• Title/Summary/Keyword: hospital dietitians

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Nurses' Perception on Clinical Nutrition Services by Types of Medical Institution and Area (병원 유형 및 지역에 따른 임상영양서비스에 대한 간호사의 인식)

  • Lee, Han Na;Lee, Song Mi;Park, Yoo Kyung;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
    • 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.

Analysis of Current Operational Practices and Issues of Contract-Managed Foodservice Companies in Republic of Korea (위탁급식 전문업체의 운영 현황 조사 및 현안과제 분석)

  • Eom, Yeong-Ram;Ryu, Eun-Sun
    • Journal of the Korean Dietetic Association
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    • v.9 no.3
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    • pp.197-208
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    • 2003
  • This study was surveyed to provide the information on current operational practices and issues of contract-managed foodservice companies. Questionnaires were distributed to 79 contract-managed foodservice companies (eight large-size, 48 mid-size, 23 small-size companies) from March to May in 2002. The contract-managed foodservice companies provided averages of 269,184 (range 140,036-503,500), 14,837 (range 450-75,269), and 4,065 (range 930-8,050) meals daily from large, medium, and small-size companies, respectively. The companies managed to averages of 268.2 (160-619) foodservice contracts at large-size companies, 21.9 (5-63) contracts at mid-size companies, and 4.7 (1-10) contracts at small-size companies. The average numbers of dietitians were 298.6 (range 104-671) in large-size companies, 22.2(6-86) in mid-size companies, and 3.8(1-9) in small-size companies. The averages of sales were 156.5 billion at large-size companies, 6.7 billion at mid-size companies, and 1.7 billion at small-size companies in 2001. The contract was two types including management fee contract(5%), and profit and loss contract(95%). The cost ratios for office foodservice were 59.5% at food cost, 24.2% at labor cost, 6.3% at profit, and 10.1% at other cost. For hospital foodservice, the ratios were 54.0% at the food cost, 34.6% at labor cost, 3.0% at profit, and 11.8% at other cost. For high school foodservice, the ratios were 62.2% at the food cost, 21.5% at labor cost, 5.4% at profit, and 11.2% at other cost. When the contractors managed to the foodservice, the most important matters were the sanitation management and customer satisfaction. Also, the difficult problems were excess investment of equipments and low meal prices.

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A Study on Knowledges and Attitudes about Breast Milk Feeding and Needs for Breast Milk Feeding Education among High School Students (고교생의 모유영양 지식과 태도 및 모유수유 영양교육 요구)

  • Choi Kyung-Suk;Lee Hee-Jeong
    • Korean Journal of Community Nutrition
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    • v.11 no.2
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    • pp.191-204
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    • 2006
  • This study was carried out to investigate the experiences of breast milk feeding information and education, breast milk feeding knowledge and attitude and needs for breast milk feeding nutrition education of high school students to encourage breast milk feeding. The subjects were 565 (male: 250, female: 315) high school students from first to third grade. The results obtained were as follows: In this survey, only 30.0% of subjects experienced breast milk feeding information and only 6.1% of subjects had breast milk feeding education. And the subjects showed the average scores of knowledge of breast milk feeding were 0.29 points of 1 point. Subjects knew well about ingredients of breast milk but they didn't know well about the physiology and method of breast milk feeding and benefits of breast milk feeding for mothers. The average scores of attitude of breast milk feeding were 3.03 points of 4 points, showed slight positive attitudes of breast milk feeding, but they had negative attitudes of emotional and practical aspects. The future plan of feeding practices was breast milk feeding 35.9% and 60.0% of formula milk feeding. A concern was that the students showed high ratio of formula milk feeding plan and they decided by incorrect knowledge of breast milk feeding. The 33.5% of students answered high school students will need breast milk feeding nutrition education, and they thought hospital faculties were the proper educators of breast milk feeding education, but dietitians were recomended as educators because of easy access at school and good knowledge of life-cycle nutrition. Therefore, to encourage breast milk feeding by mothers and supporters of breast milk feeding, breast milk feeding nutrition education is needed urgently among high school male and female students. And nutrition education programs will have to contain benefits of breast milk for babies and mothers and physiology and practical methods of breast milk feeding to improve emotional and practical attitudes for breast milk feeding. Nationwide campaign to promote breast milk feeding at public areas will be needed.

