• 대한영양사협회학술지
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• 제23권4호
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• pp.431-452
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• 2017

This study was conducted to investigate the effect dietitians' perceived organizational culture has on organizational commitment at hospital foodservices. A total of 382 dietitians working at general hospitals with 500 beds or more participated in the survey from January 16 to February 8, 2017. The result of perceived organizational culture showed hierarchical culture, rational culture, development culture, and group culture scored to be 5.29, 5.25, 5.15, and 4.97 out of 7, respectively. Differences in the perception of organizational culture and organizational commitment were observed according to the general demographics of subjects, but no significant differences were shown according to the general characteristics of hospitals. For organizational commitment perception, affective commitment (5.14), normative commitment (4.41), and continuance commitment (4.21) were identified. There were differences according to age, work experience at the present job, position, and education level by type of organizational culture. In terms of organizational commitment, there were significant differences in age, work experience at the present job, employment status, and possession of clinical dietitian certificate, position by type of commitment. A positive correlation between dietitians' perceived organizational culture and organizational commitment such as overall organizational commitment, affective commitment, and normative commitment was observed (P<0.01). Group culture, development culture, and hierarchical culture positively affected overall organizational commitment (P<0.001). Development culture, group culture, and hierarchical culture had positive effects on affective commitment, whereas rational culture had a negative influence. Development culture (P<0.05), group culture (P<0.001), and hierarchical culture (P<0.01) positively influenced normative commitment. Results suggest that it is necessary to develop plans for the improvement of rational culture, group culture, and development culture at hospital foodservice organizations.

• 대한영양사협회학술지
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• 제21권2호
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• pp.123-139
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• 2015

The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

• 대한영양사협회학술지
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• 제19권1호
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• pp.69-81
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• 2013

The purpose of this study was to evaluate the difference in perception of clinical nutrition service (CNS) between doctors and dietitians working in hospitals in Busan and the Gyeongnam area. Research was performed through questionnaires (from November to December 2011) at over 100 beds. 73.3% of dietitians were aware of the Nutrition Support Team (NST), while only 15.6% of doctors were aware of it. Due to heavy work and lack of medical staff, doctors didn't participate in NST, although most of them recognized the necessity of NST. 61.7% of dietitians screened and managed malnourished patients, whereas only 29.8% of doctors did. The main reason dietitians didn't treat malnourished patients was the absence of a treatment system in the hospital. Less than 50% of dietitians participated in the doctor's round to malnourished patients. As for why dietitians didn't participate in doctor's rounds, 71% of doctors chose understaffed dietitians and 38.1% of dietitians chose the doctors' unawareness of the importance of the dietitian in doctor's rounds. For the lower rate of nutrition counseling in provincial regions, compared to the capital region, 46.8% of doctors cited a lack of connection between doctors and clinical dietitians, while 43.3% of dietitians cited the lack of doctors' awareness on the importance of nutrition counseling. Although 87.3% of the doctors and 91.6% of the dietitians answered that CNS is important for treatment, the perception of onsite performance status on CNS was found to be low in both groups. 48.9% of doctors and 50.0% of dietitians regarded dietitians in the hospital as personnel in charge of food services, rather a member of the medical team. To improve the awareness of the importance of the CNS, and the image of clinical dietitians, 31.2% of doctors answered "to introduce a professional dietitian license for each disease" and 26.7% of dietitians answered "to change the system in the hospital". Most subjects found that a separation of clinical nutrition services from the food service part is needed. These results suggest that it is important to narrow the difference in perceptions of clinical nutrition services between doctors and dietitians for an organized clinical nutrition management of patients in hospitals in Busan and the Gyeongnam area.

