• 제목/요약/키워드: medical nutrition care service

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A Study for Identification of Nursing Diagnosis using the Roy's Adaptation Model in Maternity Unit (Roy's Adaptation Model에 의한 모성영역에서의 간호진단 확인연구)

  • Jo, Jeong-Ho
    • The Korean Nurse
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    • v.33 no.3
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    • pp.79-91
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    • 1994
  • The purpose of this study was to identify the meaningful nursing diagnosis in maternity unit and to suggest formally the basal data to the nursing service with scientific approach. The subject for this paper were 64 patients who admitted to Chung Ang University Hospital, Located in Seoul, from Mar. 10, to July 21, 1993. The results were as follows: 1. The number of nursing diagnosis from 64 patients were 892 and average number of nursing diagnosis per patient was 13.9. 2. Applying the division of nursing diagnosis to Roy's Adaptation Model, determined nursing diagnosis from the 64 patients were 621 (69.6%) in physiological adaptation mode and (Comfort, altered r/t), (Injury, potential for r/t), (Infection, potential for r/t), (Bowel elimination, altered patterns r/t), (Breathing pattern, ineffective r/t), (Nutrition, altered r/t less than body requirement) in order, and 139 (15.6%) in role function mode, (Self care deficit r/t), (Knowledge deficit r/t), (Mobility, impaired physical r/t) in order, 122 (13.7%) in interdependence adaptation mode, (Anxiety r/t), (Family Process, altered r/t) in order, 10(1.1%) in self concept adaptation mode, (Powerlessness r/t), (Grieving, dysfunctional r/t) in order. 3. Nursing diagnosis in maternity unit by the medical diagnosis, the average hospital dates were 3.8 days in normal delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 64.6%, (Self care deficit r/t) 13.6% in order, and the average hospital dates were 9.6 days in cesarean section delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 51.6%, (Self care deficit r/t) 15.2%, (Infection, potential for r/t) 9.9%, (Injury, potential "for r/t) 8.1%, (Anxiety r/t) 5.0%, (Mobility, impaired physical r/t) 3.3% in order, and the average hospital dates were 15.8days in preterm labor and majority of used nursing diagnosis, (Comfort, altered r/ t), (Anxiety r/t), (Injury, potential for r/t) in order, and the average short-term hospital dates were 2.5days, long-term hospital dates were 11.5days in gynecologic diseases and majority of used nursing diagnosis, (Comfort, altered r/t). (Self care deficit r/t), (Injury, potential for r/t), (Infection, potential for r/t) in order.

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Living Arrangements Affect Nutritional Status of the Elderly

  • Kim, Cho-Il;Lee, Haeng-Shin
    • Journal of Community Nutrition
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    • v.3 no.2
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    • pp.103-109
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    • 2001
  • With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.

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Assessment of Nurses' Nutritional Knowledge and Educational Needs Regarding Stroke Specific Diet Regimens (간호사의 뇌졸중 관련 영양지식 및 영양교육 요구도 조사)

  • Song, Suk-Hee;Choi-Kwon, Smi;Baek, Ji Hyun;Song, Kuyng-Ja;Koh, Chi-Kang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.228-235
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    • 2015
  • Purpose: Although the prevalence rate of chronic diseases is rapidly increasing due to an unhealthy diet in Korea, nurses may not have enough nutritional knowledge to educate their patients. This study investigated the level of nurses' nutritional knowledge for chronic diseases as well as for strokes, and the needs for nurses' nutritional education. Methods: This research is a descriptive research conducted from April to August of 2014, on 242 nurses who work with stroke patients, in two tertiary general hospitals in the city of Seoul, South Korea. Results: The average nutritional knowledge score of our subjects was $19.9{\pm}2.51$ (range 12-24). The correct response rate was 83% which was higher than expected. However, many nurses (31-66%) answered incorrectly on items such as 'Drinking low-fat milk is better than whole milk', and 'Seasoning with a large amount of soy sauce instead of salt can reduce sodium consumption'. We also found that nurses who received continuing education regarding nutrition scored higher than those who did not (p=.020). There was no correlation between nutritional knowledge and the need for nutritional education (r=.034, p=.601). Conclusion: The level of nutritional knowledge of the nurses was relatively low and irrelevant to the completion of nutrition courses during university or duration of experience. Rather, the relevance was higher when the nurse received nutrition-related training after graduating from university. Our results imply that continuous nutritional education is necessary for hospital nurses.