Importance-Performance Analysis of Clinical Nutrition Management in Convalescent Hospitals in the Gyeongnam Area (경남지역 요양병원 임상영양관리에 대한 중요도와 실행도 분석)

  • Lee, Seon-Jeon;Park, Eunju
    • 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.

A Study on Tube Feeding Practices of Adult In-patients (병원 성인 환자의 경관급식에 관한 연구)

  • 한경희
    • Journal of Nutrition and Health
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    • v.25 no.7
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    • pp.668-683
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    • 1992
  • To evaluate the current practices of the tube feeding and the status of tube feeding patient 76 adult in-patients at 6 hospitals located in Seoul and Chung-buk province were examined through reviewing patient charts observing patients and interviewing patients nurses dietitians patients' family or care-givers. The results were as follows : 1) An average age of the patients was 54.5 years with 41% over 60 years old. Patients with decreased mental status dysphagia esophageal obstruction and respiratory problem were fed by tubes. 2) The range of duration of tube feeding is between 4 days and 6 years. Most patients were received formula through nasogastric tube(89.5%) while 7.9% of gastrostomy and 2.6% of jejunostomy. Administration method for formula were bolus feeding regardless of the route of formula delivery. 3) Mean total calories received for men were 1590 kcal and 1450 kcal for female. Mean volume per meal was 282m, l and mean frequency of feeding was 5.68 while mean feeding interval 3$\frac{1}{4}$ hours and mean rate of infusion 68.4ml/min. All patients received hospital-blenderi-zed formula as the major source of nutrition. Home-blenderized formula and commercial formula as a supplement were used 35%, 13.2% respectively. 4) Thirty-eight percent of patients was hypoalbuminemia and 61% was at the moderate level of deficiency in hemoglobin. 5) Complications associated with tube feeding were diarrhea (22.4%) constipation(21.1%) vomiting(11.8%) and so on. 6) Serum albumin levels of patients who have complications associated with tube feeding were significantly lower than those of patients without complications In planning a tube feeding regimen the type of a formula must be integrated with both a delivery system and a protocol for administering the tube feeding. the multidisciplinary effort required to deliver enteral therapy is essential to improve current practices used at hospitals.

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The Effects of a Comprehensive Education Program on Knowledge, Self-Efficacy, and Coping Style among Newly Diagnosed Patients with Breast Cancer (통합적 교육프로그램이 진단 직후 유방암 환자의 지식, 자기효능감 및 대응방식에 미치는 효과)

  • Lee, Keon-Suk;Lee, Ran;Kim, Dong-Mi;Kim, Soo-Hyun
    • Asian Oncology Nursing
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    • v.12 no.1
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    • pp.35-43
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    • 2012
  • Purpose: The purpose of the study was to identify the effect of a comprehensive education program on knowledge, self-efficacy for self-management, and coping style among newly diagnosed patients with breast cancer. Methods: This study used a one group pretest-posttest design. Data were collected from April to September, 2010 at a cancer-specific hospital in Goyang, Korea. One hundred forty three women received a comprehensive education program consisting of 3 sessions composed of 8 themes was conducted by several experts (nurses, doctors, dietitians and clinical psychologists) for 3.5 hours a day for 3 days (1 day before and 2 days after the operation). Results: This study showed that knowledge and self-efficacy for self-management significantly increased after education (p<.001). In terms of coping style, however, only the subscale, 'anxious preoccupation', significantly improved (p=.001) among 5 sub-scales of coping style after education. Conclusion: A comprehensive education program for newly diagnosed patients with breast cancer was effective for increasing the knowledge and self-efficacy for self-management of breast cancer, in addition to decreasing the coping style of 'anxious preoccupation'. However, it did not improve other coping style. Therefore, other strategies for improving coping style are needed.

Establishment of accreditation criteria for nutrition and dietary education materials (영양.식생활 교육자료의 인증 심사기준 개발 연구)

