• Journal of Korean Academy of Nursing
• /
• v.33 no.4
• /
• pp.478-487
• /
• 2003

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. Design. A correlational and crossectional study design was used. Method. One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. Results. The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. Conclusion: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

• Nutrition Research and Practice
• /
• v.11 no.4
• /
• pp.327-333
• /
• 2017

BACKGROUND/OBJECTIVES: Complications of diabetes, such as cardiovascular disease, are associated with increased mortality among type 2 diabetes mellitus patients. Homocysteine has been recently identified as a predictor of cardiovascular disease-related complications in diabetes. We investigated whether or not supplementation with folic acid tablets can lower homocysteine levels and improve parameters related with vascular complications. SUBJECTS/METHODS: We conducted a non-randomized 8-week trial involving postmenopausal diabetic women (n = 25) supplemented with $800{\mu}g$ of folic acid ($400{\mu}g$ twice a day) daily. Subjects' serum levels of folate, homocysteine, and vitamin $B_{12}$ were measured, along with vascular function and brachial-ankle pulse wave velocity. RESULTS: Folic acid supplementation significantly increased serum folate levels (P < 0.0001), reduced homocysteine levels (P < 0.0001), and increased vitamin $B_{12}$ levels (P = 0.0063). There were significant decreases in low-density lipoprotein cholesterol levels as well as the ratios of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein cholesterol. Brachial-ankle pulse wave velocities were not altered by supplementation. Changes in serum vitamin $B_{12}$ after folic acid supplementation were negatively correlated with changes in brachial-ankle pulse wave velocity. CONCLUSIONS: In this study on postmenopausal Korean women with type 2 diabetes mellitus, folic acid supplementation reduced serum homocysteine levels, increased serum folate and vitamin $B_{12}$ levels, and lowered lipid parameters.

• Journal of Gastric Cancer
• /
• v.23 no.2
• /
• pp.303-314
• /
• 2023

Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic function-preserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into "LTG for LPG" (LTG-P) and "LTG for LSTG" (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions: LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival. Therefore, LFPG for upper early gastric cancer should be considered in older patients.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.4 no.2
• /
• pp.337-349
• /
• 1997

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.

• Nutrition Research and Practice
• /
• v.12 no.3
• /
• pp.215-221
• /
• 2018

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

• Journal of Nutrition and Health
• /
• v.39 no.3
• /
• pp.299-306
• /
• 2006

This study was done to investigate the use of nutritional supplements (NS) in Korean elite soccer players using an anonymous questionnaire. NS were classified into health supplements, manufactured health food supplements, chinese medicines & tonic foods, and nutrient supplements. Information was sought on the type of NS and factors that might influence supplement use including selected demographic parameters and health related variables. The data were collected from 241 athletes (aged $24.6{\pm}3.8$ years) in 9 professional soccer club. The prevalence of NS use among the subjects was 81.3%. Health supplements were used most frequently and nutrient supplement drug was the second one. Among the health supplements, weight/muscle gainer and calorie replacement product were most frequently used. Vitamin supplements were most frequently used among all nutrient supplement drugs. Users of NS were higher age (p<0.05) duration of exercise (p<0.05), and income (p<0.05) than non-users. The married (p<0.05) and a member of K-league (p<0.01) tended to have higher prevalence of NS use. The main adviser of NS were family (55.3%) and oneself (39%) instead of coach or sports nutritionist. Although NS use, only 26.2% certainly check up nutritional information on their used NS. Among the subjects, 84.5% of them felt that NS use were improved athletic performance, and 86.5% of them will to keep on taking supplement. These data suggest that a large number of elite soccer players use NS and these players may require education about healthy nutritional supplement practice and on the proper use of nutritional supplements.

• Korean Journal of Community Nutrition
• /
• v.10 no.5
• /
• pp.645-653
• /
• 2005

The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, $22.3\%$ of patients were malnourished and $40.7\%$ were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p<0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p<0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p<0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.

• Journal of Nutrition and Health
• /
• v.36 no.6
• /
• pp.577-588
• /
• 2003

Severe protein-calorie malnutrition, common in patients with advanced liver disease, can seriously undermine the capacity for regeneration and functional restoration of liver. Nutritional supplementation for these patients can improve biochemical and hormonal abnormalities. However, these effects were not identified in patient with nonalcoholic liver cirrhosis. To determine effects of nutritional supplementation in patients with nonalcoholic liver cirrhosis, 77 subjects aged 29 to 69 years participated in this study for 12 weeks and were subdivided into three groups; normal diet group (Control group, n ＝ 16), branched-chain amino acid supplementation group (BCAA group, n ＝ 31), nutritional supplementation group (NS group, n ＝ 30). Anthropometric parameters, hemoglobin, hematocrit, blood cell counts, serum levels of lipids, vitamins, minerals and fatty acid composition, and plasma amino acids were examined. The mean values of age and height, and the initial values of weight and body mass index (BMI) were not different among all groups. After 12 weeks, there were no significant changes in these values in Control group. Only NS group showed significant increases in weight, lean body mass, midarm circumference, triceps skinfold thickness. Serum transferrins were increased both in BCAA and NS groups. Plasma levels of branched-chain amino acids, urea amino acids and glutamic acid were also significantly increased in these groups, but plasma levels of ammonia, serum LDL cholesterol and atherogenic index were decreased. However, there were no significant changes in serum levels of vitamin and mineral and composition of fatty acids in phospholipids in these groups. These results showed that the nutritional supplementation for patients with nonalcoholic liver cirrhosis can more improve nutritional status in these people together with increases of weight, body fat and lean body mass, compared to only BCAA supplementation. To ascertain and investigate the appropriate nutritional supplementation for patients with nonalcoholic liver cirrhosis, further studies are necessary.

• Korean Journal of Head & Neck Oncology
• /
• v.24 no.2
• /
• pp.184-188
• /
• 2008

Objectives：Weight loss and malnutrition in patients undergoing radiotherapy for head and neck cancer are usual and preventable. The effect of nutritional support with oral high protein liquid was evaluated. Material and Methods：From Feb. to Dec. 2007, twenty patients received nutritional supplement with oral high protein liquid during radiotherapy for head and neck cancer and the nutritional status was evaluated. Weight loss was compared with control group of similar clinical characteristics. Results：Nutritional parameters such as weight, arm circumference, hemoglobin, hematocrit, total protein, albumin, transferring and the number of lymphocyte were relatively well maintained in patients with nutritional support with oral high protein liquid. In addition weight loss was minimal and significantly lower compared with control group. Conclusion：Nutritional support with oral high protein liquid was effective on maintaining nutritional status for the patients with head and neck cancer during radiotherapy.

• Journal of Korean Academy of Nursing
• /
• v.47 no.6
• /
• pp.731-743
• /
• 2017

Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.