• 제목/요약/키워드: nutrition care process

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A Study for Identification of Nursing Diagnosis using the Roy's Adaptation Model in Maternity Unit (Roy's Adaptation Model에 의한 모성영역에서의 간호진단 확인연구)

  • Jo, Jeong-Ho
    • The Korean Nurse
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    • v.33 no.3
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    • pp.79-91
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    • 1994
  • The purpose of this study was to identify the meaningful nursing diagnosis in maternity unit and to suggest formally the basal data to the nursing service with scientific approach. The subject for this paper were 64 patients who admitted to Chung Ang University Hospital, Located in Seoul, from Mar. 10, to July 21, 1993. The results were as follows: 1. The number of nursing diagnosis from 64 patients were 892 and average number of nursing diagnosis per patient was 13.9. 2. Applying the division of nursing diagnosis to Roy's Adaptation Model, determined nursing diagnosis from the 64 patients were 621 (69.6%) in physiological adaptation mode and (Comfort, altered r/t), (Injury, potential for r/t), (Infection, potential for r/t), (Bowel elimination, altered patterns r/t), (Breathing pattern, ineffective r/t), (Nutrition, altered r/t less than body requirement) in order, and 139 (15.6%) in role function mode, (Self care deficit r/t), (Knowledge deficit r/t), (Mobility, impaired physical r/t) in order, 122 (13.7%) in interdependence adaptation mode, (Anxiety r/t), (Family Process, altered r/t) in order, 10(1.1%) in self concept adaptation mode, (Powerlessness r/t), (Grieving, dysfunctional r/t) in order. 3. Nursing diagnosis in maternity unit by the medical diagnosis, the average hospital dates were 3.8 days in normal delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 64.6%, (Self care deficit r/t) 13.6% in order, and the average hospital dates were 9.6 days in cesarean section delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 51.6%, (Self care deficit r/t) 15.2%, (Infection, potential for r/t) 9.9%, (Injury, potential "for r/t) 8.1%, (Anxiety r/t) 5.0%, (Mobility, impaired physical r/t) 3.3% in order, and the average hospital dates were 15.8days in preterm labor and majority of used nursing diagnosis, (Comfort, altered r/ t), (Anxiety r/t), (Injury, potential for r/t) in order, and the average short-term hospital dates were 2.5days, long-term hospital dates were 11.5days in gynecologic diseases and majority of used nursing diagnosis, (Comfort, altered r/t). (Self care deficit r/t), (Injury, potential for r/t), (Infection, potential for r/t) in order.

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Usefulness of Assessment of Stool Form by the Modified Bristol Stool Form Scale in Primary Care Pediatrics

  • Gulati, Reema;Komuravelly, Arpitha;Leb, Stephen;Mhanna, Maroun J;Ghori, Abdullah;Leon, Janeen;Needlman, Robert
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.93-100
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    • 2018
  • Purpose: Rome criteria are considered the gold standard for diagnosing functional constipation. The modified Bristol stool form scale (m-BSFS) was validated to measure stool form in children. However, neither the potential use of the m-BSFS as a tool to facilitate the diagnosis of potential constipation, nor the agreement between m-BSFS and stool consistency by Rome has been studied. Our objective is to determine if m-BSFS is a reliable tool to facilitate detection of constipation; and the agreement between stool form by m-BSFS and hard stool criteria in Rome. Methods: A survey tool with the Rome III criteria and the m-BSFS was developed. A Likert-scale addressed frequency of each stool form on the m-BSFS. Responses to Rome III and m-BSFS were compared. Results: The sensitivity and specificity of the m-BSFS was 79.2% and 66.0% respectively; and in children <4 years. improved to 81.2% and 75.0% respectively. There was poor agreement between hard stools by m-BSFS and the painful or hard bowel movement question of Rome Criteria. Conclusion: The potential utility of m-BSFS as a reasonably good tool to facilitate the diagnosis of potential constipation in children is shown. The poor agreement between painful or hard stool question in Rome III, and ratings for hard stool on the m-BSFS illustrates that one's perception may differ between a question and a picture. A useful pictorial tool to appraise stool form may, thus, be a favorable complement in the process of enquiry about bowel habits in well-child care.

