• Korean Journal of Community Nutrition
• /
• v.25 no.3
• /
• pp.214-225
• /
• 2020

Objectives: This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods: The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30~60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapy-related items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results: All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions: These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.

• The Korean Journal of Food And Nutrition
• /
• v.23 no.4
• /
• pp.470-477
• /
• 2010

The purposes of this study were to identify the evaluation categories, areas, attributes of the hospital food service and to define the relative importance of the evaluation categories, areas, attributes of the hospital food service using analytic hierarchy process. A survey was conducted from January 8th to 25th in 2007. Questionnaires were mailed to the 310 directors of dietetic departments of hospitals that included 160 primary hospitals, 107 secondary hospitals, and 43 tertiary hospitals. The result of the analytic hierarchy process indicated that relative importance of evaluation category was 0.5259 for food service management and 0.3407 for nutrition care. The food service management consisted of four subcategories, which are equipment standard, sanitation, production, and delivery service. Sanitation(relative importance: 0.2652) was the most important area among the subcategories and it was followed by equipment standard(0.2067), delivery service(0.1864) and production(0.1848). The nutrition care has two subcategories, menu management and meal management. The relative importance of menu management(0.4174) was higher than that of meal management(0.3555). The quality of food service and nutrition care to inpatients can be improved by the evaluation system based on appropriate applications of the developed evaluation indicators for hospital food service systems.

• Korean Journal of Community Nutrition
• /
• v.16 no.6
• /
• pp.730-739
• /
• 2011

The purpose of this study was to analyze the differences between child-care facilities and kindergartens towards the need for foodservice support by Center for Child-Care Foodservice Management (CCFSM). For this study, questionnaires were sent out from August of 2008 to April of 2009 to directors of 1,478 child care facilities and 299 kindergartens in Seoul and Gyeonggi-do via postal service. A total of 267 questionnaires were usable with 203 (13.7%) of child-care facilities and 64 (21.4%) of kindergartens. Statistical data were analyzed by SPSS 15.0 for descriptive analysis and t-test. For political and administrative support, government funding for foodservice was the highest need and hiring nutritionists was significantly different by type of facility (p < 0.01). Both child-care facilities (4.29) and kindergartens (4.41) demanded the balanced menu from CCFSM. There were significant differences of "information about food material sanitation management" (p < 0.05), "hygiene safety management method according to working process" (p < 0.05), "hygiene safety management method of foodservice facilities and equipment" (p < 0.05). In education and training contents from center, "types and methods to manage foodservice facilities and equipment" for directors, "dietary education by age" for teachers, and "the rules of personal sanitation and working process" and "gas, electricity and fire prevention" for culinary workers had the highest mean score of requirements.

• Journal of the Korean Dietetic Association
• /
• v.22 no.1
• /
• pp.53-69
• /
• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• Journal of Nutrition and Health
• /
• v.37 no.8
• /
• pp.712-721
• /
• 2004

The objective of this study was to evaluate the microbiological quality of heating and after-heating processed foods for implementation of a HACCP system in day-care center foodservice operations. The evaluating points were microbial assessment and temperature of foods during receiving, cooking, and serving in heating process. In non-heating process, in addition to monitoring microbial assessment of food during preparation, cooking, and serving steps, the microbial populations of employees' hands and utensils and serving temperature were also evaluated. Microbiological quality was assessed using 3M Petrifilm$^{TM}$ to measure total plate count and coliforms for foods and utensils and Staphylococcus aureus for hands in five Gumi day-care centers. Microbiological quality assessment for foods and utensils is summarized as follows. Microbiological quality of the heating processed foods was satisfactory for cooking and serving steps. The internal temperature of food was above 74$^{\circ}C$. However, temperature control before the serving step was not achieved due to inappropriate time management between the cooking and serving steps. In the after-heating process, the total plate counts of boiled mungbean sprouts salad, blanched spinach salad, com vegetable salad were below the standard at the serving step. The majority of samples showed that coliforms exceeded the norm, which is thought to be the result of the cross-contamination from utensils. These results suggest that it is essential to educate employees on the importance of hand washing and of avoiding cross-contamination by using clean, sanitized equipment to serve food in the after-heating process. Establishing Sanitation Standard Operating Procedures (SSOPs) is an essential part of any HACCP system in day-care center foodservice operations.

