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.
Objectives : This study was designed to evaluate the effects of oriental medical treatments on the facial nerve palsy in Herpes Zoster Oticus. Methods : Subjects were 1 patients with the facial nerve palsy in Herpes Zoster Oticus. She had improved slightly still she had be gotten the medical services on inpatient states for 2 month. We gave Kamiligigepung-san to the patient 90 minutes after each meal and tried acupuncture 2 times every day. And we had evaluated the conditions of the patient using VAS, House-Brackmann Grade and Yanagihara scale. Results : After the comparison between an admission and discharge date at VAS, House-Brackmann Grade and Yanagihara scale, the facial nerve palsy of the patient had improved. Conclusions : It is effective the Kamiligigepung-san and Acupuncture on the facial nerve palsy in Herpes Zoster Oticus.
Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.
Objectives : Seborrheic dermatitis is common abnormal skin condition characterized by flaking and itch. In seborrheic dermatitis, the flakes are greasy and yellowish. Inflammation is also observed. Through this paper we can understand the process of seborrheic dermatitis of the scalp and confirm the scalp changes in the treatment process. The purpose of this study was to report the clinical effects of herbal medicine on Seborrheic dermatitis Methods : We employed oriental medical treatments; herbal-medication (Hyeongbangpaedoksangamibang), infant acupuncture, moxibustion and blood therapy. We treated her three times a week. She took medicine three times a day after a meal. During taking medicine, we let her avoid fatty food, flour based food. Her father took a picture the patient's head parts and we compared the symptom with previous symptom. With the picture, we evaluated the patient's scalp condition. Results : After taking treatment, the scalp condition of the patient was much improved. At first, yellowish to reddish scaly pimples appear along the hairline and itching was severe. There were thick and black crusts on the scalp, red, greasy skin covered with flaky white or yellow scales. After that the crusts were fell off and the itching was disappeared during the treatment period. And then the hair loss was occurred. After a year of treatment, scalp condition and hair were back to normal. Conclusion : Herbal medicine (Hyeongbangpaedoksangamibang) with oriental medical treatments was effective in the treatment of seborrheic dermatitis of the scalp and it helped to improve regenerating the scalp condition.
Park, Jeong-Ho;Park, Sun-Ah;Lee, Tae-Kyeong;Sung, Ki-Bum
Annals of Clinical Neurophysiology
/
v.14
no.1
/
pp.20-24
/
2012
Background: Migraine patients can be sensitive to external or internal stimuli, such as light, noise, or hormonal changes. Using transcranial Doppler ultrasonography (TCD) with breath-holding method, we evaluated the changes of cerebrovascular reactivity (CVR) to hypercapnia in women with migraine without aura between fasting and postprandial period. Methods: Twelve women with migraine without aura and the same number of age and sex-matched healthy controls with no significant history of headache participated in this study. Using TCD examinations, we studied mean flow velocity in middle cerebral artery with better temporal window. Each subject was examined consecutively before and after a standard meal, together with serum glucose level and blood pressure. CVR was evaluated with breath-holding index (BHI). Results: Postprandial-BHI (mean+SD) was significantly higher than fasting-BHI (mean+SD) in patients group but not in controls (in patient group; postprandial-BHI=1.38, fasting-BHI=1.08, in control group; postprandial-BHI=1.25, fasting-BHI=1.18, P=0.021 and 0.239, respectively). After meal, serum glucose level was significantly enhanced but blood pressure was not in both groups. Serum glucose level of patients showed a tendency of mild positive correlation with BHIs (${\gamma}$=0.448, P=0.032). Conclusions: Although exact mechanisms are unclear, cerebrovascular reactivity of some women with migraine without aura may be influenced by prandial state.
This work has performed to find what activities of daily living are required for the intensive interests when inpatient elderly more than 3 months has been supported and convalescent care, where the inpatient elderly were judged by the inpatient assessment report in the time of December, 2013. According to the estimation with logistic function of the relationship between the state of decision making recognition technology and the Activities of Daily Living(ADL), the intensive cares for the elderly are required in the parameters of 'Having meal' and 'transferring sitting' when they are severed and convalescently cared as the degree of functional independence for ADL are severly proceeded. In addition, the senescence and disease the activities except 'Having meal' and 'transferring sitting' seem to be influenced by the decline of body function more than the state of decision making recognition technology for daily living.
The purpose of this study was to measure patients satisfaction and expectation with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out on 383 hospitalized patients of 7 hospitals in Deagu, Busan, Changwon with 350 beds to determine the quality satisfaction with foodservices. The subjects were 50.5% male and 49.5% female. 62.6% of the subjects were over 40 age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7-14 days. The mean score for taste of diet was 2.79, temperature 3.23, appearances 2.96. Most subjects agreed with following foodservice characteristics that meals of movement (4.03), dress of employees (3.84), kindness of employees and meals arrived exactly the same time every day (3.47) and cleanliness of foods (3.34) and dishes (3.33). The unsatisfied quality attributies were information provide (2.82), variety of the meals (2.91), mixing of meals (2.95), the opportunity to meet with a dietitian (2.97) and prompt dealings with meal complaints (3.01). Most subjects expectation that the decrease the multiple of menus, increase provide of fruits in hospital meals and selective menus in hospital foodservices operations. In conclusion, it would seem to be desirable that hospital foodservices departments introduce selective menus, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.
Objective: It was surveyed how to help patients get better treatment for their disease by making complements based on the survey outcomes when the pharmacists guide how to administer medicine. Methods: A total of 142 gastroesophageal reflux disease (GERD) patients answered the self-answering questions consist of 15 items about their general characteristic, lifestyle and dietary style. The frequency of survey materials was analyzed to find out specific figures of surveyed patient's general characteristic, lifestyle and eating habits. Results: Based on the outcomes on analysis there was no difference between female and male patients. The characteristic based on the age group, as ones grow older, the number of GERD patients also increased. In case on the characteristic in lifestyle, many patients had improper habit to treat GERD. The items were smoking habits, stress control habit, sleeping postures and the way in wearing outfits. In case of postures after having a meal, they had right lifestyle. Patients had improper habit in eating food. They enjoyed pungent food and drinks which can hinder the treatment. In case of the time of having meal, eating habit of meat and vegetables and eating food less than an hour before go to bed, this research showed that they have the right lifestyle. Conclusion: This research indicate that pharmacists give guidance GERD patients to stop smoking that is causative of GERD and guide patients have mental stability, and patients avoid pungent food and drinks such as coffee, soda, chocolates and mint candies.
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.
Purpose: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. Methods: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). Results: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from $0.81{\pm}0.17$ to $1.41{\pm}0.25$ after the nutrition intervention (p < 0.05). The NAR of protein (before $0.50{\pm}0.21$, after $0.58{\pm}0.17$), iron (before $0.72{\pm}0.30$, after $0.84{\pm}0.29$) and vitamin $B_2$ (before $0.31{\pm}0.16$, after $0.37{\pm}0.14$) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin $B_2$, was significantly increased by the nutrition intervention (p < 0.05). Conclusion: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.
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