Korean Journal of Community Nutrition

Research Articles

[English]
Developing educational videos to inform rightly about school foodservice from kindergarten to high school: a case study: Gyoungok Gang, Chaewon Park, Haejin Kang, Wan Soo Hong, Yoo Kyoung Park, Sook Hee Choi, Seung Hye Kim, Jieun Choi, Jihyun Park, Hyeja Chang; Korean J Community Nutr 2024;29(2):97-113. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.97

Abstract PDF: Objectives
Since the enactment of the School Nutrition Act in 1981, school lunch programs in South Korea have grown quantitatively and qualitatively with a current student participation rate of 99.8%. Nonetheless, educational materials are needed to reduce misunderstanding and ignorance about school lunch programs. This study aimed to develop 3 educational videos that help students of various ages (kindergarteners/lower-grade elementary, upper-grade elementary, and secondary school, respectively), understand the school lunch program.
Methods
A scenario was created, was made, and the opinions on the scenario from experts in foodservice sectors were collected. A survey was conducted to students and parents to determine topics they wanted to know about school foodservice. The final videos were produced using this information and the expert opinions. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a P-value of < 0.05 was considered significant.
Results
Three videos on school foodservice were developed for various age levels of students: kindergarten/lower-grade elementary, upper-grade elementary, and secondary school. Additionally, English subtitles were included for the multicultural student population. These videos, each lasting about 7 minutes, cover topics such as nutrition, hygiene, and the cultural significance of the school lunch program. The survey results showed that parents and students wanted to know the following topics about the school lunch program: “nutritionally balanced diet” (11.9%), “purchasing safe food ingredients” (10.9%), and “healthy eating habits” (9.9%).
Conclusions
The developed videos will serve as valuable educational resources on school foodservice, foster a deeper understanding of the school lunch program in parents and students, and potentially address their inquiries regarding production processes, nutrition, hygiene, cultural heritage, and health.

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[Korean]
Food and dish group diversity on menus of daycare centers provided by Center for Children’s Foodservice Management in Korea: a descriptive study: Youn-Rok Kang, Kyeong-Sook Lim, Hyung-Sook Kim; Korean J Community Nutr 2023;28(6):449-465. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.449

Abstract PDF: Objectives
This study aimed to analyze menu patterns and food group diversity in daycare centers managed by the Center for Children's Foodservice Management in South Korea.
Methods
Data from 18 Center for Children's Foodservice Management centers across various provinces (excluding Jeju Island) were analyzed. We examined 8,796 meals served in February, May, August, and December 2021, focusing on seasonal lunch and snack menus for children aged 3-5. Foods were categorized into 19 groups for lunch and 21 for snacks. The frequency of food groups and dietary patterns were assessed using the Dietary Diversity Score. Analyses were conducted using Excel 2016 and IBM SPSS Statistics version 28.
Results
Most lunch menus (89%) included five menu items, with a ratio of grain, meat, and vegetables at 88%. Snack menus typically had one item (57%), with significantly more items in the afternoon compared to the morning (P < 0.001). Regarding snack patterns, 75.2% of morning snacks and 61.1% of afternoon snacks contained only one solid food and drink (P < 0.001). Fruit and milk (22.4%) was the most prevalent pattern in morning snacks, while grain and milk (31%) dominated afternoon snacks (P < 0.001). Only 48% of daycare center menus (all snacks and lunch) included all five food groups (grain, meat, vegetables, fruit, and milk). Notably, only 83% included milk and 57% included fruit.
Conclusions
These findings highlight the need to improve food variety and diversity in the Center for Children’s Foodservice Management-managed daycare center menus. Developing more detailed guidelines for menu structure and food composition is crucial to ensure children receive balanced and diverse nutrition.

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[Korean]
Foodservice Status and Perception regarding Foodservice Management in Kindergartens attached to Elementary Schools in Seoul: Ranmi Jung, Gun-Hee Kim, Jieun Oh, Sunny Ham, Seungmin Lee; Korean J Community Nutr 2022;27(6):492-502. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.492

