The prognosis of maintenance hemodialysis (HD) patients is closely related to their nutritional status. It is important to develop and use of a reliable, useful and easy method of nutritional assessment scale for evaluation of nutritional status and progression of the patients. This study was initiated to evaluate the clinical usefulness of Instant Nutritional Assessment Scale(INAS) by cross-sectional and longitudinal studies. One hundred HD patients entered a continuing nutritional study and followed for 1 year. The results were as follow ; 1. 24% of patients was normal to mild, 43% was moderate and 33% was severe deficit of nutritional status. 2. The mean INAS score of the patients was 8.00(S. D.=2.83), and there didn't reveal any differences in INAS score by general characteristics. The mean transferrin score was 1.98, whih was the highest of 5 nutirtional parameters of INAS. Only 7 patients had within nomal range of transferrin concentration. 3. Within one year since this study was initiated, 10 patients died. Six of them were with severe deficit and one of them was normal to mild deficit groups. The death rate in severe deficit group was higher than that of normal to mild deficit group (P=.0640). 4. Occurrence of acute complication during HD in severe deficit guoup was higher than that of normal to mild deficit group(P=.001). 5. The number of consultation to the doctor and hospital admission in severe deficit group was higher than that of normal to mild deficit group(P=.0001). 6. INAS score was significantly correlated with occurrence of acute complications during HD and the number of consultation to the doctor. In conclusion, INAS based on the levels of body mass index, midarm circumference, triceps skinfold thickness, transferrin concentration and total lymphocyte count seems to be a reliable predictive nutritional index for prognosis. So nurses are encouraged to adopt INAS in care of the chronically illed patients. Recommendations for further research was suggested.
Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.
Nowadays, the nutritional deficits are rarely seen in Korea. However, an increased availability of the highly palatable energy dense, nutrient-poor foods increases the risks of obesity and deficits of vitamins and minerals in the general population. Also, optimum intake of vitamins and minerals, which varies with age and genetic back ground, might not suffice the poor, young, obese, and elderly people. Young girls and individuals participating in weight reductions and aesthetic components are prone to micronutrient deficiencies because they restrict food intake and specific micronutrient rich foods. An inadequate intake of vitamins or minerals is associated with reduced physical performance and exercise capacity, increased obesity, decreased cognitive function, increased DNA damages such as single- and double-stranded breaks or oxidative DNA lesions, and accelerated aging process and increased neuronal damages with mitochondrial oxidative decay. Most of these deleterious effects of the deficit could be prevented by a one tablet of multivitamins with a good balanced diet. High dose B vitamins are frequently administered to overcome the metabolic inadequacy to the people with the less functional enzymes with increased Km values for their coenzymes due to the single gene mutation or due to the single nucleotide polymorphisms. And some certain antioxidant vitamins are also used in large quantities to overcome the oxidative stress and to repair the damages. In this review, new nutritional concepts of some vitamins and minerals, which are widely used and useful for the children, will be discussed.
Purpose: This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy. Methods: This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics. Results: Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified. Conclusion: The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.
The purpose of this study was to investigate the correlation between food behavior and Attention Deficit Hyperactivity Disorder (ADHD) score in elementary students in Suwon-si, Gyeonggi-do. Two hundreds and thirty two students (113 male and 119 female) in grades 4~6 participated. We assessed food behavior by using Nutrition Quotient (NQ). NQ was examined by an NQ questionnaire, which consisted of 19 food behavior checklist items. Their items were grouped into five categories: balance, diversity, moderation, regularity, and practice. All data were statistically analyzed by SPSS 18.0. Among the five factors, NQ for food behavior and balance factor showed the lowest score, whereas that of diversity factor showed the highest score. The final Nutrition Quotient (NQ) score weighted on such five factors was 62.59 points. The average level of ADHD by Conners-Wells Adolescent Self-Report Scale (Short Form) [CASS(S)] was 17.02 points out of a total of 81 points. Six students (2.2%) who scored more than 41 points were classified as ADHD risk. By gender, male students (19.76 points) showed a higher CASS(S) score than female students (14.41 points) did. There was a significant negative correlation between NQ and CASS(S) score (r=-0.445, P<0.001). Multiple regression determined the effects of moderation ($Exp({\beta})=-0.193$, P<0.01) and practice ($Exp({\beta})=-0.345$, P<0.001) on CASS(S) score. In conclusion, distinctive nutritional education is needed for students with a high level of ADHD to help their understanding considering their different levels of attention.
Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.
This study was conducted to provide basic information on the nutritional status and health status of the rural elderly. The food intake, food habits and others health related factors were surveryed by interview method. The subjects was 200 people(71 male, 129 female) aged over 65 year in the Han-an area. The obtained results as follows; Their average age is 73.5$\pm$5.6. Mean height and weight of elderly men were 163 cm and 58.1 kg. respectively and 148.7 cm and 50.0 kg for women. The regularity appetite and frequency of eating snacks and eating out were higher in men than in women. The favorite snacks for men were alcohol fruit coffee and for women was fruit, candy, cookies and coffee. The daily alcohol drinking and smoking ration were 50.0%, 60.6% for men, respectively and 14.0%, 24.8 % for women. The nutritional intake ratio to RDA of men was significantly higher than women. Especially, the intakes of energy, Ca, Vit.A, Vit B$_1$, Vit B$_2$ niacin were extremely low in women. The frequency of alcohol intake was related to nutrient intake of women . There was a negative correlation between age. smoking rate and the nutritional intake. The pocket money, weight height appetite, and frequency of snacks showed a positive relation to nutritional intake. In conclusion the study shows that gender did influence food intake in the elderly, Food intake of women was extremely in deficit, because the most elderly rural women live alone. For successful aging. a program for rural elderly is needed on the govermment level, i.e actions to provide minimum economic life, food delivery and psychological/ physical health care through regional pubilc health centers.
This study was conducted to investigate the relationship among dietary behavior, meal balance, and clinical symptoms related nutritional status and Attention Deficit Hyperactivity Disorder(ADHD) in preschool children. The survey was conducted using questionnaires and the subjects were 3~6 years old preschool children in Samcheok. Subjects were divided into an ADHD dispositions group(n=88) and a normal group(n=129) based on assessments conducted by the children's mother using the Abbreviated Conners's Parent Rating Scale. There was no significant difference in meal frequency, meal speed, meal regularity or meal balance between children with ADHD dispositions and the normal groups. The ADHD disposition group had a higher proportion of children with picky eating(p<0.05), too much snacking(p<0.05) and over eating (p=0.05) habits than the normal group. In addition, the ADHD dispositions group had a higher frequency of clinical symptoms such as 'breathlessness when going up stairs', 'sleeplessness', 'anxiety' and 'tiredness'. Overall, there was a significant relationship between ADHD disposition and dietary problems and clinical symptoms related to poor nutritional status in preschool children. Therefore, to prevent and treat ADHD in preschool children, proper dietary management such as correcting of picky eating, over snacking and overeating is needed.
Skalny, Anatoly V.;Mazaletskaya, Anna L.;Ajsuvakova, Olga P.;Bjorklund, Geir;Skalnaya, Margarita G.;Chernova, Lyubov N.;Skalny, Andrey A.;Tinkov, Alexey A.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
제31권1호
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pp.41-45
/
2020
Objective: The objective of this study was to assess serum, hair, and urinary magnesium (Mg) levels in children with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and both ASD and ADHD to reveal potential interactive effects. Methods: A total of 148 boys aged 4-9 years old were enrolled in this study, including 44 children with ADHD, 40 pediatric patients with ASD, 32 patients with both ADHD and ASD, as well as 32 healthy neurotypical children. Hair, serum, and urinary Mg levels were assessed using inductively-coupled plasma mass spectrometry (ICP-MS). Laboratory quality control was performed using certified reference materials of human hair, plasma, and urine. Results: No significant group difference in serum Mg levels was observed. Mg content in hair was found to be reduced in children with ADHD and ADHD+ASD compared to that in healthy controls by 11% and 15%, respectively. Urinary Mg levels in children with ADHD+ASD exceeded the control, ADHD, and ASD values by 51, 76, and 65%, respectively. Factorial analysis revealed significant contribution of ADHD to hair and urinary Mg levels. Multiple regression analysis demonstrated that hair and urinary Mg levels were considered as significant predictors of neurodevelopmental disorder complexity. Conclusion: We propose that impaired Mg status may provide a link between ADHD and ASD.
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