Feasibility Study on the Dietary Improvement Program Development for Senior Citizens

Sung-Hee Kim; Boram Kim; Nami Joo

doi:10.5720/kjcn.2017.22.3.218

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Research Article: Korean Journal of Community Nutrition 2017;22(3):218-227.
DOI: https://doi.org/10.5720/kjcn.2017.22.3.218
Published online: January 20, 2017

¹⁾Nutrition Education Graduate School, Sookmyung Women's University, Seoul, Korea

²⁾Department of Food & Nutrition, Sookmyung Women's University, Seoul, Korea

†Corresponding author Nami Joo Department of Food & Nutrition, Sookmyung Women's University, Hyochangwon-gil 52, Yongsan-gu, Seoul 140-742, Korea Tel: (02) 710-9471 Fax: (02) 710-9479 E-mail: fanta-fun@sookmyung.ac.kr ORCID: 0000-0002-8205-0399

• Received: June 13, 2017 • Revised: June 26, 2017 • Accepted: June 26, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Objectives
The purpose of the study was to develop dietary change program items that could be used to improve dietary life of the elderly and investigate their validity.
Methods
The survey was were analyzed by SPSS program (Ver. 21) and descriptive statistics was performed; a t-test, χ² test, One-way ANOVA and Friedman test were used to determine the priority.
Results
Programs for feeding senior citizens that need to be newly established are largely divided into two fields, namely, application of welfare facilities and application of home care, classified into large, medium and sub-classes. The large class was divided into nutrition management, sanitary control, and other health management. The medium class of nutrition management was divided into nutrition education, nutrition intervention, and menu management and supply. The sub-class was composed of division into application of welfare facilities for the elderly and application of home care for the same age group. Responses showed high rate saying that all the categorized items were necessary and valid. With respect to expectation effect on a community program for old people feeding, ‘yes' was 65 people (55.6%) showing very high expectation toward the question whether a community program for old people feeding are newly set up.
Conclusions
It is believed that nutrition for the aged will be improved and it will be a help not only to a small facilities without obligation of employing a dietician but also to the aged at home if a community program for old people feeding are newly established.
Keywords: dietary improvement program; senior citizens; welfare facilities for the aged; home care for the aged

Table 1.

General characteristics of the study subjects

Category		N (%)
Age in years	Between 20 To 29	22 (18.6)
	Between 30 To 39	33 (28.0)
	Between 40 To 49	33 (28.0)
	over 50	30 (25.4)
Work period	Less than a year	17 (14.2)
	More than 1 year – less than 3 years	11 (59.2)
	More than 3 years – less than 6 years	37 (30.8)
	Over 6 years – less than 9 years	23 (19.2)
	More than 9 years	32 (26.7)

Table 2.

Foodservice management issues

Foodservice management issues	First	Second	Third	Fourth	Fifth
Lack of food expenses	15 (12.9)¹⁾	15 (52.4)	15 (13.6)	25 (23.4)	44 (41.1)
Lack of cooking staff	60 (51.7)	29 (25.2)	11 (10.0)	12 (11.2)	1 (50.9)
Elderly care facility director's lack of awareness	10 (58.6)	14 (12.2)	28 (25.5)	22 (20.6)	33 (30.8)
Absence of foodservice manual and guidelines development for elderly facilities	29 (25.0)	37 (32.2)	23 (20.9)	21 (19.6)	2 (51.9)
Absence of education system	2 (51.7)	20 (17.4)	33 (30.0)	27 (25.2)	26 (25.2)

¹⁾N (%)

Table 3.

Rank Test of foodservice management issues

Foodservice management issues	Average rank	χ² (p)
Lack of food expenses	3.63	109.647∗∗∗ (.000)
Lack of cooking staff	1.85
Elderly care facility director's lack of awareness	3.50
Absence of food service manual and guidelines development for elderly care facilities	2.48
Absence of education system	3.55

^∗∗∗: p < 0.001

Table 4.

Feasibility of large classification items of the program

Large classification	Absolutely inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	0 (0.0)¹⁾	14 (11.7)	54 (45.0)	52 (43.3)	4.32 ± 0.67
Sanitary control	0 (0.0)	59 (57.6)	59 (49.6)	51 (42.9)	4.35 ± 0.62
Other health management	0 (0.0)	23 (19.3)	54 (45.4)	42 (35.3)	4.16 ± 0.73

¹⁾N (%)

Table 5.

