• 대한영양사협회학술지
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• 제2권2호
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Nutrition Research and Practice
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• 제10권1호
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• pp.99-107
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• 2016

BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: $38.75{\pm}17.20%$, post: $62.08{\pm}21.85%$). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.

• 대한영양사협회학술지
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• 제21권1호
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• pp.37-56
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• 2015

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

• 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.

• 대한지역사회영양학회지
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• 제12권3호
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• pp.299-309
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• 2007

The purpose of this study was to evaluate the effectiveness of nutrition education with nutrition services provided by dietitians who were placed in child care facilities from the Korean Dietetic Association. For this, we investigated the levels of nutrition knowledge and dietary intakes of children who attended child-care centers as well as dietary practices of children assessed by their parents. The treatment for children consisted of nutrition education and food service activities that are provided by the dietitian who have 3 to 5 years experience. Nutrition education was implemented during 10 weeks, 20 times, and a total 400 min and it's effectiveness was evaluated by questionnaire. Data were obtained for 123 children aged 4 to 5 years old who attended four child-care centers, one for a control group and 3 for intervention groups. Dietary intakes were investigated by measuring one-serving size and plate waste a of child for one-day dietary records before and after nutrition education. The levels of nutrition knowledge of children improved showing 70.80 points before to 83.45 points after nutrition education (p<0.001). Dietary intakes of the children after nutrition service increased significantly on cooked rice (133.66 g), Kimchi (19.41 g), side dish of meat/fish (48.40 g), and side dish of vegetables (24.88 g). Dietary practices of children after treatment also improved especially 'eat diverse meat, fish, egg, and bean' and 'never leave plate waste'. To summarize, this study pointed out that nutrition service and nutrition education provided by dietitians had influences on increases of the nutrition knowledge, dietary intake, and dietary practices. Therefore, placement of dietitians needs to extend to child care facilities from the 100 persons-over-capacity facility to the 50 persons-over-capacity facility, for providing professional service such as nutrition education and nutrition counseling.

• 대한영양사협회학술지
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• 제2권2호
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• pp.112-122
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• 1996

This study was designed to provide data useful for the efficiency of dietitians' nutrition care by evaluating medical staffs' perception of nutrition in a hospital. The datas were collected through a questionnaire survey conducted upon 874 medical staffs at 50 general hospitals , each one with more than 100 beds, in Seoul and Pusan. A logistic regression analysis was used to determine the influential factors of medical staffs' perception about nutrition among the selected variables. As a result, most medical staffs(96.9%) had positive perceptions about the importance of nutrition as a medical therapy. However, more than half of the respondents(69.1%) said that the dietary department plays the auxilliary role of producing patients' meals according to diet prescriptions. 271% of the medical staffs perceived that the dietary department as contributor to patient's health care through involvement in medical nutrition therapy, while 4% of the medical staffs misunderstood the dietary department as part of the hospital administration. The results of logistic regression analysis showed that factors related to hospital size and dietitian manpower( Total No. of beds, No. of beds per dietitian) have more influence upon medical staffs' perception about nutrition than their personal and occupational characteristics(P (0.001). In case where medical staffs' perceptions were more positive, the efficiency of dietitians performing nutrition care was higher. Results of this study suggests optimal dietetics staffing as a way to increase the efficiency of nutrition care in a hospital.

• Journal of Community Nutrition
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• 제7권4호
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• pp.207-214
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• 2005

The purpose of this study is to identify the transformational or transactional leadership styles of Korean dietitians. The study was completed with Korean dietitians (n = 268, $67\%$ response) using mail survey. The leadership styles were divided into transformational (including charisma, intellectual stimulation, individualized consideration) and transactional (contingent reward, management by exception) leadership found in the several literature. Overall, the score of Korean dietitians' transactional leadership was higher than that of the transformational leadership (p < .05). Among three sub-dimensions of the transformational leadership styles, the score of 'individualized consideration' was higher than 'charisma' and 'intellectual stimulation'. Between two sub-dimensions of the transactional leadership styles, Korean dietitians used more 'management-by-exception' than 'contingent reward'. ANOVA results suggested that the transformational leadership was more likely to be used by the younger dietitians, while the transactional leadership was more likely to be used by the older dietitians (p < .05). Data showed that dietitians having 3-6 year dietetic experience used more transformational leadership than other experienced dietitians (p < .05). It was also found that the Korean dietitians' leadership styles were influenced by the type of dietetic practice area. Data showed that 'charisma', 'intellectual stimulation', 'individualized consideration' and 'contingent reward' were more likely to be used by Korean dietitians from school than by dietitians from health. care and industry (p < .05). This study will be useful for dietitians to guide the application of appropriate leadership style in order to increase employees' job satisfaction as well as organizational performance. (J Community Nutrition 7(4) : $207\∼214$, 2005)