Abstract PDF

Objectives
This study examines the foodservice status of kindergartens attached to elementary schools in Seoul. We further determine the perception of elementary school principals and kindergarten assistant principals on the foodservice management for kindergartens.
Methods
This survey was conducted from July 17 to 23, 2019, enrolling 207 kindergartens attached to elementary schools in Seoul. Questionnaires were sent to principals of elementary schools and assistant principals of kindergartens, and the data obtained from 89 kindergartens were included in the analysis. The questionnaire consisted of four parts: general information on subjects, foodservice management status, foodservice management status during elementary school vacations, and the perception of principals of elementary schools and assistant principals of kindergartens on foodservice management. Data are presented as frequency and percentage or mean and standard deviation. Statistical comparison between principals of elementary schools and assistant principals of kindergartens was conducted by paired t-test, chi-square test, and Pearson's correlation analysis.
Results
A separate menu (10.1%) or recipe (20.2%) that considers preschooler characteristics was rarely used for foodservice at kindergartens attached to elementary schools. Most kindergartens did not have a separate dining space (3.4%) or a dedicated cook (93.3%). Although most kindergartens (92.1%) had operational foodservice during elementary school vacations, non-professional staff and non-nutrition teacher were mainly in charge of organizing the menu and purchasing ingredients (34.1% and 41.5%, respectively). The rate of using a contract catering company (28.0%, 23.2%) was also high. Both elementary school principals and assistant principals of kindergartens showed a high perception of the necessity for providing responsibility allowances for nutrition teachers and improving the cooking environment for kindergartens during elementary school vacations.
Conclusions
There is a need for policies and administrative support measures to improve the quality of foodservices for kindergartens attached to elementary schools.

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Developing educational videos to inform rightly about school foodservice from kindergarten to high school: a case study
Gyoungok Gang, Chaewon Park, Haejin Kang, Wan Soo Hong, Yoo Kyoung Park, Sook Hee Choi, Seung Hye Kim, Jieun Choi, Jihyun Park, Hyeja Chang
Korean Journal of Community Nutrition.2024; 29(2): 97. CrossRef

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[Korean]
Management of Food Allergy in the Facilities Registered at Center for Children's Foodservice Management in Gangdong-gu: Soon Mi Kim; Korean J Community Nutr 2021;26(5):396-407. Published online October 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.5.396

Abstract PDF

Objectives
We examined the common allergenic foods, symptoms and management of food allergies in children attending the facilities registered at Center for Children's Foodservice Management in Gangdong-gu, Korea. Methods: The survey was conducted among the directors or head teachers of 186 children’s food service facilities with 7,591 children in 2019. The questionnaire consisted of three parts, including general information about food service facilities, information related to food allergies and allergenic foods and symptoms in individual children. Results: The number of children with food allergy was 271 (3.6%), and the proportion decreased with the increase of age. There were 91 children (33.6%) with a medical certificate, and these children had a significantly higher number of allergenic foods and symptoms than those without a medical certificate. Allergenic food groups included meat, fish, eggs and legumes (59.1%), fruits (12.4%), milk and dairy products (8.9%), cereals (7.8%), vegetables (6.2%), processed foods (3.8%) and oils and sugars (1.9%). Eggs accounted for 22.1%, followed by peanut and tree nuts (18.6%), fruits (12.4%), milk and dairy products (8.9%), shellfish (8.6%), vegetables (6.2%), fish (5.7%), cereals (4.3%) and meat (1.1%). The common allergenic foods were eggs, peanuts, walnuts, kiwi, shrimp, milk, tomatoes, mackerel, blue-green fish, peaches, shellfish (clams and abalone), buckwheat, wheat and soybeans. The most common allergic symptoms were skin and mucous membrane symptoms, such as hives, rash, itching and oral angioedema. Meal management for children with food allergies showed different trends depending on the causative food. Conclusions: The objective diagnosis by an allergist should be done for food allergy management in children's catering facilities. A system for systematic meal management of causative foods should be prepared.

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Knowledge and management of food allergy by parents of preschool children who experience food allergies
Seung Hui Kim, Seung-Min Lee
Journal of Nutrition and Health.2023; 56(2): 184. CrossRef
Knowledge of atopic dermatitis and food allergies, as well as health information literacy, among North Korean refugee mothers: a descriptive survey study
In-Sook Lee, Jeong-Hee Jeon
Child Health Nursing Research.2023; 29(4): 300. CrossRef

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[Korean]
Analysis of Surveys to Determine the Real Prices of Ingredients used in School Foodservice: Seo-Hyun Lee, Min A Lee, Jae-Yoon Ryoo, Sanghyo Kim, Soo-Youn Kim, Hojin Lee; Korean J Community Nutr 2021;26(3):188-199. Published online June 30, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.3.188

