• Title/Summary/Keyword: nutritional care and management

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영양사 직무기술서 작성 연구 (Analysis and Framing of Dietitian's of Description)

  • 문현경;이애랑;이영희;장영주
    • 대한영양사협회학술지
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    • 제7권1호
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    • pp.87-104
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    • 2001
  • This study was conducted as a part of the project developing the standards of national board test for the dietitian's licence. The purpose of this study was to define the job description of dietitians, and to describe the task elements based on the detailed analysis of the dietitians' work. This study team established the research team which was composed of food and nutrition experts, 7 of registered dietitians and 3 of university professors. Draft job description form was made to fully explain the dietitians' task elements, process and sequence by the research team. Final job description form was confirmed after the validity of 576 task elements was reevaluated upon 4 point scale test based on the frequency, importance, and difficulty by 21 field registered dietitian by the study team. It was also confirmed by the university. This form was formated by following DACUM method which analyzed the job description containing duty, task and task elements. It was organized to include every dietitians' work and to describe the every detailed process of work. Duty was defined as the specific and independent work as a dietitian, and was composed of 17 parts, i.e 10 parts in food supply management area and 6 parts in nutritional care service area and self promotion area. Duties were also divided into 99 tasks containing the 576 detailed task elements to describe definite action, steps and decisions. Seventeen parts are following; menu planning, storage and inventory control, food production, meal service, waste management, sanitation, equipment and facility management, human resource management, financial management, nutrition assessment of life cycle, nutritional assessment of several disease, nutritional assessment in specific condition, medical nutrition therapy, nutritional education, public health nutrition and self promotion. If these protocols are properly performed and presented, they can provide the likelihood that dietetics professionals work as a primary contributors in promoting health care and preventing disease nationally.

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일반외과 입원 환자에 적용되는 간호진단-간호결과-간호중재 연계 확인 (Identification of Nursing Diagnosis-Outcome-Intervention (NANDA-NOC-NIC) Linkages in Surgical Nursing Unit)

  • 이은주;최순희
    • 성인간호학회지
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    • 제23권2호
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    • pp.180-188
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    • 2011
  • Purpose: This study was to identify nursing diagnosis-outcome-intervention (NANDA- NOC-NIC: NNN) linkages applied to inpatients in general surgical nursing units. Methods: We developed the NNN linkage computerized nursing process program, which consisted of the 107 nursing outcomes and the 190 nursing interventions linked to the 39 nursing diagnoses. This program was applied to 324 patients who admitted to those nursing units from July, 2004 to February, 2005. Results: First, nursing outcomes of each nursing diagnosis were identified as follows: for 'acute pain', pain control, pain level, and comfort level; for 'risk for infection', wound healing: primary intention, wound healing: secondary intention, and infection status; for 'nausea', nutritional status: food & fluid intake, comfort level, symptom severity and hydration. Second, major nursing interventions for each nursing outcome were analyzed as follows: for pain control or comfort level, pain management and medication management; for pain level, pain management and analgesic administration; for wound healing: primary intention, incision site care and wound care; for Wound healing: secondary intention or infection status, infection control; for nutritional status: food & fluid intake, fluid monitoring; for comfort level, nausea management; for symptom severity, nausea management and vomiting management; for hydration, fluid/electrolyte management. Conclusion: This identified NNN linkages will facilitate the use of nursing process in surgical nursing practice and documentation systems.

Evidence-based customized nutritional intervention improves body composition and nutritional factors for highly-adherent children and adolescents with moderate to severe obesity

  • Kim, Jieun;Kim, YoonMyung;Seo, Young-Gyun;Park, Kyung-Hee;Jang, Han Byul;Lee, Hye-Ja;Park, Sang Ick;Lim, Hyunjung
    • Nutrition Research and Practice
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    • 제14권3호
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    • pp.262-275
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    • 2020
  • BACKGROUND/OBJECTIVES: Evidence-based customized nutritional interventions are required for effective treatment of moderate to severe obese children and adolescents. SUBJECTS/METHODS: Sixty six (64.1% of 103) of the eligible participants who joined the usual care or physical activity group in the clinic were involved in 16-week intervention. Customized nutritional intervention was implemented for each participant based on a nutrition care process (NCP) model. Sociodemographic assessment, anthropometrics data, health- and dietary-related behaviors, and dietary intake of the study subjects were assessed at baseline and follow-up. All participants engaged in 30-minute nutritional sessions on a monthly basis. RESULTS: After 16 weeks, there were significant improvements in body composition [BMI (-0.8 ± 0.9, P < 0.05), BMI z-score (-0.3 ± 0.2, P < 0.001), body fat (kg) (-1.3 ± 2.1, P < 0.05), and body fat (%)(-1.5 ± 1.9, P < 0.05)] as well as macronutrient intake [total energy intake (kcal) (-563.7 ± 656.8, P < 0.05), energy (%) (-26.5 ± 30.0, P < 0.05) and fat (g) (-28.3 ± 40.6, P < 0.05)] in the adherent group than the non-adherent group. The SOC was higher in both groups after the intervention (P < 0.001). CONCLUSIONS: Our results highlight the positive effects of an evidence-based approach as a multidisciplinary intervention for people-centered nutritional care and weight management.