The Single-Session Group Education for Advanced & Terminal Cancer Patients and their Family Members (진행암 및 말기암 환자와 가족을 위한 집단 교육 프로그램)

  • Lee, Young-Sook;Heo, Dae-Seuk;Kim, Mi-Ra;Kim, Won-Gyung;Choi, Jeong-Yun
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.64-72
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    • 2004
  • Purpose: This research aims to assess the effect of a single session of group education of hospice program at Seoul National University Hospital for the advanced and terminal cancer patients and their family members. Methods: Response to questionnaires from 89 participants were evaluated using SAS and CHISQ analysis. The questionnaires included the following items: 1) the characteristics of participants; 2) the characteristics of patients; 3) the difficulties of patient care; 4) the satisfaction with the program Results: The participants consist of 33 patients (37.5%) and 56 family members (56.2%). Diagnosis included mainly stomach, lung, breast, and colon cancer. Participants of family members consisted of spouse, parent, children, daughter-in-law, and siblings (in decreasing order). The participants were interested in the medical information, nutrition, pain and symptom management, and psychosocial adaptation. They had difficulties in emotional problem, nutrition and symptom management. Even though it was a single session of group education, the level of satisfaction was high (95%). Conclusion: This research shows that even the single session of the group education for the advanced and terminal cancer patients and their family members is very helpful by giving them the necessary information. In order to develop comprehensive care-giving services, more specific informations, more opportunities to participate in such sessions and longer question-answer time is required.

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Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method (DACUM 기법에 의한 병원 임상영양사의 직무기술서 개발)

  • Cha, Jin-A;Kim, Kang-Eun;Kim, Eun-Mi;Park, Mi-Sun;Park, Yoo-Kyoung;Baek, Hee-Joon;Lee, Song-Mi;Choi, Soo-Kyong;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.19 no.3
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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.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Study on Home Visiting Hospice Care of the Terminally Ill Patients (가정 호스피스케어환자 방문간호 조사분석)

  • Lee, So-Woo;Lee, Eun-Ok;Park, Hyun-Ae;Oh, Hyo-Sook;Ahn, Hyo-Seop;Huh, Dae-Suk;Yun, Young-Ho;Kim, Dal-Sook;Rho, Yoo-Ja
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.39-46
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    • 1998
  • Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.

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Utilization Behavior of Medical Services According to Socioeconomic Characteristics and Prevalence (사회경제적 특성 및 유병에 따른 의료서비스 이용 행태)

  • Lee, Ko-Eun;Im, Bok-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.7
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    • pp.443-452
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    • 2018
  • The purpose of this study was to investigate the utilization behavior of medical services according to the characteristics of socioeconomic status (SES) and prevalence by using the 6th National Health and Nutrition Survey data for adults over 25 years old. Frequency and technical statistical analysis, ANOVA, ${\chi}^2$-test, and regression analysis were performed using SPSS 23.0. The results were as follows: more female than male, 65 years old and over, high school graduate, and unemployed and income quintiles were similar. The SES score considering education level, function, and income quintiles was the highest at 7-8, and most of the respondents felt moderate about their subjective health condition. The mean number of prevalence was $1.07{\pm}1.497$, the mean utilization of outpatient services was $0.50{\pm}0.045$, and the mean number of inpatient services use was $0.12{\pm}0.454$. Depending on general characteristics, there was a significant difference between subjects with prevalence and subjective health conditions. Higher age was associated with lower education, skill level, income, and SES score, and average prevalence was associated with poor subjective health conditions. More serious prevalence was associated with greater utilization of inpatient services. More chronic prevalence was associated with utilization of outpatient services. In other words, higher SES score was associated with lower overall use of medical services. Lower SES score was associated with higher use of medical services. In conclusion, we must develop appropriate health education programs that can prevent diseases in groups with low socioeconomic characteristics. There is the need to construct and implement a community-based appropriate health service system so that proper medical services can be used.