Abstract PDF: Objectives
The purpose was to identify the ingredients that are usually surveyed for assessing real prices and to present the demand for such surveys by nutrition teachers and dietitians for ingredients used by school foodservice.
Methods
A survey was conducted online from December 2019 to January 2020. The survey questionnaire was distributed to 1,158 nutrition teachers and dietitians from elementary, middle, and high schools nationwide, and 439 (37.9% return rate) of the 1,158 were collected and used for data analysis.
Results
The ingredients which were investigated for price realities directly by schools were industrial products in 228 schools (51.8%), fruits in 169 schools (38.4%), and specialty crops in 166 schools (37.7%). Moreover, nutrition teachers and dietitians in elementary, middle, and high schools searched in different ways for the real prices of ingredients. In elementary schools, there was a high demand for price information about grains, vegetables or root and tuber crops, special crops, fruits, eggs, fishes, and organic and locally grown ingredients by the School Foodservice Support Centers. Real price information about meats, industrial products, and pickled processed products were sought from the external specialized institutions. In addition, nutrition teachers and dietitians in middle and high schools wanted to obtain prices of all of the ingredients from the Offices of Education or the District Office of Education.
Conclusions
Schools want to efficiently use the time or money spent on research for the real prices of ingredients through reputable organizations or to co-work with other nutrition teachers and dietitians. The results of this study will be useful in understanding the current status of the surveys carried out to determine the real price information for ingredients used by the school foodservice.

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[Korean]
Awareness and Practice of Sugar Reduction in School Foodservice and the Practice of Nutrition Education in Daegu: Suhyang Jang, Kilye Kim, Yeon-Kyung Lee; Korean J Community Nutr 2021;26(3):167-176. Published online June 30, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.3.167

Abstract PDF

Objectives
This study was conducted to identify the awareness and practice of reducing sugar in school meals and the status of nutrition education regarding sugar reduction.
Methods
An online survey was conducted on 101 nutrition teachers (dietitians) working at elementary, middle, and high schools in Daegu.
Results
School nutrition teachers in Daegu recognized the need for efforts to reduce the sugar intake in the Korean diet, and it was found that elementary nutrition teachers were more aware of the implementation of the sugar reduction policy at the national level than middle and high school nutrition teachers (P = 0.002). Among the policies to reduce sugar intake at the national level, there was a high need for the promotion of self-control and limiting the sales of food with high sugar content in schools and their vicinity. The degree of practice for reducing sugar in school meals was found to be higher in the preparation, purchase, and cooking stage compared to the serving stage (P < 0.05). There was a high need for changing the preferences of the subjects for a sweet taste as a means of reducing the sugar in school meals. Thirty-six percent of nutrition teachers conducted sugar reduction education, and sending out school newsletters was the highest type of nutrition education at 80.6%.
Conclusions
To effectively promote reduced sugar intake in school meals, it is necessary to change the preference of the subjects for sweetness and to conduct continuous education that can improve the awareness of people for reducing their sugar intake. For this, it is necessary to set aside time for nutrition education and to prepare an institutional framework for providing this education.

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Analytic Hierarchy Process approach to estimate weights of menu management in the school foodservice
Hyo Bin Im, Seo Ha Lee, Hojin Lee, Lana Chung, Min A Lee
Journal of Nutrition and Health.2024; 57(3): 349. CrossRef
Sugar Intake and Perception of Sugar Reduction among University Students in Gwangju
Yeon-Ok Park
Journal of the Korean Society of Food Science and Nutrition.2023; 52(11): 1170. CrossRef
Analysis of the Perception and Need for Education about Genetically Modified Foods among Elementary, Middle and High School Parents:Focus on the Jeonnam Region
Da-Hye Choi, Bok-Mi Jung
The Korean Journal of Community Living Science.2022; 33(1): 67. CrossRef
Comparison of the Sodium and Sugar Reduction Practices at Samsam Foodservices and General Foodservices in Daegu
Sung-young Kwon, Kilye Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2021; 26(4): 270. CrossRef

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[English]
Dietary Quality Comparison of the School and Home Lunches Consumed by Chinese School-Age Children and Adolescents:Analysis of the 2011 China Health and Nutrition Survey: Chengyu Zhang, Suhua Jin, Jihyun Yoon, Meeyoung Kim; Korean J Community Nutr 2020;25(6):474-484. Published online December 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.6.474