  • Lee, Kyoung Ae;Kim, Ji-Myung;Park, Yoo Kyoung;Lee, Kyung-Hea;Oh, Sang Woo;Lee, Hee Seung
    • Journal of Nutrition and Health
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    • v.46 no.5
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    • pp.470-481
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    • 2013
  • This study provides standardized scientific criteria for education materials on nutrition and diet that could be used in schools, workplaces, and health and medical facilities. The study was conducted from April 2011 to October 2011. Literature reviews, institutional visits, and telephone interviews were conducted for the first draft of the accreditation criteria. Expert meeting and advisory councils were conducted in order to obtain feedback after development of the first draft of accreditation criteria. In order to verify the validity and reliability of the first draft on certification criteria, a survey was sent out to 143 professionals, including professors, researchers, health and medical experts, teachers, nutrition teachers, dietitians, and clinical nutritionists. After several modifications, the final accreditation criteria were established for 1) printed materials (authority, credibility, objectivity, organization, editing, real-life usability, activities and participation, and public interest), 2) web-sites (authority, credibility, objectivity, design, real-life usability, accessibility, currency, and public interest) and 3) materials with activities (credibility, organization, design, convenience of utilizing, safety, and public interest). Out of several criteria, contents (authority, credibility. and objectivity) and publicity (public interest) areas are mandatory requirements. For the accreditation, books for learning and materials with activities are required to meet more than six evaluation components, and the other materials are required to meet more than five evaluation components, including the required area. Accreditation criteria developed in this study could be used as a standard for development or selection of good education materials for nutrition and dietary life.

Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas

  • Dong-Yeon Kim;Hee-Jae Suh
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.729-738
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    • 1998
  • In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritionally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group of heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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Intakes of Energy and Nutrients and Risk of Breast Cancer - Case-Control Study in Daegu.Gyeongbuk Area, Korea - (영양소 섭취 수준과 유방암 위험 - 대구.경북지역 환자-대조군 연구 -)

  • Lee, Eun-Ju;Lee, Won-Kee;Suh, Su-Won;Suh, Bo-Hyun;Lee, Hye-Sung
    • Journal of Nutrition and Health
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    • v.41 no.8
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    • pp.754-766
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    • 2008
  • This study was performed to evaluate the effect of nutrient intake levels on the relative risk of breast cancer in the Daegu and Gyeongbuk area. The case subjects were 103 patients newly diagnosed as breast cancer at Kyungpook National University Hospital. The control subjects were 159 healthy women without breast cancer-related disease in the same community selected by frequency matching of age and menopausal status. The survey was administered by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were determined by using unconditional logistic regression after adjusting for the confounding factors found in the analysis of general characteristics of the subjects. In overall, it has been found that high consumptions of energy and carbohydrates significantly raised the relative risk of breast cancer, and that high intakes of total fat, plant fat, dietary fiber, all kinds of fatty acids, vitamin E and calcium significantly lowered the risk of breast cancer. The results of the study suggest that the possible protective factors to the breast cancer risk include a higher intakes of total fat, especially plant fat, dietary fiber, and micronutrients such as vitamin E, folic acid, calcium, phosphorus and potassium. On the other hand, high intakes of energy and carbohydrate appeared to be the risk factors.

Analysis of Relative Risk of Stroke by Nutrient Intake Levels - Case-Control Study in Daegu.Gyeongbuk Area, Korea - (영양소 섭취 수준에 따른 뇌졸중 위험도 분석 - 대구.경북지역 환자-대조군 연구 -)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.8
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    • pp.1050-1061
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    • 2009
  • The present study was performed to evaluate energy and nutrients intakes of stroke patients in Daegu Gyeongbuk region, and to analyze the relative risk of stroke related to the intake levels of energy and nutrients. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community residents who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were calculated by using unconditional logistic regression. In male subjects, patient group had significantly higher consumption than the control group in mean daily intakes of energy, all energy yielding nutrients, vitamin $B_1$, $B_6$, niacin, folic acid, vitamin E, phosphorus, potassium, zinc and dietary fiber, and also in the ratio of energy intake from protein and fat. In women subjects, the patient group consumed significantly lower intakes than the control group in fat, vitamin C, folic acid, vitamin E, iron, but vice versa in carbohydrate energy ratio. As for men, the increased intakes of energy, protein, carbohydrate vitamin $B_1$, E and niacin, zinc, total fatty acids, monoand poly-unsaturated, n-6 fatty acids significantly raised the relative risk of stroke. As for women, the increased intakes of fat, vitamin A, $B_2$, $B_6$, niacin, vitamin C and E, iron, sodium, potassium, selenium, mono-, poly-unsaturated, n-6 fatty acids, cholesterol, taurine and dietary fiber significantly lowered the relative risk of stroke. The results of the study demonstrated that the effect of several nutrient intake levels, such as niacin, vitamin E and fatty acids, on the relative risk of stroke was inconsistent between sex. The reason for this sex difference needs to be elucidated in a larger scale study.