• Title, Summary, Keyword: 영양선별검사

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The Verification of Korean Version Swallowing Disturbance Questionnaire (K-SDQ) (한국판 삼킴 곤란 척도(K-SDQ)의 번안본 검증)

  • Jung, SoWoon;Kim, JungWan
    • 재활복지
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    • v.22 no.4
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    • pp.43-58
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    • 2018
  • Swallowing disorders that can affect nutrient intakes and quality of life are commonly shown among the elderly as well as patients with neurogenic disorder. This study verifies the reliability and validity of the Swallowing Disturbance Questionnaire (SDQ), a subjective swallowing disability assessment tool, modified for Koreans' eating habit and cultural sentiment, against 105 stroke patients, in order to help identify early swallowing problems of the elderly. Reliability of internal consistency in the Korean version of SDQ is .601, test-retest reliability is .97, and concurrent validity is .956. Based on 8 points of cut-off score, 46.8% of sensitivity and 81.6% of specificity. Comparing the results of video fluoroscopic study (VFSS), an objective swallowing disorder test with those of Korean version of SDQ, negative predictive value (NPV) and positive predictive value (PPV) was shown as 81% and 53%. The Korean version of SDQ is expected to be a useful testing tool to discriminate swallowing disorders in stroke patients. It has great clinical significance in that swallowing difficulties shown by subjects can be sorted out to request a diagnostic assessment before clinical evaluation by a rehabilitation therapist or ruling out unnecessary exposure to additional tests by accurately identifying stroke patients without swallowing problems.

Application and Efficacy Evaluation of Nutritional Screening Tool (영양부족 환자의 조기발견을 위한 선별검사의 적용 및 효용성 평가)

  • Nam, Gung-Hwan
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.1-11
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    • 2006
  • "본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함. Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.

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Current Knowledge on Fatigue in Advanced Cancer Patients (진행된 암환자에서 피로의 최신지견)

  • Kim, Jung-Hyun;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.175-180
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    • 2008
  • 진행된 암환자에서 피로는 70% 이상이 경험하게 되는 흔한 증상이며 삶의 질을 저하시키는 주된 요인이다. 피로에 대한 선별검사는 "피곤하거나 지친감이 있나요?"라는 단순한 질문으로 가능하며 이미 개발된 평가도구를 사용하여 평가할 수 있다. 동반 질환이나 피로의 원인을 알기 위한 병력청취와 검사실 검사가 필요할 수 있으며 결과에 따라 가역적 인자를 치료하는 과정이 우선되어야 한다. 적절한 약물치료를 시행하여 증상을 호전시킬 수 있으며 이중 methylphenidate는 암 연관 피로를 호전시키고 마약성 진통제에 의한 진정에 효과가 입증되었다. 환자의 여명에 따라 부신 피질 호르몬제도 사용할 수 있고, 운동 및 환자의 교육과 영양관리 또한 중요하다.

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Changes of Salt and Calcium Concentration in Radish during Salting (무우의 소금절임 과정 중 소금의 침투와 칼슘의 용출)

  • Kim, Soon-Dong;Kim, Mee-Jung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.17 no.2
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    • pp.110-114
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    • 1988
  • Salt penetration, moisture effluence and elution of calcium of radish were investigated during salting in $3{\sim}10%$ salt solution. The desirable salt concentration of kimchis were also evaluated by sensory method. Among 20 samples collected from domestic and commercially prepared kimchis, 8 samples were found to be desirable salt concentration having the concentration range of $1.2{\sim}2.2%$. Moisture and calcium diffused from radish tissue were increased as the salt concentration increased. The proper salting time were estimated to be two hours at 3%, one hour at 5% and 30 minutes at 10% of salt at $20^{\circ}C$. Salting at high concentration shortened the salting time but brought a significant calcium loss.

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The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal of Rehabilitation Patient (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myo-Young;Choi, Nam-Gil;Han, Jae-Bok
    • Proceedings of the Korea Contents Association Conference
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    • pp.189-190
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    • 2014
  • 뇌경색, 뇌 신경장애 및 뇌졸중환자 중 급성기 환자는 의식이 없어 연하기능장애로 인한 흡인성 폐렴을 유발하기 때문에 비위관(nasogastric tube)을 삽입하고 영양공급을 한다. 재활훈련 후 회복기에 침상선별검사를 시행하지만 임상적 검사를 통해서는 무증상흡인은 발견할 수 없다. 그래서 연하장애로 비위관을 삽입한 연하재활치료 중인 환자 10명을 대상으로 VFSS를 시행하여 식이재료에 따른 삼킴 정도, 자세에 따른 삼킴을 재활의학과전문의가 평가 후, 흡인이 있거나 삼킴 곤란 등이 있으면 연하재활치료를 시행하여 환자의 상태에 따라 약 30일 ~ 50일후에 재평가를 시행한 후 흡인이 없을 시 비위관을 제거 하였다. 이때 VFSS 영상을 기능적 연하곤란척도를 이용, 분석하여 부여된 점수를 통계 산출 하였는데 비위관 유지군은 $49.79{\pm}9.431$을 보여 흡인의 위험을 나타내며, 비위관 제거군은 $11.20{\pm}1.932$로 흡인의 위험성이 낮아 비위관 제거관련 의미 있게 낮은 점수를 보였다. 두 군의 유의성을 평가하기 위해 Mann-Whitney test를 시행한 결과 p<0.001로 통계적으로 유의하다고 평가하였다. 결론적으로 VFSS는 구강, 인두, 식도의 구조적 이상과 움직임을 가장 효과적으로 평가, 기도흡인여부를 즉시 확인 및 환자에게 적합한 식이나 연하자세를 결정할 수 있어 비위관 제거를 위한 연하평가에 가장 확실한 표준검사로 제안할 수 있다.

