• Journal of Nutrition and Health
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• v.34 no.4
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Journal of Nutrition and Health
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• v.33 no.4
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• pp.464-476
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• 2000

The purpose of this study was to measure patient satisfaction with hosptial foodservices, and thereby identify areas for improvement and provides basic data for the introduction of total quality management into hospital foodservice in the Taegu·Kyungpook area. This survey was carried out on 676 hospitalized patients in 11 hospitals with over 200 beds to determine the quality satisfaction with foodservices. The subjects were 62.4% male and 37.6% female. Sixty-two percent of the subjects were over age 40, 46.7% were only educated to middle school or below, 41.8% were hospitalized for 1 - 10 days. Eighty-seven precent of the subjects did not receive any nutrition education. The expectation and perception grid showed that the high expectation to the low perception items were the seasoning of the meals, taste of the meals, and prompt dealings with meal complaints. The quality satisfaction values of all the attributes indicated a minus. The unsatisfied quality attributes were the opportunity to meet with a dietitian, seasoning of the meals, taste of the meals, explanation of the meals, and prompt dealings with meal complaints. Among the demographic characteristics, age, education, length of admission, and experience with nutrition education produced significant differences in the quality satisfaction scores. In conclusion, it would seem to be desirable that hospital foodservice department introduce selective menus, hygiene education for foodservice employees, standard recipes, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.

• Journal of Nutrition and Health
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• v.13 no.1
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• pp.9-14
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• 1980

A total of 35 hospitals throughout Korea were surveyed for the assessment of the educational function of dietitians. The current situation and the depth of practices were diagnosed in such areas as: 1. The continuing education for the hospital dietitians 2. The characteristics of patient consultation performed by the hospital dietitians 3. Systems and methods of patient instruction practiced by the dietitians, and 4. Prospectives in establishing the nutrition education center for the in-and out-patients. The major findings are: 1. Approximately half of the hospital dietitians feel positive about the practicality of their college education for the job. Extremely small number of them are on any kind of continuing education program 2) The monthly average of only 20 patients at one hospital receive diet consultation or nutrition education service from dietitians. The 50% of the consultation cases is taken up by the patients with diabetes and various circulartory diseases followed by the tube feedings, liver and renal diseases with less frequencies 3) Not even a single hospital has an office for the diet consultation and nutrition education for the in-or out-patients. Very few hospital dietetics have educational aids and/or any feedback system to evaluate the effect of the consultation. Charting is not practiced by most dietitians leaving no record of their contributions to the patient care. 4) Although the necessity of the nutrition education center in the hospital is strong1y recognized among dietitians the progress has been blocked by such obstacles as the poor system in the hospital administration in general, short in funds, lack of preparation in the dietetics and the lack of recognition both by the hospital administration and by the dietitian themselves.

• Journal of Nutrition and Health
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• v.40 no.3
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• pp.281-287
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• 2007

The purpose of this study was to measure patients satisfaction and expectation with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out on 383 hospitalized patients of 7 hospitals in Deagu, Busan, Changwon with 350 beds to determine the quality satisfaction with foodservices. The subjects were 50.5% male and 49.5% female. 62.6% of the subjects were over 40 age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7-14 days. The mean score for taste of diet was 2.79, temperature 3.23, appearances 2.96. Most subjects agreed with following foodservice characteristics that meals of movement (4.03), dress of employees (3.84), kindness of employees and meals arrived exactly the same time every day (3.47) and cleanliness of foods (3.34) and dishes (3.33). The unsatisfied quality attributies were information provide (2.82), variety of the meals (2.91), mixing of meals (2.95), the opportunity to meet with a dietitian (2.97) and prompt dealings with meal complaints (3.01). Most subjects expectation that the decrease the multiple of menus, increase provide of fruits in hospital meals and selective menus in hospital foodservices operations. In conclusion, it would seem to be desirable that hospital foodservices departments introduce selective menus, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.71-78
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• 2017

Child obesity has become a significant health issue in Korea. Prevalence of obesity in school-age children in Korea has been alarmingly rising since 2008. Prevalence of obesity among infants and preschool-age children in Korea has doubled since 2008. Obese children may develop serious health complications. Before nutritional counseling is pursued, several points should be initially considered. The points are modifiable risk factors, assessment for child obesity, and principles of treatment. Motivational interviewing and a multidisciplinary team approach are key principles to consider in managing child obesity effectively in the short-term as well as long-term. Nutritional counseling begins with maintaining a daily log of food and drink intake, which could possibly be causing obesity in a child. Several effective tools for nutritional counseling in practice are the Traffic Light Diet plan, MyPlate, Food Balance Wheel, and 'Food Exchange Table'. Detailed nutritional counseling supported by a qualified dietitian is an art of medicine enabling insulin therapy and hypoglycemic agents to effectively manage diabetes mellitus in obese children.