Feasibility of middle classification items of program

Large classification	Middle classification	Absolutely inappropriate	Inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	Nutrition education	2 (1.8)¹⁾	0 (0.0)	27 (23.7)	51 (44.7)	34 (29.8)	4.03 ± 0.78
	Nutrition intervention	0 (0.0)	3 (2.7)	32 (28.3)	52 (46.0)	26 (23.0)	3.89 ± 0.78
	Dietary management and supply	1 (0.9)	1 (0.9)	12 (10.5)	52 (45.6)	48 (42.1)	4.27 ± 0.76
Sanitary control	Purchasing management	0 (0.0)	5 (4.4)	30 (26.3)	48 (42.1)	31 (27.2)	3.92 ± 0.84
	Cooking management	0 (0.0)	2 (1.8)	18 (15.8)	50 (43.9)	44 (38.6)	4.19 ± 0.76
	Distribution management	0 (0.0)	2 (1.8)	22 (19.3)	51 (44.7)	39 (34.2)	4.11 ± 0.77
	Facilities management	0 (0.0)	2 (1.8)	17 (15.2)	52 (46.4)	41 (36.6)	4.18 ± 0.75
Other health management	Physical health management	0 (0.0)	1 (0.9)	29 (25.9)	43 (38.4)	39 (34.8)	4.07 ± 0.80
	Mental health management	0 (0.0)	1 (0.9)	25 (22.5)	43 (38.7)	42 (37.8)	4.14 ± 0.79
	Social health management	0 (0.0)	1 (0.9)	28 (24.8)	46 (40.7)	38 (33.6)	4.07 ± 0.79

¹⁾N (%)

Table 6.

Feasibility of small classification items of the program for the elderly at care facilities

Large classification	Middle classification	Small classification Care facility residents	Absolutely inappropriate	Inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	Nutrition education	Development of nutrition and diet education program for the elderly	0 (0.0)¹⁾	5 (54.3)	22 (19.1)	57 (49.6)	31 (27.0)	3.99 ± 0.80
		Dietary guidance education and nutrition counseling for the elderly	0 (0.0)	4 (53.5)	20 (17.4)	56 (48.7)	35 (30.4)	4.06 ± 0.79
		Chronic disease prevention education	0 (0.0)	6 (55.2)	29 (25.0)	54 (46.6)	27 (23.3)	3.88 ± 0.83
		Nutrition label reading education	4 (3.4)	25 (21.6)	44 (37.9)	30 (25.9)	13 (11.2)	3.20 ± 1.02
	Nutrition intervention	Dietary management and nutrition counseling by disease	0 (0.0)	6 (55.2)	25 (21.7)	58 (50.4)	26 (22.6)	3.90 ± 0.81
	Nutrition intervention	Management of nutrition DB of the elderly: classification of general elderly people and elderly people who receive hospital treatment	0 (0.0)	7 (56.1)	31 (27.0)	51 (44.3)	26 (22.6)	3.83 ± 0.85
	Dietary management and supply	Diet development and supply: classification of regular meals and therapeutic meals	0 (0.0)	2 (51.7)	20 (17.2)	55 (47.4)	39 (33.6)	4.13 ± 0.75
	Dietary management and supply	Development and supply of standard recipes: classification of regular meals and therapeutic meals	0 (0.0)	3 (52.6)	17 (14.8)	54 (47.0)	41 (35.7)	4.16 ± 0.77
Sanitary control	Purchasing and cooking	Food purchase management (ordering)	0 (0.0)	5 (54.3)	42 (36.2)	46 (39.7)	23 (19.8)	3.75 ± 0.82
		Food purchase, development and distribution of cooking instructions	0 (0.0)	2 (51.7)	32 (27.6)	60 (51.7)	22 (19.0)	3.88 ± 0.72
		Development and distribution of foodservice sanitation management guidelines for the elderly	0 (0.0)	1 (50.9)	26 (22.4)	63 (54.3)	26 (22.4)	3.98 ± 0.70
	Food service sanitary control	Hygiene checklist development and distribution	0 (0.0)	7 (56.1)	36 (31.3)	46 (40.0)	26 (22.6)	3.79 ± 0.86
		Hygiene inspection and DB management by facility	0 (0.0)	4 (53.5)	35 (30.4)	52 (45.2)	24 (20.9)	3.83 ± 0.79
		Development and operation of cooking staff training program	0 (0.0)	2 (51.8)	29 (25.4)	45 (39.5)	38 (33.3)	4.04 ± 0.81
Other health management	Physical health management	Standard exercise program development and operation	1 (0.9)	5 (54.3)	43 (37.4)	43 (37.4)	23 (20.0)	3.71 ± 0.87
		Basic exercise education for the elderly	1 (0.9)	5 (54.3)	43 (37.4)	43 (37.4)	23 (20.0)	3.71 ± 0.87
		Linking daily sports program	1 (0.9)	4 (53.5)	53 (46.1)	36 (31.3)	21 (18.3)	3.63 ± 0.85
	Mental health management	Psychological test	1 (0.9)	4 (53.5)	47 (40.9)	40 (34.8)	23 (20.0)	3.70 ± 0.86
		Psychological counseling	1 (0.9)	2 (51.7)	45 (39.1)	42 (36.5)	25 (21.7)	3.77 ± 0.84
		Psychotherapy program development and operation	1 (0.9)	6 (55.2)	46 (40.0)	40 (34.8)	22 (19.1)	3.66 ± 0.88
		Elderly education counseling	1 (0.9)	3 (52.6)	44 (38.3)	45 (39.1)	22 (19.1)	3.73 ± 0.83
		Elderly (Continuing) education program development and operation	2 (1.7)	3 (52.6)	43 (37.4)	47 (40.9)	20 (17.4)	3.70 ± 0.85

