Analysis of Operational Characteristics and Substantiality Plan of Inpatient Diets for Foreigners in Hospitals

The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and χ2 test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA·European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.

Perioperative Nutritional Management of Morbid Obesity

Morbid obesity is associated with several comorbidities and increase risk of mortality. To avoid risk multifactorial intervention must be implemented. Morbid obese subjects who failed dietary and medical treatment should be considered as candidates for bariatric surgery. Although bariatric surgery is the most effective and sustainable treatment for morbidly obese patients, several nutritional deficiencies and metabolic complications can occur. Therefore, the perioperative assessment of nutritional status and education in all undergoing bariatric surgery, and encouragement of adherence to supplementation are important aspects of long term result. The patient had bariatric surgery also should understand postoperative dietary habit and component. The postoperative bariatric diet is based on modification of food texture and consistency, volume of food and liquid, frequency, and duration of meal, food intolerance and nutrients requirement for the patients. In addition, the bariatric patients need to adhere to dietary guideline to optimize long-term weight loss. Therefore structured nutrition counseling and education by qualified dietitians is essential part in the lifetime management of the patients.

Comparative analysis of food intake according to the family type of elderly women in Seoul area / 한국영양학회지

PURPOSE: As the rate of senior citizens living alone increases in the current aging society, there is much concern regarding the health and nutritional intake of solitary senior citizens. Therefore, this study compared the nutritional intake of senior citizens according to their family type. METHODS: In July and August of 2011, two senior citizen welfare centers in Seoul were visited to survey 267 elderly women. Excluding 54 subjects for which the data were incomplete, information from 213 subjects was analyzed. The subjects were divided into three family types, living alone (LA, n = 74), living with spouse (LS, n = 78), and living with children (LC, n = 61). RESULTS: The mean age of the LA group was the highest, while the mean age of the LS group was the lowest (p < 0.001) , and WHR of the LC group was the highest (p = 0.049). Income was the highest in the LS group (p < 0.001). Frequency of eating out was the lowest in the LA group (p = 0.031). By Duncan's multiple analysis, the amounts of energy intake, vegetable protein, fat, calcium, phosphorus, potassium, selenium, Vit D, Vit E, Vit B2, niacin, Vit B6, Vit B12, and cholesterol were significantly higher in the LS group compared with the LA or LC group (p < 0.05). The intakes of calcium, Vit D, Vit B12, and cholesterol were still significantly different among the three groups, even after adjustment for age and monthly income. The LA group ate less fruit and fish than the LS or LC group (p < 0.05). The LA group showed the lowest dietary diversity and the LS group showed the highest diversity (p = 0.014), however, the significance of dietary diversity score among the three groups disappeared after adjustment for age and monthly income. CONCLUSION: Elderly women living with spouse were receiving better nutrition than elderly women living alone or living with children. Therefore, solitary elderly women who do not live with their spouse or children should be offered greater opportunities to receive a balanced meal at a congregational kitchen or welfare center. To ensure their healthy diet, it is essential to provide continuous nutrition education with these groups in mind.

Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method

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.

A Survey on the Status of Nutrition Care Process Implementation in Korean Hospitals

The Nutrition Care Process (NCP), developed by the American Dietetic Association, is a significant issue to dietetic professionals in many countries and there are rising needs for NCP implementation in Korea. We surveyed clinical nutrition managers of Korean general hospitals regarding the perception of NCP, the status of NCP implementation, and the opinions on NCP. The questionnaire was collected from 35 hospitals. Most clinical nutrition managers perceived NCP, but NCP implementation in hospital was at early stage. NCP was implemented in a fourth of the surveyed hospitals and many clinical nutrition managers responded that the lack of knowledge and the concern on increasing working time were major barriers to implementing NCP. To successfully implement NCP in Korean hospital, ongoing education and training programs should be developed to provide adequate knowledge and help dietitians to cope with the barriers.

Nutrition Support in the Intensive Care Unit of 6 Korean Tertiary Teaching Hospitals: A National Multicenter Observational Study / 대한구급학회지

BACKGROUND: Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery in the ICU patients and its relations to clinical outcomes. METHODS: This study was a multicenter retrospective observational study based on the medical records of 163 patients admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical ventilation for 3 or more days and received enteral or parenteral nutrition. RESULTS: According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 +/- 29.3% and 46.1 +/- 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 +/- 1.4 days after admission, enteral nutrition (EN) did at 3.6 +/- 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05) CONCLUSIONS: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should be made to develop nutritional support guidelines for Korean ICU patients.