Strategic Planning for the Contract-Managed Hospital Foodservice Through QFD Methodology (QFD 기법을 이용한 병원 위탁급식 운영전략 수립)

  • 양일선;박수연;김현아;박문경;신서영;이해영
    • Korean Journal of Community Nutrition
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    • v.8 no.5
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    • pp.744-754
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    • 2003
  • At present, health care industries throughout the world are struggling with the challenges to set up financial structures as cost-effective ways and means of satisfying customer needs for health care services. Many hospitals consign foodservice management to foodservice companies for the purpose of efficiency. The companies taking charge of hospital foodservice are also striving to gain an advantage over keen competitions. This study applied Quality Function Deployment(QFD) to one hospital (which will be shown as $\ulcorner$A hospital$\lrcorner$ below) managed by a contract foodservice company for the purpose of strategy planning to provide sustainable competitive advantage. First of all, this study scanned internal and external environment of $\ulcorner$A hospital$\lrcorner$ by means of a Quality Measurement Tool and a fieldwork study. With the result of environment scanning, this study elicited 20 strategies through SWOT analysis, which were categorized by 4 perspectives such as financial, customer, internal process, learning and growth perspectives. Finally, the priorities of 20 strategies were extracted from QFD methodology. According to the results obtained by applying QFD to $\ulcorner$A hospital$\lrcorner$'s foodservice, the strategies which $\ulcorner$A hospital$\lrcorner$ foodservice was obliged to introduce and implement were : the specialization of Children's hospital foodservice, scientific foodservice management through the standardization of foodservice operations, the maintenance of sanitary quality through sanitary system, the remodeling of facilities, the introduction of new equipment, the prompt and accurate response to customer needs, the development of appropriate patient menus, the provision of competitively priced meals for patient selection, the development of a demand forecast model by considering the characteristics of a children's hospital, improvement of productivity and the reduction of labor costs through the employment of experienced employees based on their seniority.

Evaluation of Dietitians' Perception of Importance about HACCP Guidelines in Foodservice Facilities (급식소 HACCP 관리항목에 대한 영양사의 중요성 인지도 평가)

  • Bae, Hyeon-Ju
    • Journal of the Korean Dietetic Association
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    • v.11 no.1
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    • pp.105-113
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    • 2005
  • The purpose of the study was to evaluate the perception of importance about HACCP guidelines of dietitians. A questionnaire was developed to achieve research objectives and sent to random samples of 500 dietitians by a mail ; 418(84%) responses were analyzed. The respondents used three-point-scale to rate their perception of importance about HACCP from 1-"will be necessary" to 3-"very important". All statistical analyses were conducted using SAS package(version 8.12) for Windows. Means and standard deviations were computed for all variables. One-way analysis of variance and Duncan's multiple range test were used to assess differences in the perception of importance about HACCP guidelines among business and industry, health care and school foodservice managers. The study results were summarized as follows. Dietitians especially had lower perception of importance on the contents of Critical Control Points(CCPs), such as; adequate thawing methods and keeping records(1.95) and correct cleaning and sterilizing for raw vegetables and fruits(1.93). The rates of perception of importance about HACCP guidelines were significantly different from 19 of the 37 contents among business and industry, health care and school foodservice(p<.05 or p<.01 or p<.001). Generally, the item related to purchasing and inspection management had the highest perception level score and the item related to pre-preparation management had the lowest perception level score in foodservice production process(p<.001). Results indicate that there is a need for increased education of dietitians about HACCP principles and appropriate practices.