¹⁾N (%)

Table 7.

Feasibility of small classification items of the program for the elderly at home

Large classification	Middle classification	Small categories General home residents	Absolutely inappropriate	Inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	Nutrition education	Development of nutrition and diet education program for the elderly	1 (1.0)¹⁾	2 (2.0)	13 (12.9)	56 (55.4)	29 (28.7)	4.09 ± 0.76
		Dietary guidance education and nutrition counseling for the elderly	0 (0.0)	0 (0.0)	10 (10.0)	59 (59.0)	31 (31.0)	4.21 ± 0.61
		Chronic disease prevention education	0 (0.0)	1 (1.0)	17 (17.0)	49 (49.0)	33 (33.0)	4.14 ± 0.73
		Nutrition label reading education	1 (1.0)	6 (6.1)	33 (33.3)	37 (37.4)	22 (22.2)	3.74 ± 0.91
	Nutrition intervention	Dietary management and nutrition counseling by disease	0 (0.0)	0 (0.0)	17 (17.0)	53 (53.0)	30 (30.0)	4.13 ± 0.68
		Management of nutrition DB of the elderly: classification of general	0 (0.0)	2 (2.0)	29 (29.0)	42 (42.0)	27 (27.0)	3.94 ± 0.80
		elderly people and elderly people who receive hospital treatment
	Dietary management and supply	Food delivery service operation	1 (1.0)	3 (3.0)	19 (19.0)	41 (41.0)	36 (36.0)	4.08 ± 0.87
	Dietary management and supply	Diet guidance service operation	1 (1.0)	1 (1.0)	22 (22.0)	48 (48.0)	28 (28.0)	4.01 ± 0.80
Sanitary control	Purchasing and cooking	Development and distribution of food purchase tips	0 (0.0)	1 (1.0)	33 (33.0)	47 (47.0)	19 (19.0)	3.84 ± 0.74
	Purchasing and cooking	Development and distribution of cooking instructions for home use	0 (0.0)	5 (5.0)	29 (29.0)	45 (45.0)	21 (21.0)	3.82 ± 0.82
	Foodservice sanitary control	Development and education of food safety management guidelines	0 (0.0)	2 (2.0)	31 (31.0)	46 (46.0)	21 (21.0)	3.86 ± 0.79
	Foodservice sanitary control	Development and distribution of food safety management poster	0 (0.0)	4 (4.0)	28 (28.3)	44 (44.4)	23 (23.2)	3.87 ± 0.82
Other health management	Physical health management	Visiting nurse service operation	1 (1.0)	1 (1.0)	13 (13.0)	46 (46.0)	39 (39.0)	4.21 ± 0.78
		Visiting bathing service operation	1 (1.0)	1 (1.0)	12 (12.0)	50 (50.0)	36 (36.0)	4.19 ± 0.76
		Visiting education of exercise method for the elderly	0 (0.0)	0 (0.0)	16 (16.0)	56 (56.0)	28 (28.0)	4.12 ± 0.66
	Mental health management	Visiting psychology test	1 (1.0)	1 (1.0)	27 (27.3)	46 (46.5)	24 (24.2)	3.92 ± 0.80
		Visiting psychological counseling	1 (1.0)	1 (1.0)	21 (21.2)	48 (48.5)	28 (28.3)	4.02 ± 0.80
		Visiting short-term protection service and day and night protection service	1 (1.0)	1 (1.0)	16 (16.0)	49 (49.0)	33 (33.0)	4.12 ± 0.78
	Food development	Silver food development	0 (0.0)	1 (1.0)	2 (21.0)	48 (48.0)	30 (30.0)	4.07 ± 0.74
	Food development	Silver food nutrition analysis and DB management	0 (0.0)	1 (1.0)	26 (26.0)	46 (46.0)	27 (27.0)	3.99 ± 0.76
	Food education Food business	Visiting education of food safety management and cooking method	0 (0.0)	1 (1.0)	31 (31.0)	45 (45.0)	23 (23.0)	3.90 ± 0.76
		Food service for the low income group	0 (0.0)	1 (1.0)	16 (16.0)	49 (49.0)	34 (34.0)	4.16 ± 0.72
		Food bank operation	0 (0.0)	2 (2.0)	23 (23.0)	46 (46.0)	29 (29.0)	4.02 ± 0.78
		Food market operation	0 (0.0)	2 (2.0)	22 (22.2)	46 (46.5)	29 (29.3)	4.03 ± 0.78

