• 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.

• 대한영양사협회학술지
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• 제9권1호
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• pp.32-39
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• 2003

Although medical nutrition therapy (MNT) is considered as a cornerstone of medical treatment for hypercholesterolemia, few studies have evaluated medical and economical outcome of MNT. This study was conducted to identify whether MNT administered by registered dieticians could lead to a beneficial clinical and cost outcome in persons with hypercholesterolemia. A prospective clinical trial was carried out at outpatient clinics, which involved an initial visit with a dietitian followed by another visit at first 4 weeks during the 6 weeks study periods. Thirty-nine subjects took part in a 6 weeks nutrition intervention program. Clinical and economical outcomes were compared before and after MNT. Medical nutrition therapy lowered total serum cholesterol level 6.1% (P<0.05), low-density lipoprotein cholesterol (LDL-C) 9.4% (P<0.05) and high-density lipoprotein cholesterol (HDL-C) 3.0% (P<0.05). The cost-effective ratio was ￦ 1,520/cholesterol mg/dl and ￦ 1,441/LDL-cholesterol mg/dl, respectively. After dietitian's intervention, lipid drug eligibility was obviated in 16 of 39(41%) subjects. The cost savings from the avoidance of lipid medications was ￦ 151,107 per patient annually. In conclusion, it is suggested that provision of systemic intensive nutritional care for persons with hypercholesterolemia has significant effects on serum cholesterol reduction and clinical cost savings.

• 대한영양사협회학술지
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• 제19권3호
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• pp.265-286
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• 2013

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

• 대한영양사협회학술지
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• 제21권2호
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• pp.91-109
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• 2015

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

• 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.

• Journal of Nutrition and Health
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• 제50권5호
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• pp.519-529
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• 2017

임상영양서비스에 대한 의사의 인식과 임상영양사 요구도에 대한 의사의 인식에 대한 인과관계를 명확하게 파악하기 위해 매개효과를 분석하고 부트스트래핑으로 매개효과를 검증한 이 연구의 결과물을 요약하면 다음과 같다. 연구목적을 달성하기 위해 5가지 가설을 다음과 같이 세웠다. 가설 1. '의사가 인식하는 임상영양서비스의 실행에 대한 의사의 인식'은 '임상영양서비스의 중요도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 2. 의사가 인식하는 '임상영양서비스의 질병 치료 효과에 대한 의사의 인식'은 '임상영양서비스 중요도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 3. '임상영양서비스의 중요도에 대한 의사의 인식'은 '임상영양사 요구도에 대한 의사의 인식'에 정(+)의 영향을 줄 것이다. 가설 4. '임상영양서비스 중요도에 대한 의사의 인식'은 '임상영양서비스 실행에 대한 의사의 인식'과 '임상영양사 요구도에 대한 의사의 인식' 사이에서 매개역할을 할 것이다. 가설 5. '임상영양서비스 중요도에 대한 의사의 인식'은 '임상영양서비스의 질병 치료 효과에 대한 의사의 인식'과 '임상영양사 요구도에 대한 의사의 인식' 사이에서 매개역할을 할 것 이다. 가설검증 결과와 매개효과 분석 결과 가설 1~5까지의 가설이 모두 지지되었다. 결론적으로 1) '임상영양서비스의 중요도에 대한 의사의 인식'이 완전 매개로 작용한 경우는 임상영양서비스 실행 횟수에 상관없이 의사가 임상영양서비스의 중요도를 인식해야만 임상영양사 요구도를 인식한다는 것이며, 2) 임상영양서비스의 중요도에 대한 의사의 인식이 불완전 매개로 작용한 경우는 임상영양서비스의 질병 치료 효과에 대한 의사의 인식과 임상영양서비스 요구도에 대한 의사의 인식 사이에서 프로세스 역할을 수행하지만, 임상영양서비스의 질병 치료 효과에 대한 의사의 인식이 임상영양서비스 요구도에 대한 의사의 인식에 더 큰 영향을 준다는 것이다. 따라서 임상영양서비스에 대한 의사들의 긍정적인 인식은 임상영양사 요구도에 대한 의사의 인식을 높이지만, 단순히 임상영양서비스의 양적 횟수 즉 임상영양서비스의 실행에 대한 의사의 인식이 아니라 환자 치료에 있어서 도움이 되는 질적 효과 즉 임상영양서비스의 질병 치료효과에 대한 의사의 인식과 임상영양서비스의 중요도에 대한 의사의 인식이 의사들에게서 임상영양서비스에 대한 긍정적인 인식을 이끌어 낼 수 있다. 이러한 의료진의 긍정적인 인식을 높이기 위해서는 추가적으로 임상영양서비스를 수행하는 임상영양사의 전문성이 요구된다. 이상의 결과를 근거로 임상영양서비스에 대한 의사의 인식이 임상영양사 요구도에 영향을 준다고 여겨진다. 더불어 영양학 분야의 유사연구에서 사회과학 분야 통계기법을 활용하여 명확한 인과관계를 규명하는데 본 연구가 발판이 되어 질 것으로 기대하는 바이다.