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Education based on the health belief model to improve the level of physical activity

  • Khodaveisi, Masoud;Azizpour, Bahman;Jadidi, Ali;Mohammadi, Younes
    • Korean Journal of Exercise Nutrition
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    • v.25 no.4
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    • pp.17-23
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    • 2021
  • [Purpose] This study aimed to investigate the effect of education based on the health belief model on the physical activity of the staff of the University of Medical Sciences. [Methods] This semi-experimental study was conducted on 130 university staff aged 25-50 years from the Hamadan University of Medical Sciences. Inclusion criteria were having at least 1 year of work experience, lack of acute and chronic physical and mental illnesses, and not using drugs that affect physical activity. The samples were randomly divided into two groups. The experimental group received three training sessions based on the health belief model. Before and 2 months after training, the control and experimental groups were evaluated via the following questionnaires: (1) demographic information questionnaire, (2) Health Belief Model Questionnaire, and (3) International Physical Activity Questionnaire. Finally, data were analyzed statistically. [Results] The training process resulted in a significant increase in the mean scores of the health belief model constructs in the experimental group, but changes in the control group were not significant. Self-efficacy was the strongest predictor of physical activity. [Conclusion] The health belief model is a useful model for improving individuals' understanding of the benefits of physical activity.

Measurement of the Nursing Staff Needed for Two Specialized Nursing units in a University Hospital (간호업무량 측정 및 간호인력 수요산정)

  • 이윤신;박정호
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.589-603
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    • 1992
  • This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

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A Case of Clostridium difficile Pseudomembranous Colitis (Clostridium difficile 감염에 의한 위막성 대장염 1례)

  • Seo, Jung-Ho;Lee, Jong-Won;Lee, Chang-Han;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.98-104
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    • 2000
  • Pseudomembranous colitis, thought to be uncommon in children, is a bacterial, toxin-mediated inflammatory process resulting in acute or chronic diarrhea and is characterized by colonic pseudomembranes. It is mediated by toxins produced by Clostridium difficile and is increasingly recognized in pediatric population. Diagnosis is based on positive culture of C. difficile in selective media and positive test of C. difficile toxin. Oral metronidazole or vancomycin are the main treatment options but avoidance of further antibiotics should also be encouraged where possible. We have experienced a case of pseudomembranous colitis in a 4-year-old female presented with septic shock and colitis. This case was diagnosed with positive test of C. difficile toxin B and confirmed by isolation of the organism on cultire in selective media. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metronidazole and oral vancomycin, and ICU care.

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Menu Development and Evaluation through Eating Behavior and Food Preference of Preschool Children in Day-Care Centers (보육시설 유아들의 식행동과 식품기호도 조사를 통한 식단개발 및 평가)

  • Sin, Eun-Kyung;Lee, Yeon-Kyung
    • Journal of the Korean Society of Food Culture
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    • v.20 no.1
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    • pp.1-14
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    • 2005
  • This study was conducted to develop and evaluate food menus after investigating eating behaviors and food preferences of preschool children. Parents of the preschool children In 2 Gumi City day-care centers completed questionnaires in July 2003, which were used to assess eating behaviors and food preferences of their preschool children. Analysis of the questionnaires led to the development of the menus. Menus (n=10) were developed for five different categories (two menus were developed for each category) including general menu, unbalanced menu, anemia menu, obese menu, and traditional menu. The preschool children(n=656) evaluated the menus as they were provided with each them throughout October 2003. The five score scale method was used to evaluate taste, smell, looks, texture and general preference of each menu. Results in eating behaviors showed that 70.7% of preschool children had unbalanced eating behaviors. No gender based differences in eating behaviors were found, but in regard to food preferences boys tended to prefer carbonated drinks more than girls. Results indicated that among all menus, fruit ranked highest $(3.97{\pm}0.65)$ for food preference, and vegetables ranked lowest for food preference $(2.46{\pm}0.68)$. Food preference in regard to cooking process indicated the highest preference was for fried foods $(3.80{\pm}0.68)$ and the lowest preference was for raw vegetables $(2.61{\pm}1.27)$ and namul $(2.85{\pm}1.13)$. Preference for taste ranked the highest $(4.30{\pm}0.91)$ but preference for looks recorded the lowest $(3.95{\pm}0.89)$. Of all the foods in the menus, steamed tofu rated the highest for individual food item preference, while tuna sesame leaf rice rated the lowest preference. Statistical analysis of interrelationships among food taste, smell, looks, texture and general preference were significant (p<0.0l). Results from this study suggest that various factors including food taste, smell, looks, and texture influence the food preferences of preschool children. Therefore, it is concluded that by developing a variety of appetizing menus for use at home and in day-care centers, containing varied food items and cooking methods, preschool children will be encouraged to increase their food preferences and to establish appropriate eating behaviors.

