The purpose of this study was to evaluate the patient perception of clinical nutrition service. The research was performed by using questionnaires and conducted from February 14 to March 15 at 42 hospitals (over 400 beds). 41.7% of patients experienced nutritional education and counseling. The mean score of the patients' perception on clinical nutritional service was 4.62/5.00 for "nutrition care is important for treatment of the disease", 4.49/5.00 for "diet therapy is necessary for treatment of the disease", 4.16/5.00 for "nutritional counseling call-centers are necessary", 4.13/5.00 for "nutritional consultation fee is required to apply insurance benefits", 4.12/5.00 for "one-to-one nutrition system is necessary", and 3.56/5.00 for "nutrition services I am willing to pay". The patients who had no past experience in nutritional education and counseling showed significantly higher scores for "nutrition care is important for treatment of the disease", "one-to-one nutritional care system is necessary", and "nutritional counseling call-centers are necessary" (P<0.05). The mean scores for the importance (4.26/5.00) and performance (3.88/5.00) of nutrition counseling service were significantly different (P<0.01). "Nutritional counseling is available whenever I want" had the highest gap score between performance and importance among nutrition counseling service items. The importance and performance grid showed that highly important items had high performance (doing great area) and less important items have low performance (low priority).
This study was conducted to examine the association of dietary behaviors, serum lipid profiles according to the progression of angiographically evaluated atherosclerosis. The subjects were 32 male patients aged 59-80 yrs living in the Daegu area who underwent initial angiography for their lower extremities. We classified the subjects into two groups according to the seriousness of iliac lesions based on angiographic results : Group I (lower lesion group) and Group II (higher lesion group). Dietary habits were evaluated by 10-item questionnaires. Daily food intake of each subject was assessed by the 24-hour recall method. There were no significant differences in serum cholesterol and triglyceride levels between the two groups. The food habit score of Group II was significantly lower than that of Group I (P<0.001). Group II showed significantly lower dietary habit scores in the consumption of fish and bean product (P<0.001), seaweed product (P<0.01), and salt use (P<0.001) than those of Group I. Dietary intake of vitamin C was significantly lower in Group II (P<0.01). Our results indicate that the more serious of atherosclerotic lesions the patients had, the poorer dietary habits they exhibited. Therefore, medical nutrition therapy for atherosclerotic patients should emphasize maintaining a balanced diet by consuming more fishes, beans, and seaweed as well as by reducing salt intake.
This study was conducted as a part of the project developing the standards of national board test for the dietitian's licence. The purpose of this study was to define the job description of dietitians, and to describe the task elements based on the detailed analysis of the dietitians' work. This study team established the research team which was composed of food and nutrition experts, 7 of registered dietitians and 3 of university professors. Draft job description form was made to fully explain the dietitians' task elements, process and sequence by the research team. Final job description form was confirmed after the validity of 576 task elements was reevaluated upon 4 point scale test based on the frequency, importance, and difficulty by 21 field registered dietitian by the study team. It was also confirmed by the university. This form was formated by following DACUM method which analyzed the job description containing duty, task and task elements. It was organized to include every dietitians' work and to describe the every detailed process of work. Duty was defined as the specific and independent work as a dietitian, and was composed of 17 parts, i.e 10 parts in food supply management area and 6 parts in nutritional care service area and self promotion area. Duties were also divided into 99 tasks containing the 576 detailed task elements to describe definite action, steps and decisions. Seventeen parts are following; menu planning, storage and inventory control, food production, meal service, waste management, sanitation, equipment and facility management, human resource management, financial management, nutrition assessment of life cycle, nutritional assessment of several disease, nutritional assessment in specific condition, medical nutrition therapy, nutritional education, public health nutrition and self promotion. If these protocols are properly performed and presented, they can provide the likelihood that dietetics professionals work as a primary contributors in promoting health care and preventing disease nationally.
