• Journal of the Korean Dietetic Association
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• v.2 no.2
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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.

• Journal of the Korean Dietetic Association
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• v.14 no.3
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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 the Korean Dietetic Association
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• v.7 no.3
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• pp.295-306
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• 2001

The purpose of the study was to develop an internet nutritional counseling program using an expert system to assist obese people to lose weight through behavior modification. The internet counseling program for weight loss was developed by the accumulation of knowledge dealing with eating habits and exercising behaviors in expert system tool, Knowledge Engineering Agent (KEA) by a dietitian without any help of computer expert. To accumulate knowledge into KEA, survey was performed in 150 obese people, dietitians reviewed and consulted each survey case, and the consulted contents were learned and accumulated into KEA. Survey questionnaire was the same as that of the internet consulting program, and it included general characteristics, dietary habits, lifestyle, and exercise patterns related to obesity. Also, the dietitian selected proper factors inferred from the survey questionnaire of each case, and added the conclusions for them. Conclusions were made for helping clients to correct bad eating behaviors and accumulate good behaviors to lose weight. Counseling was divided into two parts; a two-week part and a daily part. Two-week counseling was performed based on 4 step questionnaires, and daily counseling was done for daily food consumption and physical activity. When clients answered survey questionnaires in a counseling internet program, the recommendations on how to eat, to exercise and to deal with stress in a real time for each case, was given. In conclusion, a counseling internet program for weight reduction can be used to give advices how to deal with obesity in a man-to-man way in a real time using KEA where nutritional knowledge based on behavior modification for weight loss was accumulated.

• Journal of Nutrition and Health
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• v.43 no.5
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• pp.533-542
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• 2010

The objective of this study is to provide basic information and policy implications needed to balance the supply and demand for dietitian by projecting supply and demand for dietitian. The data from the Ministry of Health Welfare and Family on the number of licensed nutritionist, resident registration data of the Ministry of Public Administration and Security, and health insurance qualification data of the National Health Insurance Corporation were used to examine the current status of supply. To project the supply of nutritionist workforce, the in-out moves method and demographic method were used. The ratios of nutritionist to population and GDP, and that of other countries were applied as the demand projection method. According to the study results, the projection on the imbalance of supply and demand for dietitian by year 2021 differs depending on the method used. First, according to the results based on age-adjusted population ratio, there is an oversupply of 1,643 dietitians in year 2010, and 2,076 dietitians in year 2020. Second, although the projection on the imbalance of the supply and demand for dietitian differs depending on whether the GDD is calculated in won(￦) or dollar($). it is expected that there will be an oversupply in general. Third, as to the scenario using the nutritionist ratio in foreign countries, the oversupply of dietitian is likely in Korea, under any scenario, when comparing the nutritionist supply projection with the demand projection based on the nutritionist ratio in the United States. However, the projection of the supply and demand varies in each scenario when the European nutritionist ratio is applied. Under European 'scenario 1', an oversupply is expected, whereas under 'scenario 2', a shortage of supply is expected. A careful approach is required in interpreting the supply and demand projection using criteria of other countries, because dietitian assumes different roles and functions in each country. Although a slight oversupply of nutritionist workforce is projected, it does not cause a major problem as the demand for diet therapy is expected to rise due to aging and the increase of chronic diseases, and as the demand for clinical dietitians in hospitals increases. Accordingly, the demand for dietitians will rise and, in this context, the oversupply of nutritionist will not incur much problem. However, the nutritionist qualification is much too open in Korea, and this has a negative effect on the quality of the nutritionist workforce. Therefore, it is important that the nutritionist qualifications and requirements are reinforced in the future, enhance the quality level of the nutritionist supply, and maintain the balance between the supply and demand.