• 대한영양사협회학술지
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• 제7권1호
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• pp.38-49
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• 2001

This study was designed to analyze the dietetic practitioner's job in the over 600-ed hospitals in korea and to assess their labor time spent and staffing need indices. The actual time spent and expected labor time spent on dietitians' activities were investigated and the proper dietic staffing needs in the hospitals was also calculated. A job analysis questionnaires were developed and mailed to 20 hospitals. Completed questionnaires were received form 12 hospitals for a response rate of 60%. The followings are summary of the results. 1. The jobs dietitians at the hospitals were classified into the following 7 areas, direct patient care, indirect patient care, therapeutic patient care, education & counseling, meeting & research, delay & movement, and administration & food services. 2. The actual time spent on dietetic practice was 48.6 hours and expected labor time spent was 99.2 hours, Therefore, the proper time required to conduct classified jobs was 2.1 times higher than the time spent. Especially, the time required for performing clinical nutrition services including direct patient care, indirect patient care, therapeutic patient care was significantly higher than the time needed. 3. The average times required for the direct patient care was 1334.6min, for the indirect patient care was 796.3min, for the therapeutic patient care was 1634.5min, for the education & counseling was 265.2min, for the meeting & research was 366.7min, for the delay & movement was 327.3min, and for the administration & food services was 1170min. The staffing need indices was 12.3. As a conclusion, the standardized job descriptions for the dietitian to carry out their job at the hospital should be established. And the clinical dietitians as nutrition professionals have to be recruited to provide systematically hospitalized patients with medical nutrition therapy at each hospital.

• 대한지역사회영양학회지
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• 제14권1호
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• pp.100-113
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• 2009

This research aims to examine the experiences of hospital dietitians' burnout and the factors of their burnout, such as demographic factors, unique characteristics of hospitals, their self-respect, and organizational factors. In order for this, a questionnaire survey was conducted with hospital dietitians working in general hospitals of over 400 beds in the Seoul Metropolitan area. The average point of self-respect of dietitians is 3.67 out of 5.00. Their experience of burnout turned out to be 3.17 out of 7, the extent of job satisfaction is high, that is 3.35 out of 5.00. The decrease of personal accomplishment is shown to be closely related to the burnout of dietitians. The emotional exhaustion in burnout at the significant level 0.001 is increasing as the annual gross salary is low, their age is young, extra-working hours are long, and is high to the dietitians serving meals and working at entrusted companies. The factors affected by burnout experience vary with individual circumstances. So, to prevent the emotional exhaustion, depersonalization, and reduced personal accomplishment, hospital dietitians' spiritual and physical health needs to be kept up by their self-development and investment.

• 대한영양사협회학술지
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• 제8권4호
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• pp.408-414
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• 2002

The purpose of this study was to develop the standardized manual for dietetic internship. The general information of the dietetic internship program in Korea was gathered and of dietetic internship(DI) in the USA was also surveyed. The existence of DI program manual, the number of intern and length of the dietetic internship program, and other general information were investigated. At first, the questionnaire was developed and mailed to 130 hospitals in Korea and the number of returned questionnaires was 42 showing participating rate of 28%. Second, telephone survey was carried out and the number of response was 40 out of 46 participating rate of 87%. The results of this study could be summarized as follow. 1. eneral informations of dietetic internship program in Korea; The hospital having a dietetic internship program was 31.7% and of them 14.6%(12 hospitals) have a manual developed by themselves. The number of dietetic intern per hospital was 2.0$\pm$ 1.4. The length of the program was from 3 to 12 months. Ten hospitals (38.5%) have a only food service program and 16 hospitals (62.5%) have both food service and clinical program. Seventy one percent (58 hospitals) of total hospital were willing to use the well developed standardized dietetic internship manual. 2. eneral information of Dietetic Internship Program in the USA; Two hundred fifty nine hospital had the dietetic internship program approved by ADA. The number of dietetic intern in each hospital was 10.6$\pm$ 6.3. The mean length of the program was 13.6$\pm$ 6.3 months. Twenty seven percent of institution have coordinated internship/masters degree program. The range of tuition for DI program was from 300 to 30,855(otherwise, interns were payed by the hospital in Korea). As a conclusion, the standardized dietetic internship program for the clinical dietitian as nutrition professionals to carry out their job at the hospitals should be developed. And the coordinated internship/masters degree program could be considered to improve the skill levels and job performances of clinical dietitian.

• 한국식품조리과학회지
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• 제29권1호
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• pp.63-71
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• 2013

The purpose of this study was to analyze the gap between importance and performance in perceived sanitation management for general hospital foodservice operations. Data were collected through surveys given to 168 hospital dietitians in the Seoul-Incheon, Gyeonggi-do, Daegu, and North Gyeongsang province. The 65 questionnaires from total questionnaires were usable and the response rate was 38.7%. All statistical analyses were conducted using the SPSS package program (version 20.0) for t-test, ANOVA, and importance-performance analysis (IPA). According to the importance and performance analysis for 26 items, the importance score was significantly higher than the performance score for 22 items. In addition, the results of IPA showed the following areas as improvement priorities: handling foods on working table and management of distribution temperature. In conclusion, the performance level of prerequisite programs applying to the hospital foodservice needs improvement, especially cross-contamination prevention and temperature control for distribution. Additionally dietitians should be educated about sanitation management items that perceived to be less important than the others.