This study was reviewed databases and outcomes of national/international off-line and on-line(Internet) nutrition softwares to identify the present conditions of nutrition softwares, and investigated user's needs and determine which component should be included in nutrition software. The most frequently used databases for the national programs were the food composition table provided from the National Rural Living Science Institution in Rural Development Administration and the food composition table and the nutrient contents of foods provided from the Korean Nutrition Society. For international programs, the food composition table from the USDA was commonly used. The analysed outcomes included the degree of obesity, nutrient analysis and nutrient intake compared with RDA, food intake from each by food group, food habits and the frequency of food consumption. As to the result of needs assessment for the Internet nutrition softwares, it was suggested that the needs of the Internet nutrition softwares were high because most of the respondents replied that 3-point('it is needed') or 4-point('it is necessary') on 4-points likert scale. As to the databases, the needs of 'food composition analysis' and 'the suggestion of the Korean RDA' were high. For the basic information for foods, the respondents replied that 'the classification of foods', 'foods codes', 'the amount of ingredients' and 'nutrient analysis' should be included. The needs of 'nutrient analysis of meal', 'diet therapy' and 'meal plan by caloric requirements' were high. As for utilizing the Internet meal planning programs, the respondents replied that 'it should be easy to use' most and demand for 'data saving and the saved data should be usable later' and 'meal planning education tools' were high. In conclusion, the Internet nutrition software that satisfies various needs of users should be developed for policy making that promote public health, nutritional care and self-supporting of foods.
The aim of this study was to develop and apply a list of meals and standard recipes using barley for diabetic patients. The degree of interest and requirements of diabetic patients were investigated for the development of meals. The ingredients of the meals were selected through the diabetic literature and previous research. While developing a list of meals, dietetic therapies for diabetic patients were considered. After developing 15 kinds of meals and modifying them through sensory evaluation, a standard recipe was completed. In the standard recipe, the menu name, the ingredients, quantity, and recipe were stated and the nutritional components were indicated. Photographs of the meals were included. The calorie prescription for the diabetic patients was aimed at elderly women, that is, those 65 years old or above, based on research showing this to be the average age of diabetics. The prescribed calories were 1,500 kcal based on the food exchange list. Weekly lists of meals including the developed dishes were made for diabetic patients. The list were modified after consultation with a clinical nutritionist. When completed, one meal item was selected for each day and cooked. A photograph was taken and presented diabetic patients. This article presents the standardized recipes of the developed list of meals and applies them to modifying the diabetic diet, with an aim to be of service to diabetic patients attempting to meet their dietetic therapy goals. We also provide basic data on institutional food services for diabetic patients and nutrition education.
The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.
Dietary nitrate supplementation from green leafy vegetables and beetroot is involved in the 'nitrate-nitrite-nitric oxide (NO) pathway' and is reported to have important vascular impacts. This study evaluated the blood parameters and blood flow change subsequent to a raw juice diet program. The 28 subjects who voluntarily participated in the raw juice diet program at Sahmyook University were instructed to drink the juice composed of fruits and vegetables instead of partaking the usual meal, at a scheduled time daily. The study was approved by the research ethics council of the Sahmyook University (SYUIRB 2014-043). Evaluation of the participants after the required duration revealed decreased levels of soft lean mass (P<0.05), skeletal muscle mass (P<0.001), body fat mass (P<0.001), body mass index (P<0.001) and circulating levels of total cholesterol (P<0.001), triglycerides (P<0.05), HDL-cholesterol (P<0.01), LDL-cholesterol (P<0.01), and blood urea nitrogen (P<0.001). Conversely, circulating levels of creatinine (P<0.001), hemoglobin (P<0.001), and hematocrit (P<0.01) were increased after the intervention. The blood flow levels were also increased after the program (P<0.001). Our results indicate that a short-term raw juice diet contributes to the improvement of vascular blood flow and blood lipid parameters, and decreases the lean muscle mass related to dehydration.