• Journal of the Korean Dietetic Association
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• v.11 no.4
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• pp.381-392
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• 2005

This study compared he importance of food service, views to the performance, management objectives, and recognition gap about the contract contents towards the dietetic departments of hospitals that manage the patients' food service and managers of contract managed companies, and dieticians. It conducted questionnaires and survey towards the vice director and dieticians of 17 hospitals, over 500 beds, and the persons responsible for contract managed companies and dietitians who were in charge of food service. The hospitals showed significantly(p<0.05) higher the importance scores in menu planning, the distribution of meal, sanitation management, and leadership than those of the contract managed companies. In the difference of hospitals and contract managed companies about performance, it appeared high in the contract managed companies. In the importance of the foodservice management objective, the hospital had significantly(p<0.05) higher scores in the management of client's satisfaction and quality improvement element through management innovation than those of the contract managed companies. In the importance of contract term, the contract method, expense, and payment condition of commission fee were significantly(p<0.05) high scores in the contract managed companies, compared to the hospital.

• Journal of the Korean Dietetic Association
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• v.18 no.1
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• pp.72-80
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• 2012

This study examined the effects of custom nutrition education on dietary intakes and clinical parameters in patients diagnosed with iron deficiency anemia. A total of 34 patients visited the anemia clinic of Yeouido St. Mary's Hospital. Among these, only 16 patients were available for follow-ups. A follow-up was conducted by a clinical dietitian 2 months from the first nutrition education session. Patients were all women. For custom nutrition education, we investigated anthropometric data, dietary assessment (24 hr-recall, FFQ), and self-recognized anemic symptoms. Weight did not show a significant difference but hemoglobin, hematocrit (P<0.01), serum iron, and serum ferritin (P<0.05) were significantly increased after the nutrition education. Serum total iron binding capacity was significantly decreased (P<0.01). Self-recognized symptoms such as dizziness, fatigue (P<0.001), shortness of breath, headache (P<0.01), brittle nails, and sore tongue (P<0.05) were significantly improved. Daily intakes of protein (P<0.05), total iron (P<0.01), and animal iron (P<0.001) were significantly increased. A significantly negative correlation was observed between current serum iron and the intake of carbohydrates, fat, or phosphorus (P<0.05). But current serum ferritin showed a significantly positive correlation with the frequency of intake of meat, poultry, and fish. It could be concluded that the custom nutrition education might be effective on quality of diet as well as iron status and it might also improve the clinical parameters in patients diagnosed with the iron deficiency anemia.

• Journal of the Korean Dietetic Association
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• v.21 no.4
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• pp.261-279
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• 2015

This study aimed to investigate the effects of job satisfaction and self-esteem on psychological burnout in dietitians at a geriatric hospital in Busan. The survey was conducted from July 8 to August 31, 2014, and the data were analyzed using the SPSS program. The age group of over 36 years showed higher job satisfaction than the 'Under 25' group. Subjects that worked less than 2 years at their present jobs showed lower job satisfaction in job-itself than the 'Over 4 years' group did, and those who worked less than 1 year showed lower job satisfaction in terms of communication, appraisal compensation, and co-workers than did the other groups. Those who worked in '100~149 bed' hospitals showed higher job satisfaction than those in the 'Under 100 bed' group did. 'Over 200 bed' hospital dietitians showed higher satisfaction in supervision of superiors than did the other groups. Their experience of psychological burnout turned out to be 2.39 out of 5. Psychological burnout had a negative relationship with job satisfaction and self-esteem. Higher emotional exhaustion correlated with lower satisfaction in job-itself, less communication, and less supervision of superiors. Dehumanization correlated with lower satisfaction in job-itself, lower self-esteem, and worse communication, and while decreased personal achievement correlated with lower self-esteem, worse co-workers, lower satisfaction in job-itself, worse appraisal compensation, and worse communication. These results suggest that it would be effective for prevention and management of psychological burnout to mediate factors of job-itself, communication, supervision of superiors, co-worker, and appraisal compensation of dietitians in geriatric hospitals.