¹⁾N (%)

Table 8.

Expected effect of the foodservice program for the elderly

Expected effect	Not at all influential	Not influential	Moderately influential	Influential	Extremely influential	Mean ± SD
Nutrition enhancement effect	0 (0.0)¹⁾	54 (53.4)	25 (21.4)	65 (55.6)	23 (19.7)	3.91 ± 0.74
Beneficial to small facilities	2 (1.7)	13 (11.1)	12 (10.3)	61 (52.1)	29 (24.8)	3.87 ± 0.97
Helpful to the elderly at home	0 (0.0)	53 (52.6)	24 (20.5)	64 (54.7)	26 (22.2)	3.97 ± 0.73
Need for specialized organization to	0 (0.0)	51 (50.9)	14 (12.0)	67 (57.3)	35 (29.9)	4.16 ± 0.66
operate the program

¹⁾N (%)

Table 9.

Expected effect of the foodservice program for the elderly by work period

Work period/ Expected effect	Less than a year	More than 1 year – less than 3 years	More than 3 years – less than 6 years	Over 6 years – less than 9 years	More than 9 years	Mean ± SD
Nutrition enhancement effect	3.94 ± 0.68¹⁾	3.64 ± 1.03	54.0 ± 0.70	3.91 ± 0.79	3.90 ± 0.70	3.91 ± 0.74
Beneficial to small facilities	4.06 ± 0.77	4.27 ± 0.47	3.82 ± 1.11	3.61 ± 1.16	3.84 ± 0.86	3.86 ± 0.97
Helpful to the elderly at home	4.06 ± 0.68	4.00 ± 0.89	4.03 ± 0.76	4.00 ± 0.85	3.81 ± 0.60	3.97 ± 0.74
Need for specialized	3.94 ± 0.68	4.27 ± 0.65	4.24 ± 0.70	4.17 ± 0.72	4.16 ± 0.58	4.17 ± 0.66
organization to operate the
program

¹⁾Mean ± SD

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Feasibility Study on the Dietary Improvement Program Development for Senior Citizens

Korean J Community Nutr. 2017;22(3):218-227. Published online June 30, 2017

DOI: https://doi.org/10.5720/kjcn.2017.22.3.218

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Feasibility Study on the Dietary Improvement Program Development for Senior Citizens

Table 1.