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표고버섯가루와 지방대체제를 첨가한 저지방 소시지의 품질특성

  • Bang, Ju-Hwa;Jeon, Sun-Sil;Jin, Gu-Bok
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • pp.204-208
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    • 2004
  • 표고버섯가루 첨가량과 지방대체제의 첨가 유무에 따른 저지방 소시지의 이화학적 및 조직학적인 성상에 대하여 조사하였고 기존의 유화형 소시지와 유사한 성상을 갖는 저지방 처리구를 선별하기 위하여 본 연구를 실시하였다. 지방대체제를 첨가한 경우 수분함량이 높았으나 적색도는 낮았다. 표고버섯 첨가량이 증가함에 따라 명도는 낮았으나 황색도는 증가하였다. 경도의 경우 지방대체제 첨가와 표고버섯 첨가량에 따라 상관관계를 보였으며 각각의 표고버섯 첨가량에서 지방대체제의 첨가는 저지방 소시지의 경도를 낮추었다. 한편 지방대체제를 첨가하지 않은 경우 경도는 표고버섯가루의 첨가량이 증가할수록 유의적으로 낮았으나, 지방대체제를 첨가한 경우 표고버섯 첨가량이 1% 이하에서는 감소하였으나 그 이상 첨가시 변화가 없었다. 관능검사결과 지방대체제와 표고버섯가루 1% 이상 첨가 시 비 선호경향을 보였다. 결론적으로 지방대체제를 첨가하지 않을 경우 표고버섯 1% 첨가는 기존의 유화형 소시지와 유사한 경도를 보였으나, 지방대체제를 첨가한 경우 표고버섯가루 1% 이상 첨가는 불필요한 것으로 판단된다.

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Effective Screening Test for Obesity in Obese Adolescents and the Correlation Among Obesity Index, Body Mass Index and Serum Lipid Profile (청소년에서 유용한 비만의 선별검사와 비만도, BMI 및 혈청지질과의 관계)

  • Sung, Tae Jung;Kim, Dal Hyun;Hong, Young Jin;Son, Byong Kwan;Chang, Kyung Ja;Park, Jun Young;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.217-223
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    • 2003
  • Purpose : Every year, there is a remarkable increase in the prevalence of children with excess body fat. The aim of this study is to find a useful screening method in assessing adolescent, obesity and to specify the predictable risk factors that are related to adult cardiovascular disease according to BMI and obesity index. Methods : From July to November in 2001, a total of 2,814(male : female=2,011 : 803) mid to high school students who were in the obesity range according to obesity index(>20%) were evaluated according to height, weight, body mass index(BMI), obesity index, and serum lipid levels. Results : Among the obese students over 20% by obesity index, 86.6% were over the range of 95 percentile by BMI. Among students defined as obese by BMI, 21.0% of males and 21.4% of females students had hypercholesterolemia; by obesity index, the ratio was 20.7% male and 19.0% female. The frequency of hypertriglyceremia in male students was 15.0% in group I(overweight group, 85P97p); in female students 11.8%, 20.7% and 28.2% respectively. Conclusion : In this study, using BMI alone to test the serum lipid level in adolescent obesity had a limit of 10.0-17.0% omission. Therefore using obesity index as a screening method to find the adult cardiovascular disease would rather reduce the omission rate. The risk factor of cardiovascular disease according to BMI was the increasing level of triglyceride in both male and female students. We think that using the obesity index has more rationale rather than BMI in assessing lipid profiles.

