Objectives This study aimed to examine the effectiveness of the intervention of the nutrition support team (NST) on the nutritional status of critically ill patients. Methods The medical records of 176 adult patients who were admitted to the intensive care unit and received enteral or parenteral nutrition for more than 7 days were retrospectively analyzed. The patients were classified into the NST and non-NST groups according to whether they were referred to the NST or not. The NST group was further classified into the compliance and non-compliance groups depending on their compliance with the NST recommendations. Results The NST referral rate was 56.8%, and the rate of compliance with the NST recommendations was 47.0%. Significantly higher energy and protein were provided to the NST and the compliance groups than to the non-NST and the non-compliance groups. The proportion of patients who reached the target calories after the initiation of enteral nutrition was significantly higher in the NST and the compliance groups than in the non-NST and the non-compliance groups. The serum albumin and hemoglobin levels significantly decreased in every group, but the changes were significantly lower in the compliance group. The nutritional status at discharge from the intensive care unit compared to the status at admission was significantly worse in the NST, non-NST, and non-compliance groups. However, the status was maintained in the compliance group. The length of stay in the intensive care unit was significantly shorter in the compliance group. Conclusions Compliance with the NST recommendations was found to provide more calories and protein and prevent the deterioration of the nutritional status of critically ill patients. Therefore, effective communication between medical staff and the NST from the early stages of admission to the intensive care unit is needed to improve referrals to the NST and compliance with the recommendations.
Objectives This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. Methods The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30∼60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapyrelated items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. Results All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. Conclusions These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.
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OBJECTIVES This study examined the effects of nutrition education and exercise therapies on the hematological status and diabetes knowledge of diabetic patients. For this purpose, a 12-week intensive management program was provided to diabetic patients participating in an exercise program in S health subcenter in Kwangju city and the effects were analyzed. METHODS The subjects were 26 diabetic patients, who provided written informed consent. As a preliminary survey, this study examined the general characteristics, physical status, obesity, blood pressure, hematological status, daily activity level, diabetes knowledge, diet performance, and barriers to diet therapy. After the 12-week intensive management program was completed, a post-test was conducted in the same way as the preliminary test. The data were analyzed with using SPSS 18.0. The data from this study are presented as the mean ± standard deviation. A paired t-test was conducted to compare differences in the means before and after the program. Statistical significance was set to p < 0.05. RESULTS The results of the program are presented as follows. The HDL-cholesterol levels changed from 39.8 ± 10.5 mg/dL to 48.3 ± 13.1 mg/dL, showing a significant increase (p < 0.001). The blood sugar 2 hours after a meal changed from 175.2 ± 67.1 mg/dL to 140.5 ± 42.5 mg/dL, showing a significant decrease (p=0.014). The glycosylated hemoglobin levels decreased significantly from 6.7 ± 1.1% to 6.3 ± 1.0% (p=0.010). The total scores of the daily activity levels increased significantly from 3.8 ± 2.4 to 4.8 ± 2.5 (p=0.040). The scores of knowledge on diabetes increased from 11.5 ± 3.6 to 14.0 ± 3.8 (p=0.001). The scores of knowledge on diet therapy changed from 6.7 ± 2.2 to 7.9 ± 1.7, showing a significant increase (p=0.027). CONCLUSIONS The 12-week intensive management program intervened by nutrition education and exercise therapies induced positive changes to the HDL-cholesterol, blood sugar 2 hours after a meal, glycosylated hemoglobin, daily activity levels, and knowledge on diabetes.
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OBJECTIVES This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. METHODS Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. RESULTS Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. CONCLUSIONS Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving longterm enteral nutrition.
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OBJECTIVES This study investigated the improvement of food habits and eating behavior of cancer patients during treatment through the continuous nutrition counseling and monitoring. METHODS Thirty cancer patients during treatment were participated in this study, and the first nutrition counseling and the first and second monitoring were conducted after 2-3 week intervals. RESULTS As a result of the nutrition counseling and monitoring, all patients improved to a great extent to consume 3 meals a day. The frequency of having breakfast was significantly increased with the nutrition counseling and continuous monitoring as well. The meal fixed quantity was stabilized and the eating speed slowed down as more nutrition counseling were done. The snack intakes of patients did not show any significant difference after the nutrition counseling but showed a slight decline after the monitoring. The frequencies of eating out and a late-night meal significantly decreased after the monitoring. The intakes of fish, meat, vegetables, milk and fruits needed for a well-balanced diet significantly increased as more nutrition counseling were done. The intakes of processed food were significantly decreased after the nutrition counseling and the intakes of fast food were significantly decreased as more nutrition counseling were done. The water intake of patients also significantly increased. In the eating behavior related to health, the frequency of drinking alcohol significantly decreased after nutrition counseling consultation and no patients had dietary supplements after the first monitoring. CONCLUSIONS These results suggested that continuous nutrition counseling is effective in improving eating habits of cancer patients.
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OBJECTIVES The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. METHODS Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. RESULTS Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01). CONCLUSIONS Hospital-based home-visit nutrition education need the access of home nutrition support team.