Abstract PDF

Objectives
The number of schools offering school lunches has increased in China. This study examined the dietary quality of the lunches consumed by Chinese school-age children and adolescents, with a focus on comparing school lunches with home lunches. Methods: The first weekday 24-hour dietary recall data of 6~17-year-old students (n=1,084) from the 2011 China Health and Nutrition Survey were analyzed. The subjects were divided into the school lunch group and the home lunch group, and the dietary quality of lunches was compared between the two groups among 6~11-year-old students (n=634; 177 in the school lunch group and 457 in the home lunch group) and 12~17-year-old students (n=450; 144 in the school lunch group and 306 in the home lunch group), respectively. Frequently consumed foods, amount of food group intake, food group intake pattern, Dietary Diversity Score (DDS), and Dietary Variety Score (DVS) were examined. Results: The most frequently consumed foods in both lunch groups were rice and pork. An excessive intake of meat and insufficient intake of seafood were noted in both lunch groups. The school lunch group showed a lower level of vegetable consumption than the home lunch group (P=0.017 in 6~11-year-old students, P=0.003 in 12~17-year-old students).Although more students ate meals with a better dietary pattern in the school lunch group than the home lunch group, there were no significant differences in DDS and DVS between the two groups. Conclusions: Overall, the dietary quality of lunches was not superior in the school lunch group compared to the home lunch group. This suggests that much room remain for improving dietary quality of school lunches in China.

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[Retracted] Analysis of the Influence of Rural Family Education Environment on School‐Age Children’s Social Behavior and Patterns
Wenwen Yao, Ying Zhen, Yu Zhang, Zhao Kaifa
Journal of Environmental and Public Health.2022;[Epub] CrossRef

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[English]
Sodium Reduction Practice and Importance-Performance Analysis of Sodium Reduction Methods in School Foodservice in Daegu: Su-Hyeon Kim, Eun-Kyung Shin, Yeon-Kyung Lee; Korean J Community Nutr 2020;25(5):386-395. Published online October 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.5.386

Abstract PDF

Objectives
The aim of this study was to investigate sodium reduction practices in school foodservice in Daegu. Methods The survey included 199 nutrition teachers and dietitians working at elementary, middle and high schools in Daegu. The survey topics included the following: the frequency of salinity measurement, workers in charge of the measurement, average salinity of the soup and stew served, frequency and difficulties of offering low-sodium meals, Importance-Performance Analysis (IPA) of sodium reduction methods in school foodservice and the need for political support in encouraging sodium reduction. Results The mean salinity of the soup and stew was higher in high school foodservice than in elementary and middle school foodservice. Middle and high schools have difficulties in offering low-sodium meals due to concerns of decreasing satisfaction for the meals. The results of the IPA of programs to reduce sodium in school meals showed that most of the items in the cooking and serving stages were in the 2nd quadrant (Keep up the good work), and all purchasing and menu planning stages occupied the 3rd quadrant (Low priority). To reduce sodium in school meals, government support is required in developing low-sodium recipes for school foodservice, encouraging education on sodium reduction for school foodservice officials and developing low-sodium food for institutional foodservice. Conclusions To encourage sodium reduction in school meals, the priority is to make low-sodium recipes available. Also, it is necessary to develop a program that calculates the sodium content in menus and processed foods through National Education Information System and to establish standards for sodium levels in school foodservice.

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충북지역 중등학생의 건강식생활 관련 식행동과 영양관리 정책에 대한 인식
은서 고, 영은 이
Korean Journal of Food and Cookery Science.2023; 39(3): 197. CrossRef
Importance-performance analysis of sodium reduction practices by school nutrition teachers and dietitians in the Republic of Korea
Youngmi Lee, Sooyoun Kwon, Meeyoung Kim
Nutrition Research and Practice.2023; 17(4): 812. CrossRef
Comparison of Sodium Reduction Practice and Estimated Sodium Intake by Salty Food Preference on Employees and Customers of Sodium Reduction Restaurant in Daegu, Korea
Su-Jin Lee, Keon-Yeop Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2022; 27(1): 27. CrossRef
Comparison of the Sodium and Sugar Reduction Practices at Samsam Foodservices and General Foodservices in Daegu
Sung-young Kwon, Kilye Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2021; 26(4): 270. CrossRef

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[English]
Current Status of Sanitary and Nutritional Food Service in Elderly Day Care Center: Jeong hyeon Woo, Yoo Kyoung Park, Mi-Hyun Kim, Soo-Kyung Lee, Kyung hee Song, Hye-Kyeong Kim; Korean J Community Nutr 2020;25(5):374-385. Published online October 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.5.374

Abstract PDF

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.

