• Journal of Nutrition and Health
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• v.42 no.3
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• pp.234-245
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• 2009

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

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

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• Journal of Nutrition and Health
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• v.37 no.3
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• pp.210-222
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• 2004

In recent years, the number and proportion of Korean elderly have grown rapidly, and elderly individuals show a disproportionate risk for poor nutritional status. The purpose of this study was to examine the relationship of sociodemographic background to nutrient intake of persons 65 years of age or older, living in 15 cities in Korea. Data on 1973 subjects (603 males, 1370 females), who participated in the Korean Elderly Nutrition Survey (2000), were analyzed. Their mean age was 72.3 years and their mean body mass index (BMI) was 24.2 kg/$m^2$. Basic sociodemographic data were obtained through personal interviews. The 98-item semi-food frequency questionnaire, developed and previously validated for Korean middle-aged and elderly subjects, was administered. “Percentage of subjects who consumed under 75％ Korean RDA,” “number of nutrients consumed below 75％ Korean RDA,” “mean nutrient adequacy ratio,” and “nutrient density” were used to determine nutritional status. Male elderly had better nutritional quality than female elderly. Nutritional quality decreased with age, especially in older elderly (over 75). Elderly who were underweight (BMI 〈 20 kg/$m^2$) showed poorer nutritional quality than those who were normal weight (BMI 20∼25 kg/$m^2$) and overweight (BMI $\geq$ 25 kg/$m^2$). Elderly who lived alone had significantly poorer nutritional quality than those who lived with a spouse, and/or with children. Lower education level and economic dependence also showed lower nutritional quality. A stepwise multiple regression analysis was performed to examine the effects of specific sociodemographic factors on nutritional quality. For number of nutrients under 75％ RDA as a dependent variable, education level explained 4.8％ of the variance, followed by living status, age, body mass index, gender, and living expense support (Model $R^2$ = 0.091). For mean nutrient adequacy ratio as a dependent variable, model $R^2$ was 0.098. Therefore, sociodemographic variables such as gender, age, body mass index, living status, educational level, and economic status influenced elderly nutrition status. These results indicate that an elderly nutrition intervention should focus on subjects who are poorly educated, living alone, age 75 or older, and/or underweight.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.1
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• pp.92-102
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• 2007

Purpose: This study was conducted to evaluate nutritional status, and the effects of lifestyles and depression on nutritional status of elderly people (NSE). Method: The participants were 280 elders who visited the Y city Senior Welfare Center between August 2006 and October 2006. Data were collected using a structured questionnaire that included general characteristics, lifestyle checklist, depression scale, and nutritional risk index. Also, Body Mass Index (BMI) was calculated from height and weight. T-test, ANOVA, Duncan test, Pearson coefficients correlation and stepwise multiple regression were used to analyze the data using the SPSS Win 12.0 program. Results: The NSE mean score was mid level at 5.03 BMI was 23.42 which indicates overweight. Depression was the factor that influenced the nutritional risk index most strongly, accounting for 17.3% of the total variance in the NSE. A combination of significance of health, concerns about health, housing, condition of teeth, activity, and smoking pattern accounted for 29.8% of the variance in the NSE. Condition of teeth accounted for only 3.8% of the variance in BMI. Conclusion: It is necessary to be aware that variance in the NSE can be affected by several factors including depression and lifestyle and that depression is strongly related to poorer NSE.

• Journal of Korean Academy of Nursing
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• v.27 no.1
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• pp.49-60
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• 1997

The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.1
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• pp.73-86
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• 2015

The present study was performed to evaluate food behavior and nutritional status of children in a community child center using nutrition quotient according to age and growth index of children. The number of subjects enrolled in this study was 152 including 73 boys and 79 girls. Participants consisted of children from 5 to 12 years old, who visited a community child center in the area. Growth index was assessed through body mass index by height and weight and examined according to age. Subjects were divided into underweight, normal weight, overweight and obese according to questionnaire, which consisted of five categories including balance, diversity, moderation, regularity and practice, were analyzed by SPSS statistical program. Current results show significant differences in the diversity and regularity (p<0.05, p<0.001, respectively). Additionally, four items in the form of 10 questions showed significant differences related to habits of sodium-related food intake. This study design will be a useful tool in the evaluation of food behavior and nutritional status of preschoolers or elementary school children in community child centers, together with food frequency questionnaires related with sodium food intake.

• Korean Journal of Community Nutrition
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• v.2 no.3
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• pp.376-387
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• 1997

The elderly are the most rapidly growing segment of the population in Korea and the largest consumers of expensive medical care. It is reasonable to believe that improving the nutritional status would be beneficial to reducing morbidity and to impro- ving the quality of their lives. This study was conducted to assess the health status and the Nutritional Risk Index of the elderly, and to provide the basic data for the Elderly Nutrition Improvement Program at the Public Health Center. One hundred and forty seven(76 males. 71 females) aged 60 years and over living in Suwon, were assessed with anthropometric measurements, body fat analysis, blood pressure measurements, and a set of questionnaires about health and other related variables. Over half of them had less than a junior middle school education and were considered low income. The percentage of overweight and obese subjects was 33% by the BMI(Body Mass Index), and the prevalence of hypertension was 28$\%$(males) and 31$\%$(females). They had a lot of self-recognized health problems, the male elderly complained about more than the female elderly. In the case of psychological health status, however, the female elderly showed a higher proportions of depression than the male elderly(p$\ll$0.05). In social health status, the elderly had good relationships with friends and collegues, whereas they had poor relationships with their families. They had many nutritional risk factors, and smoking was the most prevalent risk factor for the male elderly and anemia was for the female elderly. The results of this study suggest that Elderly Nutrition Improvement Programs should be planned that can be easily followed. It would be helpful to design a program focusing on individual phychological and social health status, this would increase the efficiency of the program.

• Journal of Gastric Cancer
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• v.22 no.1
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

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