Although it is well known that cancer patients suffer from malnutrition, there are few published studies on malnutrition in outpatients receiving chemotherapy in Korea. This study aimed to evaluate nutritional risk in oncology outpatients receiving chemotherapy and to show the baseline data to set up nutritional management programs for cancer patients. This is a retrospective observational analysis on 1,962 patients referred for nutritional education before or during chemotherapy at Seoul National University Hospital Cancer Center from January 2006 to May 2007. According to a malnutrition screening tool, the proportion of patients having malnutrition risk was 23.0%. In the case of upper gastrointestinal cancer, more than 50% of patients were assessed as being at the risk of malnutrition. They showed more than 7% weight loss compared to their usual body weight and poor oral intake; energy intake was less than 100% of Basal Energy Expenditure (BEE) and protein intake was less than or equal to 0.77 g/kg/d. However, only 6.3% of breast cancer patients had risk of malnutrition and their oral intake was better; energy intake was 121% of BEE, and protein intake was 0.90 g/kg/d. Outpatients receiving chemotherapy had different nutritional risk depending on their cancer site. Nutritional management program should be conducted differently, depending on the cancer site and upper gastrointestinal cancer patients at high risk of malnutrition should basically have nutritional assessment and intervention.
The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n=13), At-risk II (Moderate PCM, n=9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n=11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team.
The purpose of this study was to assess how the changes in the food services environment on patients satisfaction with the hospital food service. Statistical data analyses were completed using the SPSS 11.0 program. The results can be summarized as follows: The flow line and environment of the food services in the hospital were improved through remodeling, which included the replacement of all cooking utensils, ventilation facilities and material storages, the purchase of a combi steamer, and the change of meal carts and trays. After the remodeling, the hospital food service was improved so that it provided spoons at each meal, diversified the menu utilizing the combi steamer, served event meals three times a week as well as water boiled with burned rice in the morning twice a week. In addition, various types of tableware were used in the table settings to produce attractive visual effects. Among the 10 items included on the patient satisfaction questionnaire, "satisfaction with offered menus" (p<0.01) showed significantly higher scores before the remodeling. "cooking/seasoning of food", "amount of meals" and "taste of meals" were not statistically significant, but showed increased satisfaction after the remodeling. However "temperature of food", "cleanliness of clothes and features" and "satisfaction with meal times" were not statistically significant, but showed decreased satisfaction after the remodeling.
This study was done to investigate the blood pressure, BMI and serum lipids of cerebrovascular accident patients in Seoul. The subjects were 195 Korean urban cerebrovascular accident patients who were hospitalized at Dong Seo Oriental Hospital in Seoul from June, 1997 to December, 1997. There were more cerebral infarction patients(164) than cerebral hemorrhage patients(31). Cerebral infraction patients were prevalent for subjects in their sixties, but cerebral hemorrhage patients were most commonly in their fifties. The BMI of cerebral infarction accidents was significantly higher than that of cerebral hemorrhage patients(p<0.05). Mean diastolic blood pressure of cerebral hemorrhage patients was significantly higher than that of the cerebral infarction patients(p<0.05). The mean systolic blood pressure of the cerebral hemorrhage patients was higher than that of the cerebral infarction patients, not statistically significant. The serum total cholesterol and glucose levels of the cerebral infarction patients was significantly higher than those of the cerebral hemorrhage patients(p<0.05). Serum total cholesterol(p<0.01), triglyceride(p<0.05) and LDH(p<0.01) levels of female subjects were significantly higher than those of male subjects. Serum total cholesterol has a negative correlation with serum GOT and GPT, but has a positive correlation with triglyceride. Serum triglyceride has a negative correlation with diastolic blood pressure but has a positive compellation with serum glucose.
This study was performed to investigate the nutritional status of neurosurgical tube-fed patients. The objective of this study was to improve the nutrition management of tube-fed patients. The current practices of tube feeding and enteral nutrition formula as for 95 patients in the hospital were examined by reviewing patients charts, and interviewing patients, nurses and their family members. The results are summarized as follows ; 57.9% of patients that received the formula showed a decrease in mental status. Among the subjects, 55.7% had nervous system diseases due to old age. Most of the tube-fed patients were hospitalized in the emergency room and while hospitalized, the status of their respiratory organ was abnormal. The method of tube-feeding was by Bolus injection and the type of the tube was a 16Fr size silicone tube. The amount of the injection per day while tube-feeding was on average 1424 kcal for men and 1322 kcal for women and the calories per day ranged from 1000-1500 kcal(50.5%). The injection volume averaged 332.7ml and 45% of patients received more than 300ml per injection. The tube feeding intake rate was 127.9ml/min with 50% of subjects in the range of 50-100ml/min and 10% at 20ml/min. The longer the hospitalization, the older age, coma status, and the higher tube feeding rate, the more decreased were the biochemical parameters.
This study was conducted to investigate and to improve the actual condition of food service for patients in hospitals. For this purpose, were distributed to 283 patients admitted to a university hospital and three general hospitals between January 27 and February 15, 1997. The department participated in the study included internal medicine, surgery, obstetrics, orthopedics and so forth. For meal time, 61.1% of patients wanted to eat breakfast at 8 am, 55.8% lunch at noon, and 73.5% dinner at 6 pm. The patients complained about unsatisfactory hospital food itself by 37.8%, about insufficient food amount by 19.6%, about menu with no choice by 41.2% and about low variety of the meals by 32.7%. Sixty two point nine percent of the subjects enjoyed snacks between meals because of poor appetite at meal time(46.1%), delayed food service(39.9%) and others(11.2%). The types of diet were mainly regular ones(58.6%) with some high protein(12.4%) and diabetic sensitive ones(7.1%). As eating place, the patient's prefered bed(51.9%), room-table(27.2%) and dining room(17.7%). Fifty-five percent of them also wanted hospital foods available to their caring relatives.