Childcare Teacher's Perception of the Accreditation System Based on Accreditation Experience -Focused on the Second Accreditation Index of Childcare Centers- (보육교사의 평가인증 경험에 따른 평가인증제에 대한 인식비교 -2차 평가인증지표를 중심으로-)

  • Cho, Hyun-Ok;Choi, Inhwa
    • Korean Journal of Childcare and Education
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    • v.7 no.4
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    • pp.301-324
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    • 2011
  • The purpose of this study was to examine the perception of the childcare teachers regarding accreditation procedures and feasibility of the second accreditation index according their past participation in the accreditation process. The objects were 193 childcare teachers working at child care centers that were accredited using the initial accreditation index. The collected data was analyzed using frequency, percentile, $X^2$, and t-test. The major findings are as follows: First, childcare teachers without accreditation experience perceived 'continuing education of child care center directors and teachers' to be the most important for quality maintenance after successful accreditation. In contrast, childcare teachers with accreditation experience placed the most importance on 'childcare teachers' motivation and continuing enrollment'. Second, childcare teachers with accreditation experience perceived higher feasibility in the subcategories of 'art activity materials' in the category of child care environment, 'providing operation policies and information of child care teachers', 'care for children', and 'employment contract' in the operation & management category, 'sanitary management of food, cooking and feeding', 'care of sick or injured child', 'health management of children and childcare teachers', 'snacks for children' in the category of health and nutrition and 'safe procedures for handing over children' in the category of safety. In general, childcare teachers with accreditation experience perceived higher feasibility of the second accreditation index in all categories.

Association of the initial level of enteral nutrition with clinical outcomes in severe and multiple trauma patients (초기 경장영양 공급 수준과 다발성 외상 중환자의 임상 경과와의 상관성 연구)

  • Yang, Suyoung;Jung, Seungyoun;Lee, Ji-hyun;Kwon, Junsik;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.55 no.1
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    • pp.85-100
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    • 2022
  • Purpose: This study is aimed to examine the association between initial enteral nutrition (EN) and the clinical prognosis among patients with severe and multiple traumatic injuries, and to investigate whether this association is modified by the patients' catabolic status. Methods: This was a retrospective study of 302 adult patients with severe and multiple traumatic injuries admitted between January 2017 and September 2020 at Ajou University hospital in Suwon, Korea. The initial nutritional support by EN and parenteral nutrition were monitored up to day 7 after admission. Patients were classified into "No", "Low", and "High" EN groups according to the level of initial EN. Multivariable-adjusted logistic regression and linear regression models were used to estimate the association of the initial EN levels at hospital admission with the risk of mortality, morbidities, and levels of nutrition-associated biochemical markers. Results: High EN support was associated with reduced mortality (odds ratio, 0.07; 95% confidence interval [CI], 0.02, 0.32) and lower levels of C-reactive protein (β, -0.22; 95% CI, -8.66, 1.48), but longer stay in the intensive care unit (β, 0.19; 95% CI, 1.82, 11.32). In analyses stratified by catabolic status, there were fewer incidences of hospital-acquired infections with increasing EN levels in the moderate or higher nitrogen balance group than in the mild nitrogen balance group. Conclusion: Our observation of the inverse association between levels of initial EN administration with mortality risk and inflammatory markers may indicate the possible benefits of active EN administration to the recovery process of severe and multiple trauma patients. Further studies are warranted on whether the catabolic status modifies the association between the initial EN and prognosis.