Effects of Nutrition Education at a Community Health Center on Overweight and Obese Middle-aged Women in Jeonbuk Area-Focused on Personalized Daily Energy Requirement and Food Exchange Units / 대한지역사회영양학회지

OBJECTIVES: This study examined the effects of nutrition education focused on personalized daily energy requirement and food units using Food Exchange System on anthropometric, biochemical characteristics, nutrition knowledge, dietary attitude and nutrient intakes for overweight and obese in a public health center. METHODS: The subjects were 60 overweight/obese women based on BMI (educated 30 vs. noneducated 30, 50~64 years). Educated group was provided individual and/or group lessons (40 min/ lesson/week, 5 week), ‘Introduction: obese & health’, ‘6 nutrients and 6 food groups’, ‘My obesity & daily needed energy’, ‘Meal planning for personalized daily energy and food units using Food Exchange Systems’, and ‘Smart food choices’. After education, we examined the differences in anthropometric/biochemical characteristics, nutrition knowledge, dietary attitude and nutrient intakes between educated group and non-educated group. RESULTS: After nutrition education, in the educated group, there were improvements on anthropometric/biochemical characteristics, nutrition knowledge, dietary attitude and nutrient intakes in the educated group compared to the non-educated group. We observed a decrease in the mean weight, total cholesterol (TC) and the incidence of overweight/obesity and hypercholesterolemia and an increase in the mean lean body mass. The scores of nutrition knowledge, ‘Function of carbohydrate, protein, vitamin, mineral’ and ‘Food Sources of fat, vitamin, mineral’ were increased. The scores of dietary attitudes, ‘Taking a joyful meal, a leisurely meal, a balanced meal, a meal with sufficient vegetables, a meal with diversity, a meal with spicy foods, a meal with overeating’ were increased. The intakes of energy, carbohydrate, fat, protein, vitamin A, thiamin, Zn and cholesterol were decreased. The scores of INQ, protein, vitamin A, vitamin C, thiamin, riboflavin, vitamin B6, folate, Ca, P, Fe, Zn were increased. CONCLUSIONS: The nutrition education focused on personalized daily energy requirement and food exchange unit using Food Exchange System for overweight and obese may improve food behavior, dietary intakes and symptoms of overweight and obese, even in a community health center.

Phenomenological Study on Aging of Women in 40's and 50's: Applying the Parse's Theory

PURPOSE: This study was done to explore the essence and meaning of the experience of 'aging,' as a process of 40's and 50's women in Korea by applying the Parse's Human Becoming theory (2002). METHODS: Data was collected from February to April, 2013, using the phenomenological research method. Data was collected through in-depth informal interview and analyzed following Colaizzi method. After IRB permission and informed consent from the participants, all interviews were recorded with MP3 recorder and transcribed for analysis. RESULTS: Data analysis revealed 112 of meanings, 33 key subject words, 8 subject phrases, and 4 categories. The main themes were elaborated as 'going down' ('Being changed of body and mind', 'Being considered on my identity'), 'going up' ('Being expanded of productive role', 'Being transcendent multi-dimensionally'), 'pausing' ('Becoming more thoughtful about family', 'Looking back'), 'going forward again' ('Age is just a number, 'Contemplating of life and death'). Experiences in aging among women in 40's and 50's enlightened with Parse's theory of Human Becoming in terms of 'going down', 'going up', 'pausing', 'going forward again' appeared simultaneously, rather than consecutively. CONCLUSION: Women in 40's and 50's require holistic nursing intervention with physical, psychological, socio-economical, and spiritual aspects, rather than focusing on problematic physical symptom relief and prevention of further conditions. It is recommended to develop various nursing intervention considering on different environment, type of experience, and level of human becoming, individually.