• Journal of Community Nutrition
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• 제8권3호
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• pp.119-126
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• 2006

The purpose of this study was: 1) to investigate whether Korean dietitians are engaged in Foodservice Systems Management (FSM) competencies in their current jobs, and 2) to identify the relationship between types of dietetic practice areas and Korean dietitians' usage of FSM competencies. Fifteen FSM competencies were widely used, 17 were somewhat used, 13 were seldom used and the remaining two competencies were little or not used by the dietitians. The most used competency was related to menu planning (98%). Whereas, the least used competency was related to marketing skills (17%). As a whole, the categories of 'technical and communication skills' (78%) and 'production and distribution management' (77%) were more widely used than other FSM categories. Of 47 competencies, 34 competencies were found to be significantly associated with the type of practice area. Considering the findings, the type of dietetic practice area was a strong factor of Korean dietitians' usages of FSM competencies. Of 34 competencies associated with the type of dietetic practice area, 25 FSM competencies were more likely to be used by the dietitians from health care facilities.

• 대한영양사협회학술지
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• 제14권3호
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• pp.229-242
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• 2008

This study examined foodservice management performance in child-care centers and suggests ways in which meal service quality can be improved. Questionnaires were distributed to 51 child-care facilities. The majority of respondents were facility directors (dietitians) and their facility type was tax-paid (92.2%). The dietitian response rate was 51.0%, and the majority (96.2%) were hired with co-management status, visiting a facility once a week (76.0%). Only 52.1% of the facilities had menu planning by a dietitian, and improvements were needed in terms of planning menus with standardized recipes, especially for infant meals. The monthly food cost per child was 47,394 won, and the labor cost for a co-management dietitian was 3,670 won per child, indicating 21.8% and 1.8% of the tuition fee, respectively. Other necessary improvements included: more reliable food purchasing management, securing additional foodservice equipment, and better sanitation management. In addition, respondents rated the following as requirements to ensure high quality meal service: 'modernized foodservice equipment and facilities', 'government financial support', and 'information on nutrition and foodservice management provided by dietitians'. Based on the study results, the following are recommendations for improving meal service quality in child-care centers: Dietitian placement should be extended to facilities of over 50-capacity in addition to their current placement in facilities of over 100-capacity, and co-management dietitians should have their control span restricted to two facilities instead of five. Finally, nationwide nutrition support plans and nutrition education programs should be developed and implemented by dietitians, and their roles should be extended to foodservice mangers as well as nutrition teachers.

• Journal of Community Nutrition
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• 제8권1호
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• pp.9-15
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• 2006

Health care is one of the most popular reasons for accessing the Internet. Of concern is the amount of information from disreputable sources available on the Internet. A review of websites offering nutrition consulting services suggests sites are controlled by both registered dietitians and non-dietitian professionals marketing themselves as nutrition consultants. The purpose of this study was to investigate structure and content of websites controlled by registered dietitians and nondietitians professionals marketing themselves as nutritionists or nutrition consultants. Internet search queries of 'dietitian', 'dietitian consultant', and 'nutrition consultant' were completed for website selection. Thirty websites controlled by registered dietitians and 10 websites controlled by nutrition consultants were reviewed using an 18-item website evaluation instrument developed for this study. Five evaluators were recruited from the dietetics program at the University of Kentucky. Overall, websites controlled by registered dietitians ranked higher than websites controlled by nutrition consultants in a majority of categories. Sites controlled by registered dietitians ranked statistically higher for the following categories: 'accuracy of information'(p<.0001), 'inclusion of professional resume of owner or primary manager' (p<.05), and 'explanation of the affiliation to externallinks'(p<.05). A majority of sites controlled by both dietitians and nutrition consultants achieved a poor ranking in regards to provision of a legal disclaimer and inclusion of a privacy policy. Prior studies suggest personal privacy is the most important concern for consumers accessing health information on the Internet. Findings from this project will benefit dietitians to assist in development of reputable nutrition related websites.