• Journal of Nutrition and Health
• /
• 제52권4호
• /
• pp.332-341
• /
• 2019

본 연구는 입원환자의 초기영양평가를 위해 개발된 영양검색도구의 타당성을 평가하고자 입원 후 24시간이내 동일한대상자에게 PG-SGA와 개별면담을 시행 후 그 결과를 비교 평가하였다. CKUNRS와 PG-SGAS 두 그룹 모두 나이는 고위험군이 평균 연령보다 높았고, BMI, 혈청 알부민과 헤모글로빈은 영양불량이 심할수록 유의적으로 낮게 나타났다. CKUNRS와 PG-SGA를 비교 분석한 영양 평가결과 전체 686명 중 영양불량 위험 환자는 각각 107명(15.6%)과 380명 (44.6%)으로 조사되었다. 민감도와 특이도는 각각 98.7% (96.8 ~ 99.5)와 33.3% (28.1 ~ 39.0)로 나타났으며, 두 도구 간 유사성 kappa 지수는 0.34로 CKUNRS는 PG-SGA를 기준으로 어느 정도 타당한 검색도구로 검증되었다. 결론적으로, CKUNRS를 PG-SGA와 같은 공인된 영양검색도구와 비교한 결과 민감도와 유사성 면에서는 어느 정도 타당한 수준의 영양검색도구인 것으로 판정되었으나, 특이도가 높지 않은 부분에 대해서는 추가적인 고려가 필요할 것으로 보인다. 초기입원 영양평가로 효과적인 영양검색도구를 위하여 재원기간, 합병증 유무, 사망률, 환자의 질병 예후와 관련된 유용성은 검증되지 않아 이에 관련하여 추가적 연구가 필요하다고 사료된다. 그리고 보다 정확한 영양불량 환자의 검색을 위해서는 간호사의 입원환자 초기 평가 및 재평가 부분에서 누락 가능성이 있는 체중변화, 소화기계장애, 식욕상태, 저작곤란, 연하곤란 등의 정확한 기록을 할 수 있도록 간호사정 기록자의 지속적인 교육이 필요할 것으로 보이며, 효과적인 초기 영양관리를 위해서는 향후 CKUNRS의 영양검색 기준에 대한 수정보완이 필요하다고 사료된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권7호
• /
• pp.3279-3286
• /
• 2014

Background: Cancer is one of the leading causes of death in Korea. To reduce cancer incidence, the Korean National Cancer Center (KNCC) has been expanding its organized cancer screening program. In addition, there are opportunistic screening programs that can be chosen by individuals or their healthcare providers. The purpose of this study was to investigate factors associated with participation in organized and opportunistic cancer screening programs, with a particular focus on socioeconomic factors. Materials and Methods: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional nationwide study conducted by the Korean Ministry of Health and Welfare from 2007 to 2011. The study included information from 9,708 men and 12,739 women aged 19 years or over. Multinomial logistic regression analysis was conducted, adjusting for age, year of data collection, residential region, current smoking status, current alcohol consumption status, exercise, marriage status, job status, perceived health status, stress level, BMI, limitation of activities, cancer history, health insurance type, and private insurance status, to investigate the association between education level, economic status, and cancer screening participation. Results: In terms of education level, disparities in attendance were observed only for the opportunistic screening program. In contrast, there was no association between education level and participation in organized screening. In terms of economic status, disparities in opportunistic screening participation were observed at all income levels, but disparities in organized screening participation were observed only at the highest income level. Conclusions: Our findings reveal that socioeconomic factors, including educational level and economic status, were not significantly associated with participation in organized cancer screening, except at the highest level of income.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권9호
• /
• pp.3653-3657
• /
• 2015

We aimed to investigate the differences in health screening, including medical checkups and cancer screening, between HBV carriers and non-carriers in the Republic of Korea. In the fifth Korean National Health and Nutrition Examination Survey (KNHANES V), conducted between 2010 and 2012, 17,865 persons who answered regarding their HBV-infection status, medical checkup history, liver cancer screening and general cancer screening within the past years were included in the final analysis. In total, 295 persons were HBV carriers. Logistic regression models were used to compare the health check-up rate between the HBV carriers and non-HBV carriers. The HBV carriers were more likely to have been screened for liver cancer [adjusted odds ratio (OR): 2.83, 95% confidence interval (95%CI): 1.90-4.21] or cancer [OR: 1.44, 95%CI: 1.04-1.99]. The HBV carriers showed a probability of receiving medical checkups that was identical to that of the non-carriers [OR: 0.99, 95%CI: 0.72-1.35]. The HBV carriers, who were at higher risk of developing chronic liver disease, were more likely to be screened for cancer, including liver cancer, than the non-HBV carriers; no difference in the rate of medical checkups was observed between the HBV carriers and non-HBV carriers.

• 한국전자통신학회논문지
• /
• 제7권3호
• /
• pp.687-692
• /
• 2012

우리나라 40세 이상 성인들에서 대장암의 건강검진 관계성을 파악하여 이들의 대장암 검진 이행에 영향을 미치는 변수를 확인하고자 수행되었다. 조사도구는 국민건강영양조사 제4기 2차년도 자료를 이용하였다. 주요 변수는 국민건강수준, 건강관련의식 및 행태, 식품 및 영양섭취실태에 대해 12,528명을 대상으로 실시하였다. 대장암검진 대상자인 40세 이상 성인 남, 여 4,703명을 연구대상으로 하였다. 연구결과는 대장암 검진 이행여부와 관련성이 있는 변수로는 성별, 연령, 거주 지역, 건강기능 식품 복용여부, 건강검진 수검여부, 암 과거력 등 이었다. 배우자 유무, 교육수준별, 가구 월 총소득, 민간보험, 규칙적 운동여부에서는 관련성이 없었다. 대장암검진 수검을 높이기 위해서는 무료 암검진 확대실시와 암검진의 간편한 검사법에 대한 체계적이고 효과적인 교육과 홍보가 수행되어야 할 것이다.

• 대한지역사회영양학회지
• /
• 제14권3호
• /
• pp.340-353
• /
• 2009

It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

• 한국병원경영학회지
• /
• 제24권4호
• /
• pp.1-12
• /
• 2019

Purposes: The purpose of this study, was to identify similar factors between reasons for unscreening and unmet health care needs through prior research, and based on this, we wanted to figure out the relevance between the medical screening and unmet health care needs. Methodology: The analysis was conducted using data from 9,640 adults aged 19 or older who don't have a missing value from 16,277 participants in the 7th, 1st&2nd Year (2016&2017) of the National Health and Nutrition Examination Survey (KNHANES). Unmet health care needs were investigated as a self-reported questionnaire of whether medical service was required but not received. And the analysis was performed through the Chi-Square Test and Multi-logistic Regression analysis. Findings: As a result of the analysis, unmet healthcare needs were higher who received only one type of screening comparative to who screened both. and were highest who screened neither. Practical Implications: Unmet health care needs are the center of a vicious cycle, such as morbidity and mortality, which is detrimental to the quality of life, and continues to increase. Therefore, it is necessary to find ways of realizing health care that guarantees the health rights of all citizens by policy guarantee and support for the subjects to recognize the importance of thorough education of screenings rather than only health screening or cancer screening.

• Nutrition Research and Practice
• /
• 제13권5호
• /
• pp.410-414
• /
• 2019

BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제26권4호
• /
• pp.213-223
• /
• 2023

Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제16권2호
• /
• pp.95-103
• /
• 2013

Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

• Epidemiology and Health
• /
• 제39권
• /
• pp.36.1-36.8
• /
• 2017

OBJECTIVES: To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS: Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS: Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.