• 한국식품조리과학회지
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• 제17권2호
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• pp.105-116
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• 2001

국내 의료기관 96개소를 대상으로 이들의 급식위생관리 실태를 파악하기 위하여 2000년 3월부터 한 달간 총 96개 의료기관에 대해 해당병원 영양사를 대상으로 일반 위생관리 및 교육 프로그램에 대하여, 그리고 이들 중 35개소에 대해서는 급식을 위한 생산단계별 위생, 개인 위생, 급식설비 위생 분야로 구분하여 설문조사를 실시하였다. 조사에 응한 의료기관들의 급식위생관리 상태는 전반적으로 양호하게 나타났으나, 총 참여기관 중 병원급식에 HACCP을 도입하였다고 응답한 곳은 4%에 지나지 않았으며 문서화된 위생작업기준을 소지한 곳도 1/3에 지나지 않았다. 세부 항목별로 살펴보면 전체적으로 기록이나 문서화가 필요한 부분이 취약하게 나타났다. 의료기관의 종류, 소재지, 병상규모, 급식유형, 그리고 영양사의 업무분장에 따라 위생수칙 준수 율을 비교하여 보았을 때, 경우에 따라 차이는 있었으나 예상과 달리 종합병원이 3차 병원보다 양호한 결과를 보인 경우가 다수 있었으며, 소재지별로는 대도시에서 읍면지역으로 갈수록 취약하게 나타났다 또한 위탁급식 형태가 직영급식보다 대체적으로 양호한 위생수칙 준수 율을 보였고, 영양사의 업무가 임상영양서비스와 급식서비스로 구분되어 있을 때 그렇지 않은 경우보다 위생수칙 준수 율이 높았다. 위 설문조사에서 파악된 구체적인 문제점들은 추후 국내 의료기관의 급식위생수준 향상을 위한 지침 또는 프로그램의 개발에 유용한 기초자료가 될 것이다.

• 대한영양사협회학술지
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• 제8권4호
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• pp.408-414
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• 2002

The purpose of this study was to develop the standardized manual for dietetic internship. The general information of the dietetic internship program in Korea was gathered and of dietetic internship(DI) in the USA was also surveyed. The existence of DI program manual, the number of intern and length of the dietetic internship program, and other general information were investigated. At first, the questionnaire was developed and mailed to 130 hospitals in Korea and the number of returned questionnaires was 42 showing participating rate of 28%. Second, telephone survey was carried out and the number of response was 40 out of 46 participating rate of 87%. The results of this study could be summarized as follow. 1. eneral informations of dietetic internship program in Korea; The hospital having a dietetic internship program was 31.7% and of them 14.6%(12 hospitals) have a manual developed by themselves. The number of dietetic intern per hospital was 2.0$\pm$ 1.4. The length of the program was from 3 to 12 months. Ten hospitals (38.5%) have a only food service program and 16 hospitals (62.5%) have both food service and clinical program. Seventy one percent (58 hospitals) of total hospital were willing to use the well developed standardized dietetic internship manual. 2. eneral information of Dietetic Internship Program in the USA; Two hundred fifty nine hospital had the dietetic internship program approved by ADA. The number of dietetic intern in each hospital was 10.6$\pm$ 6.3. The mean length of the program was 13.6$\pm$ 6.3 months. Twenty seven percent of institution have coordinated internship/masters degree program. The range of tuition for DI program was from 300 to 30,855(otherwise, interns were payed by the hospital in Korea). As a conclusion, the standardized dietetic internship program for the clinical dietitian as nutrition professionals to carry out their job at the hospitals should be developed. And the coordinated internship/masters degree program could be considered to improve the skill levels and job performances of clinical dietitian.

• 대한영양사협회학술지
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• 제18권3호
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• pp.266-275
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• 2012

