Validation of initial nutrition screening tool for hospitalized patients / 한국영양학회지

PURPOSE: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. METHODS: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. RESULTS: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. CONCLUSION: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

Nursing Service R&D Strategy based on Policy Direction of Korean Government Supported Research and Development / 간호행정학회지

PURPOSE: To develop strategies for research and development (R&D) in nursing service based on the policy direction of government supported R&D in Korea. METHODS: This was a descriptive study to develop strategies for promoting R&D in nursing by analyzing investment trends and status quo, policy directions, and implementation of the details of government supported R&D through government reports, websites of relevant agencies and literature reviews. RESULTS: Few nursing experts participated in clinical research on overcoming major diseases and in R&D for well-being and care. Development of nursing topics that meet the direction of government supported R&D were lacking. Insufficient implementation of nursing service R&D in a timely manner equipped with a performance-based system. Few research studies in R&D projects that included research using big data or contributing to developing medical instruments. Finally, an insufficient number of nursing specialists participated on government R&D advisory committees. CONCLUSION: For nursing service R&D development efforts should be toward quantitative expansion and qualitative improvements by sensitively recognizing policy direction of government supported R&D. The promotional capacity of nursing service R&D must be reinforced through a multidisciplinary approach and collaborative association with other professionals and the inclusion of nurse specialists on government R&D advisory committees.

The Feasibility and Future Prospects of Robot-Assisted Surgery in Gastric Cancer: Consensus Comments from the National Evidence-based Collaborating Agency Round-Table Conference / 보건행정학회지

To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

Systematic Review of Exercise Effects on Health Outcomes in Women with Breast Cancer

PURPOSE: Exercise is commonly recommended to women after breast cancer surgery, yet it is difficult for patients and health professionals to adopt safe and beneficial types and modes of exercise. Thus studies on exercise interventions targeting women with breast cancer treatment were systematically reviewed. METHODS: The review process and quality assessment of the studies followed the guideline of the National Evidence-based Healthcare Collaborating Agency. Relevant studies were obtained from electronic databases, and two trained reviewers independently analyzed the studies. Of the 902 articles sorted, 11 were selected. Then, quality assessment for each study was carried out with the Scottish Intercollegiate Guideline Network (SIGN) checklist. RESULTS: Seven different types of exercise interventions were identified from 3 quasi-experimental and 8 randomized controlled trial studies. The interventions varied in duration from several days to 13 weeks, and tended to show significant effects on psychological outcomes and upper body functions within a short-term period and were effective in alleviating lymphedema at a longer 1-year point. Supervised, professional intervention had significant effects on health indicators and a higher adherence rate. CONCLUSION: Well-designed exercises are effective and beneficial for improving women's physical, physiological, and psychological health outcomes after breast cancer treatment as well as to facilitate changes in exercise behaviors. The feasibility of applying intervention protocols, efficiency of interventions, and strengths of exercise protocols should be further examined.

The Association between Bone Mineral Density, Bone Turnover Markers, and Nutrient Intake in Pre- and Postmenopausal Women

The purpose of this study was to examine the association among bone mineral density (BMD), biochemical bone markers, nutrients, and salt intake in premenopausal and postmenopausal women. We evaluated 431 subjects who visited a health promotion center of a university hospital between January 2008 and July 2009. We excluded those who were taking medications or who had an endocrine disorder affecting osteoporosis. The subjects were divided into premenopausal (n = 283) and postmenopausal (n = 143) women. We evaluated the correlation among BMD of the lumbar spine, femoral neck, and total femoral, as well as biochemical bone markers, hormone, serum profiles, general characteristics, nutrient intakes, and food intake frequencies. From a stepwise multiple regression analysis, lumbar spine BMD was positively correlated with weight (p < 0.001) and negatively correlated with osteocalcin (OC)(p < 0.001), Femoral neck BMD was positively correlated with weight (p < 0.001) and negatively correlated with C-telopeptide (CTx) and alkaline phosphatase (ALP)(p < 0.001, p < 0.05). In premenopausal women, femoral total BMD was positively correlated with BMI (p < 0.001) and negatively correlated with CTx (p < 0.001). In postmenopausal women, lumbar spine BMD was positively correlated with calcium intake (p < 0.01) and negatively correlated with sodium intake (p < 0.01). Femoral neck and femoral total BMD were both positively correlated with weight (p < 0.001), and femoral neck BMD was negatively correlated with age and ALP (p < 0.001, p < 0.05). Femoral total BMD was negatively correlated with age and OC (p < 0.001, p < 0.01). These results suggest that reducing sodium intake may play an important role delaying bone resorption and preventing a decrease in BMD.

Comparison of Dietary Patterns Between Glaucoma Patients and Normal Control Subjects

PURPOSE: To compare the dietary patterns between normal or high tension glaucoma patients and a normal control population. METHODS: A survey using the self-assessment food-frequency questionnaire was given to normal tension glaucoma (NTG) or high tension glaucoma (HTG) patients who visited a glaucoma clinic between June 2008 and September 2008. Healthy Korean subjects who had received routine health examinations at Samsung Medical Center between October 2007 and September 2008 were evaluated with the same questionnaire. Statistical analysis of variable factors including fatty fish, seaweeds, soy products and greasy meats, was performed to compare between groups. RESULTS: Sixty-two of NTG patients, 25 of HTG patients and 29,376 normal subjects were included in the present study. The mean age of each group was 51.3 +/- 13.4, 51.8 +/- 17.4 and 50.5 +/- 10.4 years, respectively. No significant difference in dietary pattern was found between the subjects with glaucoma and the normal controls (p > 0.2 in all factors). The dietary pattern of NTG and HTG patients showed no statistically significant difference in all factors (p > 0.2). CONCLUSIONS: There was no significant difference in a dietary pattern between glaucoma patients and normal subjects. In terms of glaucoma, no possible beneficial or harmful food was found.