• Korean Journal of Community Nutrition
• /
• v.18 no.2
• /
• pp.154-164
• /
• 2013

The objectives of this study were to assign reasonability to importance of weight selection issue in key performance indicator for performance evaluation of Centers for Child-care Foodservice Management (CCFSM) developed by using Balanced Scorecard (BSC), to draw key performance indicator (KPI) by perspective and to analyze differences in recognition on importance. From September 25 to October 9, 2012, we conducted a questionnaire-based study via e-mail, targeting chiefs and team leaders of nationwide 21 CCFSMs (43 persons), officials of local governments where CCFSM was established (21 persons), officials of Korea Food and Drug Administration (2 persons) and foodservice management experts (27 persons) in order to estimate the relative importance on 4 perspectives and 14 KPIs and analyzed its results by using 61 collected data. The results showed that relative importance of perspectives was estimated in order of importance as follows: business performance (0.3519), customer (0.3393), resource (0.1557), learning and growth (0.1531). Relative importance of KPIs was in order of importance as follows: Evaluation of sanitary management level in child-care foodservice facilities (0.1327), Level of customer recognition and behavior improvement (0.1153), performances of round visiting inspection on foodservice, sanitary, safety management, and foodservice consulting (0.0913). Our results showed that the recognition differences exist on the relative importance of perspectives and KPIs between officials of CCFSM, KFDA, local government and foodservice management experts. These observations will form the basis for developing evaluation systems, and it is considered that performance indicators developed on this basis will suggest direction of operation which CCFSM will have to perform.

• Korean Journal of Community Nutrition
• /
• v.20 no.1
• /
• pp.61-72
• /
• 2015

Objectives: This study was performed to examine nutrition problems and causes/contributing risk factors. Methods: This study was conducted using data 1,863 adults visited Asan health screening & promotion center located in Seoul, Korea during May to June of 2013. We used Nutrition Care Process Model developed by the International Dietetics & Nutrition Terminology (IDNT). Results: The most frequent nutrition problem in male subjects was excessive alcohol intake. Men in fifties showed the highest rate of excessive alcohol intake among the age groups examined (22.4%). By comparison, the most frequent nutrition problem in women was inadequate protein intake. Women in fifties exhibited the highest rate of inadequate protein intake (22.5%). The most common contributing factors for these observations were a low preference for dairy products followed by high preference for alcohol and a deficit in food-and nutrition-related knowledge, regardless of the sex and age. The most common nutrition problem observed among the group diagnosed with hyperglycemia or hypertriglyceridemia or hyperuricemia or fatty liver was excessive alcohol intake (p < 0.001), whereas the group diagnosed with hyperglycemia or hypercholesterolemia showed significantly higher rate of inappropriate intake of carbohydrate (fructose) compared to the group not diagnosed with such disease conditions (p < 0.05). The group diagnosed with hypercholesterolemia, hyperuricemia and fatty liver showed significantly higher occurrence of inappropriate intake of fat (saturated fat) than the group free of such diseases (p < 0.001). The osteopenia group showed higher rate of inadequate protein intake (p < 0.001) and the fatty liver group with excessive energy intake (p < 0.001). Overall, the results suggest that there is a significant relationship between nutrition problems and health conditions found in groups diagnosed with a diverse array of medical conditions. Conclusions: Therefore, we strongly suggest that dieticians should implement nutrition interventions with people visiting health screening & promotion center based on nutrition problems and the contributing factors diagnosed by dietitions in order to prevent chronic diseases in this population.