The purpose of this study was to evaluate the perception and needs of doctors on clinical nutrition services. A cross-sectional survey design was used. The doctors' perception and needs were assessed by questionnaires that had been specifically designed for the study. The research was conducted from February 14 to March 15, 2011 for 544 doctors at 42 large hospitals (with over 400 beds). Ninety-eight percent of doctors responded that clinical nutrition service was important. The mean scores of importance on clinical nutrition service were 4.45 for 'nutrition screening at admission', 4.50 for 'treatment of malnutrition', and 4.43 for 'nutrition education and counseling'. The mean scores of needs for clinical nutrition service were 4.42 for 'individual nutrition counseling & education' 4.39 for 'nutrition management for malnourished patients' and 'nutrition management for tube fed patients'. The medical specialists showed significantly (P<0.01) higher scores than the residents on the importance and needs for clinical nutrition services. Eighty-five percent of the doctors recognized the necessity of the specialized dietitians classified by diseases. The medical specialists (93.8%) showed significantly (P<0.01) higher recognition of this necessity than the residents (77.7%). The low residents' perceptions of the importance and needs for clinical nutrition services will necessitate clinical nutrition education plans. The departments of clinical nutrition in universities should improve the ability and skills of the clinical dietitians.

• 동아시아식생활학회지
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• 제18권5호
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• pp.725-731
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• 2008

The principal objective of this study was to assess the effects of low-calorie diets(LCD) for 8 weeks of medical nutrition therapy in individuals with BMI in excess of $23\;kg/m^2$. 41 over-weight or obese individuals (male=14, female=27, age $28.6{\pm}8.9\;yrs$), none of whom were diagnosed with a medical disease, were administered MNT 4 times over the study period. Approximately $1,100{\sim}1,300\;kcal/day$ were prescribed by a dietitian, via individualized counseling. Anthropometric parameters, daily nutrient intake, and blood levels of leptin, insulin, and lipid profiles were measured prior to and after the 8 weeks of the intervention period. We noted significant reductions in body weight, body mass index (BMI), fat mass (FM), visceral adipose tissue (VAT), abdominal skin-fold thickness, and waist circumference in both men and women. The mean body weight losses in men and women were $3.2{\pm}0.6\;kg$/8 weeks and $2.8{\pm}0.6\;kg$/8 weeks, respectively. However, the % of lean body mass (LBM) in men and women was shown to increase significantly (p<0.05). The daily intake of calorie, fat, protein, vitamin E, folate, and iron were significantly reduced during the LCD period. Blood levels of lipids and glucose were in normal range, and evidenced no changes after LCD. However, the serum levels of leptin in female subjects were significantly reduced (p<0.00l) from $8.9{\pm}4.8\;ng/mL$ to $6.9{\pm}4.8\;ng/mL$. In conclusion, 8 weeks of LCD with individualized counseling by a dietitian effectively reduced body fat and visceral fat in both men and women with BMI in excess of $23\;kg/m^2$.

• Nutrition Research and Practice
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• 제15권6호
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• pp.789-797
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• 2021

BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m². Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

• 대한영양사협회학술지
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• 제18권1호
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• pp.72-80
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• 2012

This study examined the effects of custom nutrition education on dietary intakes and clinical parameters in patients diagnosed with iron deficiency anemia. A total of 34 patients visited the anemia clinic of Yeouido St. Mary's Hospital. Among these, only 16 patients were available for follow-ups. A follow-up was conducted by a clinical dietitian 2 months from the first nutrition education session. Patients were all women. For custom nutrition education, we investigated anthropometric data, dietary assessment (24 hr-recall, FFQ), and self-recognized anemic symptoms. Weight did not show a significant difference but hemoglobin, hematocrit (P<0.01), serum iron, and serum ferritin (P<0.05) were significantly increased after the nutrition education. Serum total iron binding capacity was significantly decreased (P<0.01). Self-recognized symptoms such as dizziness, fatigue (P<0.001), shortness of breath, headache (P<0.01), brittle nails, and sore tongue (P<0.05) were significantly improved. Daily intakes of protein (P<0.05), total iron (P<0.01), and animal iron (P<0.001) were significantly increased. A significantly negative correlation was observed between current serum iron and the intake of carbohydrates, fat, or phosphorus (P<0.05). But current serum ferritin showed a significantly positive correlation with the frequency of intake of meat, poultry, and fish. It could be concluded that the custom nutrition education might be effective on quality of diet as well as iron status and it might also improve the clinical parameters in patients diagnosed with the iron deficiency anemia.

• Clinical Nutrition Research
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• 제12권2호
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• pp.99-115
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• 2023

Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.