은 교육적 효과 요인에서 중요도에 비해 상대적으로 낮은 수행도를 보여 우선적으로 개선되어야 할 항목들로 평가되었다. 따라서 메뉴와 연계한 식생활 교육 등 메뉴 운영기법 개선에 대한 보다 많은 관심과 연구가 이루어져야 할 것으로 보인다.