Effects of Weight Control Program on Dietary Habits and Blood Composition in Obese Middle-Aged Women

The purpose of this study was to investigate the effects of weight control program on dietary habits and blood composition in obese middle-aged women. The program consisted of nutrition education, physical exercise and nutrition counseling was conducted for 12 weeks. Participants of the preliminary study were 255 obese women, among which 82 women participated in the nutrition education program. We evaluated the anthropometry, blood lipid profiles, dietary habits of obese women before and after the nutrition education. Dietary habits of the subjects were significantly improved in regularity of having breakfast (p < .05), the frequency of eating snack after dinner (p < .001), eating out (p < .01) and the speed of meal (p < .05) after the program. There was significant decrease in total cholesterol, triglyceride, LDL-cholesterol and systolic pressure of the subjects after nutrition education. Changes of atherogenic index and diastolic pressure were not significant, but had a tendency to decrease. All of the anthropometric outcomes except lean body mass such as BMI, percent body fat, fat mass, and WHR were significantly decreased after weight control program. These findings show that weight control program including nutrition education and counseling can improve dietary habits and weight control pattern, and lead the authors to recommend that public health organizations and dietetic professionals should educate obese women on practical strategies for an effective weight management.

Grounded Theory Approach to Middle-aged Women's Experience in Family Health Care

PURPOSE: The purpose of this study is to survey health requirements of middle-aged women and their families and to provide guidelines for developing nursing interventions by describing the process of family health maintenance experienced by middle-aged women and its conceptual system. METHODS: To get saturated data, each of four researchers conducted two or three times of in-depth interview with eight middle-aged women aged between 40-64 years old and living in Seoul and Chuncheon from the 10th to the 30th of October 2004 and each interview was continued one or two hours. The Grounded theory adopted by Strauss & Corbin (1998) is a substantive theory that can explain the experiencing process of middle-aged women. RESULTS: We found that the casual condition of family health maintaining by middle-aged women was "confidence of health belief", and "pouring by body moving" was found to be its phenomenon. A textual condition that might respond to the phenomenon was "fatal roles acceptance", and intervening conditions that promote their family health were "retracing" and "gathering health information". These intervening conditions impacted middle-aged women's confidence in family health and led them to take actions/interactions such as "being a model of health", "adapting to circumstances", "do-it-myself", "taking-care" "harmonious mind" and "the pursuit of cleanness". These actions/interactions produced results such as "being stronger", "being unmanageable" and "being fruitful". CONCLUSIONS: Health confidence and practical health behaviors were observed in the process that the middle-aged female participants experienced unmanageable circumstances but they accepted their roles and responsibilities and recognized that they must be get stronger. The behaviors of health-together-with were divided into enthusiastic type, adaptation type and self-sacrificing type. Therefore middle-aged woman with the understanding of family health maintaining process as well as the theoretical system and practical principals needs to implement the intervention in acceptable level of family health process of preventing psychological and physical problems.

The knowledge and attitude of menopause and hormone replacement therapy among the middle aged women

BACKGROUND: Hormone replacement therapy(HRT) has an established role in reducing cardiovascular risk and In preventing osteoporosis. But compliance with HRT is not good as expected. There fore, So we assessed perimenopausal womens knowledge and attitude fowards menopause and HRT to. METHOD: Questionnaires were provided to the students mothers of a high school located in Seoul from June 10th, to 15th, 1996. General characteristics and routine breast examination routine Pap smear, the knowledge and practice of high calcuim diet for preventing osteoporosis, their menstural pattern, the in formation source of HRT, in attitude for HRT, and the reasons for refusing. RESULT: Among 560 women, 362 women(64.6%) responded, and the mean age was 45.5 years. For osteoporosis prevention they knew milk(74.7%) were, anchovy(27.4%), calcium(23.6%), HRT(7.4%) were beneficial. And almost(91.8%) all sublets answered that menopause was a natural course and 40.5% of women answered that physical change after menopause could not prevent. Among 34 postmenopause, 5(14.2%) received HRT and 48(20.3%) answered that they would receive HRT, and 57 (24.1%) answered that they would not receive HRT. The reasons for refusing HRT were that menopause was a natural course, there fore deciding the need for artificial hormone therapy(22.4%), increased incidence of brew cancer(21.8%), and that lack of information for HRT(13.9%).The association was not proven between the attitude for HRT and regular Pap smear, regular breast examination, exercise, oral intake for osteoprosis prevention. CONCLUSION: Almost all of the respondents recognized that menopause was a natural course. And the effectiveness of diet and exercise in preventing osteoporosis was more well known compared to HRT.