Background and Objective: The Nutrition Care Process (NCP) is a systematic method used by dietitians to provide high-quality nutrition care resulting in good patient outcomes. This study aimed to assess the NCP implementation and use of NCP Terminologies (NCPT) among hospital dietitians in the Philippines. Specifically, the study aimed at assessing the knowledge, perception, and practices on NCP and use of NCPT and correlate them with the dietitians' education, and professional and employment profile; and explain the barriers and facilitators of the practice of NCP and use of NCPT among hospital dietitians in the Philippines. Methods: The knowledge, perception, and practices (KPP) on NCP and NCPT of the dietitians employed in the Philippine Department of Health’s licensed level 3 hospitals were determined using a validated questionnaire. Significant factors associated with the KPP were also determined. The barriers and facilitators of the practice of NCP and NCPT were determined using focus group discussion and key informant interviews of chief clinical dietitians and hospital administrators, respectively. Results: The study revealed that majority of the participants had a high level of knowledge on NCP and NCPT, positively perceived its implementation, and more than half of them implement NCP and NCPT in the hospitals. The participants’ knowledge on NCP and NCPT was significantly associated with research involvement and active membership in a professional organization. While the practice of NCP and NCPT was significantly associated with having NCP-related trainings, frequency of trainings, and active membership in a professional organization. The barriers to NCP implementation were insufficient resources; lack of orientation, trainings, and support; organizational and administrative constraints; pandemic constraints; insufficient time; and lack of confidence to conduct NCP. While the facilitators of implementation were collaboration, dedication, and commitment of the healthcare team; institutionalization of NCP laws and policies; budget allocation for NCP-related activities; monitoring and consistency of NCP implementation; and work schedule. Conclusion The findings suggest that the implementation of NCP and NCPT in the Philippines needs further support from the institution, professional organizations, and policy makers by developing strategies to cope with the barriers, and strengthen the facilitators and factors associated with practice.
Nutritionists ; Surveys and Questionnaires

Objective: This study aimed to: 1) describe the current state of research activity/involvement and capacity among selected tertiary level government and private hospital dietitians; 2) identify factors associated with research capacity and involvement; and 3) develop policy recommendations to improve the current research activity/involvement towards evidence-based practice among hospital dietitians.

Methods: This is a cross-sectional descriptive study. A total of randomly selected 181 hospital dietitians from selected hospitals in Metro Manila completed a pre-tested structured self-administered questionnaire, which elicited the socio-demographic characteristics, research activity/involvement, research capacity, perception, attitude and knowledge (PAK) of the respondents.

Descriptive statistics were generated. Pearson Correlation was determined between socio-demographic characteristics and research activity/involvement score and research capacity score. Linear multiple regression analysis was conducted to test whether perceptions, attitudes and knowledge score are factors that predicted research activity/involvement and research capacity.

Results: No significant difference was observed in hospital dietitians' research capacity scores based on gender, age, educational attainment, hospital affiliation, and job description. Majority (97%) of the hospital dietitians had very little participation (10%) or involvement in any type of research activity/involvement. The significant factors that were predictive of research activity/involvement scores and research capacity scores were percent of time for research and hours per week devoted to research, respectively. Percent of time for research was significantly predictive of research knowledge of respondents.

Conclusion: The findings in this present study showed the research activity/involvement and capacity of hospital dietitians in Metro Manila were dismally low. The significant factors that were predictive of research activity/involvement scores and research capacity scores were percent of time for research and hours per week devoted to research, respectively. To support the development of research capacity and involvement of hospital dietitians, policy-makers and healthcare organizations can optimize capability-building strategies at the academic level, hospital dietitian level, and institutional level.

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 20–50 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 “it is necessary to provide separate spices and sauces to reduce sodium intake” achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item “I think it is helpful for one's health” 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.
Diet ; Diet, Sodium-Restricted ; Korea ; Nutritionists ; Seoul ; Sodium ; Spices

OBJECTIVES: This study analyzed the education participation reasons and deterrents of dietitians who work in welfare facilities for the elderly. METHODS: The survey was completed by 144 dietitians working at welfare facilities for the elderly in Korea. The survey was conducted in October, 2018, both on-line and off-line, based on the demographic characteristics, work status on welfare facilities for the elderly, Participation Reasons Scale (PRS) and Deterrents to Participation Scale (DPS-G). The data were analyzed using frequency analysis, descriptive analysis, factor analysis, reliability analysis, regressive analysis using SPSS ver. 25.0. RESULTS: The reason for participation were divided into three factors: ‘Responsibility of professional and self-development (5.76 ± 1.04)’, ‘Job stability and personal benefits (4.98 ± 1.28)’, and ‘Interaction and development of professional competencies (5.85 ± 1.00)’. ‘Interaction and development of professional competencies’ was the highest motivation factor. Also, the deterrents for participation were divided into four factors: ‘Dispositional barrier (2.70 ± 1.29)’, ‘Dissatisfaction of education usability (3.39 ± 1.38)’, ‘Institutional barrier (4.21 ± 1.45)’, and ‘Situational barrier (2.36 ± 1.30)’. ‘Institutional barrier’ showed the highest deterrents factor. In addition, ‘Responsibility of professional and self-development’ and ‘Interaction and development of professional competencies’ were negative attributes for ‘Dispositional barrier’ (p<0.001). CONCLUSIONS: These results provide basic data to promote participation in education and contribute to the improvement of their job ability and education capacity of the food and nutrition management of welfare facilities for the elderly
Aged ; Education ; Humans ; Korea ; Motivation ; Nutritionists