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Development of Protein Enhanced Diet for Socially Vulnerable Elderly
Jihye Hong, Hyung-Geun Jeon, Seulgi Kim, Gitae Park
Journal of the East Asian Society of Dietary Life.2024; 34(1): 39. CrossRef
Snack Provision Practice in Long-Term Care Hospitals and Facilities in Korea
Dayeong Yeo, Hae Jin Kang, Hyejin Ahn, Yoo Kyoung Park
Clinical Nutrition Research.2024; 13(2): 108. CrossRef
Sanitation Management Performance According to the Characteristics of Coffee Franchise Shops and Sanitation Knowledge According to the Characteristics of Employees
Suk-Kyoung Gu, Sunyoon Jung, Inyong Kim, Yoonhwa Jeong
Journal of the Korean Society of Food Science and Nutrition.2021; 50(11): 1248. CrossRef
Analysis of Awareness, Knowledge, and Behavior about Food Hygiene·Safety Among the elderly
Mi Sook Lee, Sim-Yeol Lee
Korean Journal of Community Nutrition.2021; 26(3): 200. CrossRef

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[English]
Dietary Life of Chinese International Students according to the Frequency of University Foodservice Use in Korea: Yan Cui, Hye-Jong Yoo, Injoo Choi, Jihyun Yoon; Korean J Community Nutr 2020;25(4):291-302. Published online August 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.4.291

Abstract PDF

Objective
This study investigated the current use of university foodservice among Chinese international students in Korea, focusing on the relationship between the frequency of university foodservice use and their dietary life.
Methods
An online survey was conducted on 452 Chinese international students from February 6 to 12, 2020. The respondents were classified into “the Low-frequency group” (< one time/week; n=144), “the Mid-frequency group” (one-two times/week; n=133), and “the High-frequency group” (≥three times/week; n=175) according to their frequency of using university foodservice. The dietary life was compared among the three groups. Binominal logistic regression models were constructed to determine the associations between the frequency of university foodservice use and the changes in dietary life.
Results
More than 2/3 (68.1%) of the respondents used the university foodservice at least once per week. Chinese international students who were males and Han Chinese people, lived on campus, had stayed longer in Korea, and had no cooking facilities tended to use the university foodservice more often. The level of satisfaction with the university foodservice was not high (3.52 out of 5-points). Only 20% ate meals three times per day, and only 22% ate breakfast almost every day. The frequencies of overeating and skipping meals increased after studying in Korea. The frequency of university foodservice use, along with the length of residence in Korea, was associated with these negative changes in dietary life. Overeating (OR=2.11) and skipping meals (OR=1.79) were more likely to increase after studying in Korea in the Mid-frequency group than in the High-frequency group.
Conclusions
The frequency of university foodservice use was associated with the dietary life of Chinese international students in Korea. A high frequency (i.e. ≥three times/week) of using university foodservice may positively affect the dietary life of Chinese international students in Korea.

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Comparison of Sodium-Related Dietary Behavior and Low-Salt Dietary Attitude Based on the Gender and Salty Taste Assessment of Chinese International Students in the Jeonbuk Area
Qi Li, Ji Eun Lee, Jeong Ok Rho
Journal of the East Asian Society of Dietary Life.2021; 31(2): 91. CrossRef

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Original Articles

[English]
Customers' Perceptions of Operational Status of and Needs for Sodium Reduction in the Industry Foodservice in Seoul: Na Young Yi; Korean J Community Nutr 2020;25(1):21-31. Published online February 29, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.1.21

Abstract PDF PubReader ePub: OBJECTIVES
This study aimed to compare customers' perceptions of the need for a low-sodium diet and sodium-reduced operations in the industry foodservice by age. The relationships between health concerns and perceptions of the need for sodium-reduced operations and low-sodium diets in the industry foodservice were analyzed.
METHODS
A survey was conducted among 340 industry foodservice customers aged 20â€“50 years and residing in Seoul, Korea. This study investigated the respondents' health concerns, their perception of the need for sodium-reduced foodservice operations, their perception of a sodium-reduced diet, and the general details of the foodservices they used. A cross-tabulation analysis and ANOVA were performed to identify differences in measurement items by age, and a simple regression analysis was performed to examine relationships between measurement items.
RESULTS
For the customers' perception of the need for a sodium-reduced foodservice operation, the item â€œit is necessary to provide separate spices and sauces to reduce sodium intakeâ€ achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item â€œI think it is helpful for one's healthâ€ obtained the highest score (4.13 points). Respondents' health concerns had a positive effect on increasing the level of perception of the need for sodium-reduced foodservice operations and that of a sodium-reduced diet.
CONCLUSIONS
Foodservice nutritionists could help enhance their customers' perceptions of the needs for sodium-reduced foodservice operations and sodium-reduced diets by frequently providing them with sodium-related health information.

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[English]
Generation of Food Waste and Plate Waste Reduction Strategies in School Food Services in Gyeonggi Province: Jiyeon Choi, Kyung Eun Lee; Korean J Community Nutr 2019;24(5):422-432. Published online October 31, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.5.422

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