General characteristics of the study subjects

Category		N (%)
Age in years	Between 20 To 29	22 (18.6)
	Between 30 To 39	33 (28.0)
	Between 40 To 49	33 (28.0)
	over 50	30 (25.4)
Work period	Less than a year	17 (14.2)
	More than 1 year – less than 3 years	11 (59.2)
	More than 3 years – less than 6 years	37 (30.8)
	Over 6 years – less than 9 years	23 (19.2)
	More than 9 years	32 (26.7)

Table 2.

Foodservice management issues

Foodservice management issues	First	Second	Third	Fourth	Fifth
Lack of food expenses	15 (12.9)¹⁾	15 (52.4)	15 (13.6)	25 (23.4)	44 (41.1)
Lack of cooking staff	60 (51.7)	29 (25.2)	11 (10.0)	12 (11.2)	1 (50.9)
Elderly care facility director's lack of awareness	10 (58.6)	14 (12.2)	28 (25.5)	22 (20.6)	33 (30.8)
Absence of foodservice manual and guidelines development for elderly facilities	29 (25.0)	37 (32.2)	23 (20.9)	21 (19.6)	2 (51.9)
Absence of education system	2 (51.7)	20 (17.4)	33 (30.0)	27 (25.2)	26 (25.2)

¹⁾N (%)

Table 3.

Rank Test of foodservice management issues

Foodservice management issues	Average rank	χ² (p)
Lack of food expenses	3.63	109.647∗∗∗ (.000)
Lack of cooking staff	1.85
Elderly care facility director's lack of awareness	3.50
Absence of food service manual and guidelines development for elderly care facilities	2.48
Absence of education system	3.55

^∗∗∗: p < 0.001

Table 4.

Feasibility of large classification items of the program

Large classification	Absolutely inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	0 (0.0)¹⁾	14 (11.7)	54 (45.0)	52 (43.3)	4.32 ± 0.67
Sanitary control	0 (0.0)	59 (57.6)	59 (49.6)	51 (42.9)	4.35 ± 0.62
Other health management	0 (0.0)	23 (19.3)	54 (45.4)	42 (35.3)	4.16 ± 0.73

¹⁾N (%)

Table 5.

Feasibility of middle classification items of program

Large classification	Middle classification	Absolutely inappropriate	Inappropriate	Neutral	Appropriate	Absolutely appropriate	Mean ± SD
Nutrition management	Nutrition education	2 (1.8)¹⁾	0 (0.0)	27 (23.7)	51 (44.7)	34 (29.8)	4.03 ± 0.78
	Nutrition intervention	0 (0.0)	3 (2.7)	32 (28.3)	52 (46.0)	26 (23.0)	3.89 ± 0.78
	Dietary management and supply	1 (0.9)	1 (0.9)	12 (10.5)	52 (45.6)	48 (42.1)	4.27 ± 0.76
Sanitary control	Purchasing management	0 (0.0)	5 (4.4)	30 (26.3)	48 (42.1)	31 (27.2)	3.92 ± 0.84
	Cooking management	0 (0.0)	2 (1.8)	18 (15.8)	50 (43.9)	44 (38.6)	4.19 ± 0.76
	Distribution management	0 (0.0)	2 (1.8)	22 (19.3)	51 (44.7)	39 (34.2)	4.11 ± 0.77
	Facilities management	0 (0.0)	2 (1.8)	17 (15.2)	52 (46.4)	41 (36.6)	4.18 ± 0.75
Other health management	Physical health management	0 (0.0)	1 (0.9)	29 (25.9)	43 (38.4)	39 (34.8)	4.07 ± 0.80
	Mental health management	0 (0.0)	1 (0.9)	25 (22.5)	43 (38.7)	42 (37.8)	4.14 ± 0.79
	Social health management	0 (0.0)	1 (0.9)	28 (24.8)	46 (40.7)	38 (33.6)	4.07 ± 0.79

¹⁾N (%)

Table 6.

Feasibility of small classification items of the program for the elderly at care facilities