• Quality Improvement in Health Care
• /
• v.15 no.2
• /
• pp.87-92
• /
• 2009

문제: 순천향대학교병원에서 개발된 영양검색도구를 이용한 검색 결과 본원에 입원하는 암환자들의 약 30%가 중등도이상의 영양불량위험을 가지고 있는 것으로 조사되었으나 이들 암환자의 치료 효과를 높이기 위한 전문화된 영양관리과정(Nutrition Care Process NCP)이 순천향대학교병원 영양과에는 마련되어 있지 않다. 목적: 본원에 내원하는 암 환자를 위한 암 영양교육프로그램과 암으로 입원하는 환자에게 제공할 영양식을 개발 적용으로 병원식의 섭취율 향상과 환자의 영양불량 정도가 개선되어 치료효과를 증진시킬 수 있도록 하기 위함이다. 의료기관: 서울시 한남동 소재 순천향 대학교 병원 질 향상 활동: 암과 관련된 전문적인 영양정보제공을 위해 교육자료 개발과 암환자 교육 상담 프로그램, 교육수가 등을 정하여 비급여 수가 교육 항목을 신설하고 입원환자를 위한 암영양식 식단을 개발하여 이를 특이식으로 처방할 수 있도록 마련하였다. 개선효과: 본원 의료진의 암환자 영양상담 의뢰 건수는 개선활동을 시행하기 전 2008년 5~6월에 월평균 2건에서 활동시행 후 8~12월에 월평균 13건으로 증가하였고, 암영양식은 식사를 적용하기 시작한 2008년 8월부터 12월까지 처방건수가 꾸준히 늘어났으며, 8월~9월 암영양식을 섭취한 암환자 그룹과 일반식을 섭취한 암환자 그룹의 병원식 섭취율은 88%, 67%로 암영양식을 섭취하는 그룹에서 더 높게 나타났고 식사에 대한 만족도에서도 (5점척도 기준) 평균 4.2점, 3.1점으로 조사되었다.

• Clinical Nutrition Research
• /
• v.11 no.1
• /
• pp.9-19
• /
• 2022

This study was conducted to analyze the status of medical food selection process in hospitals within Busan and Gyeongnam area. The survey was distributed to 396 hospitals (general, tertiary and long-term care hospitals) and finally 68 surveys were used for analysis. The questionnaire consisted of 9 general items and 10 items related to enteral nutrition (EN). From the survey we found out that general hospitals and tertiary hospitals normally hire clinical dietitian, while long-term care hospitals hire dietitians with no further qualifications (χ² = 27.918, p < 0.001). A significant relationship was found between hospital size and the priority for choosing medical foods for patients (χ² = 11.852, p < 0.05). In general and tertiary hospitals, medical foods were provided exactly according to the doctor's prescription, whereas in long-term care hospitals, only half followed the doctor's direction and half of them provided the products that has been conventionally used. There was also a significant relationship between hospital size and the method for determination of nutrition requirements (χ² = 20.496, p < 0.001). Finally, the priority of considerations when developing a 'medical food guidelines' was shown in the following order; 1) the type of medical food that can be selected according to the disease state, 2) the nutrient content and comparison table for commercial products, and 3) how to manage complications that may occur when supplying medical food for patients. Developing an EN practice guideline for making a sensible selection of medical foods will provide a valuable information for better patient care.

• Journal of Nutrition and Health
• /
• v.37 no.8
• /
• pp.722-731
• /
• 2004

The objective of this study was to evaluate the microbiological quality of non-heat-processed foods for implementation of a HACCP (Hazard Analysis and Critical Control Point) system in day-care center foodservice operations. The evaluating points were microbial assessment of foods, utensils, and employee's hands during preparation, cooking, and serving. The temperature of non-heated food being served was also measured. Microbiological quality was assessed using 3 M Petrifilm/syp TM/ to measure total plate count and coliforms for food and utensils and Staphylococcus aureus for hands in five Gumi day-care centers. Results showed low microbiological quality of non-heated foods. This was probably due to contaminated raw ingredients and cross-contamination that occurred during preparation and cooking (e.g., unsatisfactory washing and disinfection of raw materials and utensils). These results suggest that it is essential to educate employees on good personal hygiene (hand washing) , prevention of cross-contamination through use of properly washed and sanitized utensils, and proper washing and disinfection of raw vegetables. Establishing Sanitation Standard Operating Procedures (SSOPs) are an essential part of any RACCP system in day-care center foodservice operations.