• Journal of Community Nutrition
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• v.7 no.3
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• pp.121-129
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• 2005

Food neophobia, unwillingness to try novel foods, is a personality trait that can influence children's food preferences and consequently their food acceptance and consumption. The purpose of this study was to determine whether children with food neophobia have poor dietary and growth outcomes compared to non-neophobic children. Subjects were 332 primary school children from 6 randomly selected schools in the district of Hulu Selangor, Selangor. Parents and children were interviewed to obtain demographic, socio-economic, food neophobia and dietary intake information. The children were also measured for weights and heights. One-way ANOVA and Chi-square procedures were utilized for statistical data analysis. Children with food neophobia had higher intakes of energy and most nutrients than average and neophilic children. However, only the mean intakes of protein (p < 0.05) , fat (p < 0.05), vitamin A (p < 0.01) and iron (p < 0.01) were significantly higher in neophobic than average or neophilic children. Compared to neophilic and average groups, a higher percentage of neophobic children met 2/3 of the RNIs for energy $(85.2\%)$, protein $(98.4\%)$ and vitamin A $(72.1\%)$. Mean percentage of carbohydrate energy was lowest$(54.8\pm6.6\%)$ while fat energy $(31.8\pm6.2\%)$ was highest among neophobic children. Neophobic group had the lowest percentage of children $(49.2\%)$ with carbohydrate energy > $55\%$ but highest percentage $(50.8\%)$ with fat energy > $30\%$. For the three study groups, the mean number of servings for all food groups, except grain and cereal, did not meet the Food Pyramid recommendations. Neophobic children consumed significantly more numbers of servings from the meat group than average and neophilic groups (p < 0.01). All study groups had relatively low mean dietary diversity scores but neophobic children had the lowest score $(0.67\pm0.73)$ compared to the average $(0.97\pm0.72)$ and neophilic $(1.98\pm0.81)$ groups. Significant difference in mean dietary diversity scores were only observed between neophobic and neophilic children (p<0.05). Higher percentages of neo-phobic children had low weight-for-height and were at-risk of overweight(p < 0.05). Nutrition practitioners need to understand children's food preferences in their efforts to promote healthful diets for children. To improve children's eating behaviors, parents may need the guidance and support from nutritionists and dietitians that are specific to their needs and their child's situation.

• Journal of the Korean Dietetic Association
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• v.5 no.2
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• pp.194-204
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• 1999

The objectives of this study were to assess the current practices of implementing selective menus and to identify the perception of foodservice manager and customer on selective menus for hospital foodservice would be fulfilled. Two types of questionnaires for hospital foodservice managers as well as customers were developed. Questionnaires were distributed to managers of 8 hospital foodservice department and 317 customers of patient meal service, and 6 managers and 139 customers were responded. The data were analyzed using frequency and t-test. The results of this study can be summarized as follows : 1. In hospital foodservice operations, the selective menu pattern was first introduced by L hospital on June 1994 in Seoul and recently 8 hospitals were currently implementing selective menus. But using rate of selective menus by patients were relatively low(23.2%), ranging from 15% to 32%. 2. Customers' needs for selective menus were rated significantly higher in the group of patients(4.24/5) who chose the selective menus than their counterpart(3.88/5). 3. The main reason not choosing selective menus was identified by patients as 'not knowing the implementation of selective menus'(52.6%), inconvenient factors in using selective menus for customer were also identified as orders : 'lack of nutrition information on menu item'(38.6%), 'complexity in procedure'(29.8%), and 'lack of menu variety'(26.3%). However managers considered 'managerial burden' and 'limited human resource' as main obstacle to implement the selective menu pattern. 4. Customers indicated 'variety of menu', 'active public relations' as effective methods to enhance using rate of selective menus, however, foodservice manager indicated 'variety of menu'(50%), 'improvement of quality'(16.7%), and 'simplicity in procedure'(16.7%). Based on the results of this study, following recommendations have been suggested : Managers in patient meal service should recognize customer needs for implementing selective menus and pay more attention in implementing selective menus and activating this program. For more effective implementation of activating selective menu program, the foodservice department should establish action plan on 'active publicity work', 'simplicity in procedures', 'variety of menu' and 'improvement of quality'. Especially nutrition informations on meals should be provided for customers in order to elevate participation rate.