맞춤형 방문건강관리사업 활성화를 위한 직무교육 만족도 (A Study of Job Educational Satisfaction for Activating of Tailor Made Visiting Home Health Care)

  • 임지영;김지윤
    • 가정∙방문간호학회지
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    • 제14권1호
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    • pp.23-30
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    • 2007
  • Purpose: The aim of this study was to establish basic data for developing education program of tailor made visiting home health care. Method: For this study, the subject was recruited in one directorial area among 14 nation-wide areas. The data collection was done using self-report questionnaire developed by Korea Health Industry Development Institute. Ninety one questionnaires were analyzed and response rare was 88.3%. Result: The major results were as follows. Aspect of education operations, the satisfaction of education space was revealed high. However, the satisfaction of education time, hour, and schedule were low. The overall satisfaction of education contents were revealed high. The most useful curriculums were found Chronic disease management, Infant & toddler health management, and Case management of tailor made visiting home health care. However the most unuseful curriculums were Nutritional management according to subject's health problem, Health promotion for poor family, and Understanding of visiting service in community health center. Conclusion: With these results, it was identified that the most needed contents of tailor made visiting home health care education program. So these results will be used to develop the more effective education program to activate tailor made visiting home health care service in community health center.

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병원 중환자의 경관유동식 공급 현황 및 영양상태 변화 (Degree of Enteral Tube Feeding in the Intensive Care Unit and Change in Nutritional Status)

  • 임현숙;박은경;이종호
    • 대한영양사협회학술지
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    • 제7권3호
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    • pp.217-226
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    • 2001
  • It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

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성인을 대상으로 한 실버타운 내 영양 서비스 및 영양사 역할에 대한 요구도 조사 (A Study on the Need for a Nutritional Care Service and the Role of a Dietitian in Silver Town)

  • 서은희;황용일;박은주
    • 동아시아식생활학회지
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    • 제21권4호
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    • pp.600-608
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    • 2011
  • The purpose of this study was to investigate the need for a nutritional care service in silver town and identify awareness of the role of a dietitian in silver town using a structured questionnaire. The subjects consisted of 466 adults (216 males, 250 females), aged 20~59 years, in the Gyeongnam area. Although most of the subjects were aware of silver town and felt a necessity for it, only 24.9% of the subjects intended to live in silver town, whereas 55.6% of the respondents replied that they did not know whether they lived in silver town. Results on the importance of services offered in silver town indicated that medical service facilities, the interior and mood of silver town, the reliability of management, and meal service prepared by a dietitian were prioritized. Healthy food was the most valuable part of the meal service followed by taste. In total, 88.3% of the subjects answered that the meal service in silver town should be supervised by a dietitian. Clinical nutrition management was chosen as the most important job of the dietitian followed by sanitation management. These results could provide a better understanding of the personal needs of silver town, focusing on the meal service and the role of a dietitian.

사회복지시설과 자택거주 저소득층 노인의 영양섭취상태와 식사의 질 평가 (Nutritional Status and Dietary Quality in the Low-income Elderly Residing at Home or in Health Care Facilities)

  • 곽경순;배윤정;김미현
    • 대한영양사협회학술지
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    • 제14권4호
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    • pp.337-350
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    • 2008
  • The principal objective of this study was to assess the nutritional status and dietary quality in low-income elderly individuals residing at home (LH) or in health care facilities (LHCF) with dietitian. This study was conducted via anthropometric measurements, questionnaire interviews, and dietary surveys using a 24 hr recall method with 120 low-income elderly individuals (LHCF=46, LH=74). The average ages of the LH and LHCF group were 76.3 years and 78.6 years, respectively. The LH group evidenced a significantly higher frequency of skipping meals than the LHCF group. The average energy intakes of the LHCF and LH group were 1921.0 kcal and 1443.9 kcal, with a significant difference (p<0.001). Most of the nutrient intake and intake rates for recommended intake were significantly higher among the LHCF group as compared with the LH group. The LHCF group showed significantly higher values for the nutrient adequacy ratio (NAR), the mean adequacy ratio (MAR), nutrient density (ND), and the index of nutritional quality (INQ) by dietary qualitative estimation than in the LH group. The Korean diet diversity scores (KDDS) were 3.66 for LH group and 4.93 for the LHCF group, thus were significantly higher in the LHCF group than in the LH group. The results of the present study demonstrate that the LH group appeared to experience more dietary problems than the LHCF group. It was suggested that nutritional education is needed for low-income elderly individuals living at home, in order for them to learn proper dietary management. This can be achieved via educational programs in social welfare institutions, incentives toward employment as a dietitian, and implementation of community-based support.