A Study of Hospital Foodservice Satisfaction after Covering Hospital Foodservice in the National Health Insurance (병원 급식 식대 급여화에 따른 입원 환자의 급식만족도 조사)

  • Hwang, Rah-Il;Kwon, Jin-Hee
    • Korean Journal of Community Nutrition
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    • v.13 no.3
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    • pp.396-404
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    • 2008
  • This study aimed to evaluate the amount of patients' satisfaction with hospital foodservices among those who were benefited from national health insurance during their hospitalization. A total of 3,094 inpatients from 191 medical institutions were enrolled in this survey. The survey was carried out from July 23 to September 14, 2007 through the face-to-face interview method. All analyses were made using the SPSS software (version 13.0). The mean age of the participants was 53.3 years, 57.0% were women; 34.7% were high-school graduates. Among the respondents, 30.9% stayed in the hospital for $7{\sim}14$ days long, and 52.0% were hospitalized in multi-patient rooms for six persons. The 87.7% of total population had a general diet, and 9.6% selected the food menu that was notcovered by health insurance. In addition, 38.3% of patients regarded the fee of foodservice as inexpensive. Overall, the satisfaction score with hospital foodservice was 3.63 on a Likert-type scale ranging from 1 (extremely dissatisfied) to 5 (extremely satisfied). However, the limitations were indicated including the lack of providing nutritional information and quality of taste. In conclusion, the quality of hospital foodservice might not deteriorate even after enforcement of national payment of medical insurance. Further efforts are required for the diversification of menus and legislative work for improving quality of food service for a successful hospital foodservice policy.

The Cost-Benefit Analysis of the NutriPlus Program in Daejeon Dong-gu Health Center (영양플러스 사업의 비용편익분석 - 대전 동구보건소를 중심으로 -)

  • Kim, Hyun Ju;Kim, Sung Han
    • The Korean Journal of Food And Nutrition
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    • v.28 no.4
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    • pp.717-727
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    • 2015
  • Although the NutriPlus program has shown considerable evidence of enhancing users' nutritional status, the budget does not cover all eligible mothers and children. This study aimed to conduct a cost-benefit analysis of the NutriPlus program to assess its economic efficiency. 53 families with 79 users in the NutriPlus program at Daejeon Dong-gu Health Center participated in this study with informed consent. The costs and benefits were estimated from both the administrator's and users' perspectives. We converted the time cost into Korean currency based on the minimum wage in 2014. The value of nutrition education and service (B2), estimated by contingency valuation method (CVM), was counted as an economic benefit. 6 families (11.3%) were recipients of national medical care and 22 families (41.5%) paid 10% of the food package cost by themselves. The total cost was \7,450,167 and the total benefit was \12,402,239. The budget for the health center (C1+C2+C3+C4) was \5,984,381 a month. Time and transportation cost for receiving nutrition education (C6) differed significantly according to the economic status of families. Household food consumption increase (C4-B4) was 40,379 in the poverty group, which was four times more than in the other groups. The net benefit (B-C) was \4,852,172 and the B/C ratio was 1.66. Therefore, the NutriPlus program is beneficial in the economic aspect as well as in the nutritional aspect. If the enhancement of nutritional status was also considered, the total benefit would be even higher. These results confirm the legitimacy of a secure budget for the NutriPlus program. And we suggest expanding its budget to cover more eligible individuals to improve people's health and welfare.