The purpose of this study was to estimate the prevalence of hypertension, and to assess the risk factors associated with hypertension in elderly (over 65 years old) Koreans, using data from the 4th Korean National Health & Nutrition Examination Survey (the 4th KNHANES), 2007~2009. A total of 1,887 participants were analyzed for assessing the risk factors after excluding those who took hypertension medicines or underwent diet therapy (hypertension perceivers). On the other hand, in analyzing prevalence, a total of 3,526 people were analyzed, including hypertension perceivers. Hypertension was more frequently found in female (64.1%) and urban (62.0%) groups compared to male (55.6%) and rural (57.4%) groups. The mean age of the hypertensive group was significantly higher than that of normal group. The mean values of total cholesterol levels were also significantly higher in the hypertensive group, while body weight, waist circumference, fasting blood glucose, hemoglobin, hematocrit, LDL-cholesterol, and HDL-cholesterol were not. Multiple logistic regression showed that smoking was significantly related to the prevalence of hypertension, but alcohol drinking, stress, obesity, hypercholesterolemia, hypertriglyceridemia, diabetes, anemia, and nutrient intakes were not. The results of this study does not support clear relations of hypertension with chronic diseases including obesity, hyperlipidemia, anemia, and diabetes as well as nutrient intakes among a Korean elderly population. A prospective long-term research study is needed to establish the effects of these factors on hypertension.
Microalbuminuria is a strong predictor of diabetic nephropathy and is also associated with increased mortality in people with non-insulin-dependent diabetes mellitus(NIDDM) patients. Improved glycemic control and dietary protein restriction are recommended to retard and avoid developing microalbuminuria. The purpose of this study was to measure the dietary counseling effects for diabetes mellitus patients with microalbuminuria. To investigate the effects of the dietary counseling effect, thirty NIDDM patients with microalbuminuria were selected from outpatient diabetic clinic of Seoul National University Hospital for this study. None of them had evidence of renal and heart complications. For 24 weeks, they received individualized dietary counseling 3 times. The results of this study can be summarized as follows 1) Dietary protein and calorie intake decreased significantly from 79.8$\pm$29.9g/d to 66.6$\pm$16.5g/d, from 1845.4$\pm$631.9kcal to 1515.7$\pm$392.7kcal after dietary counseling, respectively (p<0.05). 2)The glycosylate hemoglobin level showed significantly decreased after dietary counseling(p<0.05). However there were no change in lipid profiles and blood pressure after counseling. 3) There was a significant correlation between the duration of disease and the amount of microalbuminuria. Any other cardiovascular risk factors, such as duration of diabetes, total cholesterol level and systolic blood pressure were not correlated with microalbuminuria. These results shown that dietary counseling can be used as an effective therapy to control blood sugar levels for NIDDM patients who are poorly controlled with microalbuminuria.
The purpose of this study was to investigate the effect of the web-based nutrition counseling on the dietary behavior and food intake of hyperlipidemic patients and to evaluate the web-based nutrition counseling program. Forty hyperlipidemic patients, twenty of them were hypercholesterolemia and the other twenty were hypertriglyceridemia, participated in the web-based nutrition counseling program. At the first nutrition counseling, the patients were interviewed and then follow-up nutrition counselings were accomplished four times during eight weeks through a web-based internet program. The web-based nutrition counseling program was consisted of diet management, nutrition education and nutritional assessment and the follow-up counseling program. The dietary behavior score increased significantly in both groups after the nutrition counseling program(p<0.01). The diet therapy knowledge score also increased significantly (p<0.01). For food frequency, vegetable (p<0.01), fruit (p<0.05) and seaweed (p<0.01) consumption increased significantly, while meat (p<0.01), egg (p<0.01), snack (p<0.01) and instant food (p<0.01) intake decreased significantly in both groups after the nutrition counseling program. The evaluation of the web-based nutrition counseling program by the patients showed above average in all domains, specially the evaluation scores of younger aged patients habituated to practice computer were better than those of older aged patients. Therefore, this study shows that the web-based nutrition counseling program is effective for improving dietary behavior and food consumption the patients. In addition, these results indicate that internet presents us with potential as a new medium for nutrition counseling in informationized society.
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