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보육시설 급식소의 운영현황 및 급식실태 조사 (Assessment of Foodservice management practices and Nutritional adequacy of foods served in child-care centers)

  • 곽동경;이혜상;장미라;홍완수;윤계순;류은순;김은경;최은희;이경은
    • 한국식생활문화학회지
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    • 제11권2호
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    • pp.243-253
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    • 1996
  • The purpose of this study was to evaluate the foodservice management practices in child-care centers in order to provide basic information for the development of a model of a centralized food service information center. This approach was achieved using a variety of qualitative and quantitative information including general foodservice management practices and plate waste. A self-completed questionnaire survey of 651 child-care centers in Korea was undertaken and detailed information was carefully collected at 6 representative child-care centers. The results of the empirical survey were as follows: 1. Child-care centers categorized by location were in large cities (59.9%), medium cities (27.6%) and in provincial areas (12.5). 2. Private sector of child-care centers was 46.4% of the total followed by National/public (44.2%) and licensed home day-care programs (9.4%). 3. Total average number of children in child-care centers was $63.3{\pm}43.1$ with a very significant difference (p<0.001) in types of child-care centers. 4. The average space of kitchen and dining room was $5.0{\pm}3.8\;and\;10.8{\pm}11.0$ pyung ($1pyung=3.3058\;cm^2$). 5. The average cost of interim snack in morning and afternoon in child-care centers were $345.9{\pm}459.3$ won and $359.3{\pm}226.6$ won respectively. The average cost of lunch was $644.0{\pm}481.1$ won. There was a significant difference (p<0.001) by types of child-care centers with a highest cost of 863.9 won in licensed home day-care programs. 6. Only a limited number of dietitian were employed, therefore most of food service management practice was not conducted by professional personnel. 7. The result of nutritional analysis of the food revealed that the level of energy and nutrients contained in the food was below the recommeded level (RDA/3).

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재가노인복지시설 급식소의 위생·영양관리 실태조사 연구 (Current Status of Sanitary and Nutritional Food Service in Elderly Day Care Center)

  • 우정현;박유경;김미현;이수경;송경희;김혜경
    • 대한지역사회영양학회지
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    • 제25권5호
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    • pp.374-385
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    • 2020
  • Objectives: This study was conducted to examine the status of foodservice management, with special interest on sanitary and nutritional food service in elderly day care centers. Methods: A total of 79 employees who managed foodservice facilities in elderly day care centers were included in the survey. The contents of the questionnaire consisted of general characteristics, importance and performance of sanitary and nutrition management, the reasons for poor performance, factors necessary for improvement, and the employee's demand for support. Data analysis was conducted using the SPSS v25.0. Results: Sanitary management showed an average importance score of 4.84 ± 0.40 and a performance score of 4.70 ± 0.61 (t-value: 8.260). The item with the lowest performance score was personal sanitary management (4.58 ± 0.71). In nutrition management, the average importance score was 4.52 ± 0.68, and the performance score was 4.20 ± 1.00 (t-value: 9.609). There were significant differences between the average score of importance and performance in both areas. As a result of an Importance-Performance Analysis, items that were recognized as important but had relatively low performance was "personal hygiene", "ventilation" and "food storage". Also in the nutritional management area, "menu planning for disease management" and "checking the saltiness in the soup" etc. had very low performance with low importance recognition. The items shown in the "low priority" quadrant were those that required professional management skills. In the areas that demanded support in foodservice management, education about sanitary and safe institutional food service had the highest score (4.42 ± 0.74), and all other items showed a demand of 4 points or more. Conclusions: Foodservice managers recognize the importance of foodservice facility management but performance is relatively low. Institutional support is, therefore, needed to improve performance. For items with low importance, it seems necessary to improve awareness of the necessity of these items and to provide education in this regard. To gradually improve foodservice management, continuous provision of education and training in these areas are of great importance.

Nutrition Support in Critically Ill Cancer Patient Receiving Extracorporeal Membrane Oxygenation: A Case Report

  • Ji-Yeon Kim;Gyung-Ah Wie;Kyoung-A Ryu;So-Young Kim
    • Clinical Nutrition Research
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    • 제12권2호
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    • pp.91-98
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    • 2023
  • Adequate nutritional support is crucial in preventing complications and improving outcomes in critically ill patients. Extracorporeal membrane oxygenation (ECMO) is a mode of supportive care for patients with respiratory and/or cardiac failure. ECMO patients frequently exhibit a hypermetabolic state characterized by protein catabolism and insulin resistance, which can lead to malnutrition. Nutritional therapy is a vital component of intensive care, but its optimal administration for ECMO patients is unknown. This case report aims to provide insights into effective nutritional management for critically ill patients undergoing ECMO therapy. The patient was a 72-year-old male with a history of gastric and lung cancer who underwent a lobectomy complicated by bronchopleural fistula, postoperative bleeding, pneumonia, and acute respiratory distress syndrome (ARDS). The patient's nutritional status was assessed indicating a high risk of malnutrition, using the modified Nutrition Risk in the Critically Ill (mNUTRIC) Score. Nutritional support was administered based on the recommendations of European Society for Clinical Nutrition and Metabolism (ESPEN) and the American Society for Parenteral and Enteral Nutrition (ASPEN), with energy requirements set at 25-30 kcal/kg/d and protein requirements set at 1.2-2.0 g/kg/day. The patient received parenteral nutrition until the enteral nutrition target amount was reached, with zinc supplements for wound healing. The study highlights the need for further research on proactive and effective nutritional support for ECMO patients to improve compliance and prognosis.