Diagnosis of Fatty Liver Complicated by Simple Obesity in Children: Serum ALT and Its Correlation with Abdominal CT and Liver Biopsy (소아의 단순성 비만증에 의한 지방간의 진단: ALT치와 복부 전산화단층촬영 및 간생검 소견간의 상관관계)

  • Lee, Seong-Hee;Kim, Hwa-Jung;Oh, Jae-Cheol;Han, Hae-Jeong;Kim, Hee-Sup;Tchah, Hann;Park, Ho-Jin;Shin, Mi-Keong;Lee, Min-Jin;Lee, Sang-Chun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.153-163
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    • 1999
  • Purpose: The purpose of our study is to provide useful information for diagnostic methods of fatty liver by childhood simple obesity and to provide correlation between serum alanine aminotransferase (ALT) for screening test and abdominal computerized tomography (CT) and liver biopsy for confirmative diagnostic methods of fatty liver. Methods: Among 78 obese childrens who visited our hospital, CT was carried out in 26 childrens. Of these, liver biopsy was carried out in 15 childrens who had high obesity index or severe elevated ALT. Based on the level of serum ALT, 26 cases were classified into 3 groups, and compared with physical measurements and degree of fatty infiltration on CT and liver biopsy. Results: 1) Correlation between ALT and physical measurements: Of 26 obese children, ALT was abnormally elevated (>30 IU/L) in 17 cases (67.4%) but there was no significant correlation between ALT and physical measurements (p>0.05). 2) Correlation between degree of fatty infiltration on CT and ALT: Of 26 cases, 13 cases (50%) revealed fatty liver on CT. The degree of fatty liver on CT had significant correlation with elevation of ALT (p<0.05). 3) Correlation between the degree of fatty infiltration on liver biopsy and ALT: Liver biopsy was performed in 15 cases of which 14 cases revealed fatty liver. But one case had normal hepatic histology with severe obesity and normal ALT. Fourteen fatty liver cases on liver biopsy were classified into 3 groups by the degree of fatty infiltration and analysed with obesity index and ALT. The histologic hepatic steatosis had no significant correlation with obesity index (p>0.05), but significant correlation with ALT (p<0.05). 4) Correlation between CT and liver biopsy finding: Both CT and liver biopsy were performed in 15 cases of which 6 cases revealed normal finding on CT and 9 cases manifested fatty liver. There was significant correlation between CT and liver biopsy findings (r=0.6094). Conclusion: The results of our study suggest that abdominal CT and liver biopsy are useful and accurate methods of estimating fatty liver in the childhood obesity. But biochemical abnormalities of routine liver function tests dot not correlate well with severity of the fatty liver and liver injury.

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Diagnostic Efficacy of Anorectal Manometry for the Diagnosis of Hirschsprung's Disease (Hirschsprung병에서 항문직장 내압검사의 진단적 유용성)

  • Chang, Soo-Hee;Min, Uoo-Gyung;Choi, Ok-Ja;Kim, Dae-Yeon;Kim, Seong-Chul;Yu, Chang-Sik;Kim, Jin-Cheon;Kim, In-Koo;Yoon, Jong-Hyun;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.1
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    • pp.24-31
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    • 2003
  • Purpose: As diagnostic tools for Hirschsprung's disease (HD), barium enema and rectal biopsy have radiation exposure and invasiveness respectively; however anorectal manometry does not have these disadvantages. We therefore performed this study to evaluate the diagnostic efficacy of anorectal manometry. Methods: We reviewed medical records of infants with one or two symptoms of vomiting, abdominal distension, chronic diarrhea or constipation who had a anorectal manometry followed by barium enema and/or biopsy from July 1995 to May 2002. We evaluated the sensitivity, specificity and predictive value of anorectal manometry and barium enema for diagnosis of HD. We also measured sphincter length, median value of balloon volume at which rectoanal inhibitory reflex (RAIR) occurred. Results: All 61 patients received anorectal manometry, 33 of 61 received barium enema. 18 of 61 were diagnosed as HD according to histology and 43 of 61 were evaluated as a control. The sensitivity, specificity, positive predictive value, negative predictive value of anorectal manometry and barium enema for diagnosis of HD were 1.00, 0.91, 0.82, 1.00 and 0.93, 0.67, 0.70, 0.92 respectively. The mean value of sphincter length in control was $1.68{\pm}0.67$ cm and correlated with age, weight and significantly longitudinal length. The median value of balloon volume at which RAIR occurred was 10 mL and did not correlated with age, weight and longitudinal length. Conclusion: This study suggests that anorectal manometry is an excellent initial screening test for Hirschsprung's disease because of its safety and accuracy.

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Build the nomogram by risk factors of chronic obstructive pulmonary disease (COPD) (만성 폐쇄성 폐질환의 위험요인 선별을 통한 노모그램 구축)

  • Seo, Ju-Hyun;Oh, Dong-Yep;Park, Yong-Soo;Lee, Jea-Young
    • The Korean Journal of Applied Statistics
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    • v.30 no.4
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    • pp.591-602
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    • 2017
  • The concentration of fine dust has increased in Korea and people have become more concerned with respiratory diseases. This study selected risk factors for chronic obstructive pulmonary disease (COPD) through demographic and clinical features and constructed a nomogram. First, logistic regression analysis was performed using demographic and clinical feature and the pulmonary function test results of the Korean National Health and Nutrition Examination Survey (KNHANES) $6^{th}$ (2013-2015) and the nomogram was constructed to visualize the risk factors of chronic obstructive pulmonary disease in order to facilitate the interpretation of the analysis results. The ROC curve and calibration plot were also used to verify the nomogram of chronic obstructive pulmonary disease.