OBJECTIVES: This study analyzed the education participation reasons and deterrents of dietitians who work in welfare facilities for the elderly. METHODS: The survey was completed by 144 dietitians working at welfare facilities for the elderly in Korea. The survey was conducted in October, 2018, both on-line and off-line, based on the demographic characteristics, work status on welfare facilities for the elderly, Participation Reasons Scale (PRS) and Deterrents to Participation Scale (DPS-G). The data were analyzed using frequency analysis, descriptive analysis, factor analysis, reliability analysis, regressive analysis using SPSS ver. 25.0. RESULTS: The reason for participation were divided into three factors: ‘Responsibility of professional and self-development (5.76 ± 1.04)’, ‘Job stability and personal benefits (4.98 ± 1.28)’, and ‘Interaction and development of professional competencies (5.85 ± 1.00)’. ‘Interaction and development of professional competencies’ was the highest motivation factor. Also, the deterrents for participation were divided into four factors: ‘Dispositional barrier (2.70 ± 1.29)’, ‘Dissatisfaction of education usability (3.39 ± 1.38)’, ‘Institutional barrier (4.21 ± 1.45)’, and ‘Situational barrier (2.36 ± 1.30)’. ‘Institutional barrier’ showed the highest deterrents factor. In addition, ‘Responsibility of professional and self-development’ and ‘Interaction and development of professional competencies’ were negative attributes for ‘Dispositional barrier’ (p<0.001). CONCLUSIONS: These results provide basic data to promote participation in education and contribute to the improvement of their job ability and education capacity of the food and nutrition management of welfare facilities for the elderly
Aged ; Education ; Humans ; Korea ; Motivation ; Nutritionists

For patients with short bowel syndrome who undergo ileostomy, nutritional management is essential to prevent complications associated with a high-output stoma (HOS). We report a practical example of ostomic, medical nutrition therapy provided by an intensive nutritional support team (NST). A 42-year-old male with a history of Crohn's disease visited Seoul National University Hospital for treatment of mechanical ileus. He underwent loop ileostomy after extensive small bowel resection. As his remaining small bowel was only 160 cm in length, the stomal output was about 3,000 mL/day and his body weight fell from 52.4 to 40.3 kg. Given his clinical condition, continuous tube feeding for 24 h was used to promote adaptation of the remnant bowel. Thereafter, an oral diet was initiated and multiple, nutritional educational sessions were offered by dietitians. Constant infusion therapy was prescribed and included in the discharge plan. Two months after discharge, his body weight had increased to 46.6 kg and his hydration status was appropriately maintained. This case suggests that the critical features of medical nutritional therapy for ostomy management are frequent assessments of fluid balance, weight history, and laboratory data and after nutritional interventions.
Adult ; Body Weight ; Crohn Disease ; Diet ; Diet Therapy ; Enteral Nutrition ; Humans ; Ileostomy ; Ileus ; Male ; Nutrition Therapy ; Nutritional Support ; Nutritionists ; Ostomy ; Seoul ; Short Bowel Syndrome ; Water-Electrolyte Balance

We investigated weight loss effect of personalized diet education in overweight/obese Korean adults. Overweight/obese Korean adults (body mass index [BMI] ≥ 23 kg/m2 or waist circumference [WC] ≥ 90 cm for men, ≥ 85 cm for women) were recruited, and 40 participants who completed the 10-week intervention were finally included in the analyses. At first visit, study participants (small group with individual counseling) were educated for optimal diet by clinical dietitian, and checked for their compliance through telephone/text message every 1–2 week during the intervention. Anthropometric and biochemical parameters and dietary intake were investigated. Body weight, BMI, WC, and body fat mass were significantly reduced in whole participants. Hemoglobin A1c, insulin, and low-density lipoprotein cholesterol were also significantly decreased after the intervention. Total energy intake (EI) during the intervention was not significantly decreased compared to the baseline value, but the proportions of energy derived from macronutrients were within the ranges recommended by 2015 Dietary Reference Intake for Koreans. Based on actual EI, participants were classified into high-adherence (HA) (prescribed EI ± 25%, n = 29), low-adherence I (LA-I) (< 75% of prescribed EI, n = 7), and low-adherence II (LA-II) group (> 125% of prescribed EI, n = 4). Only HA group showed significant improvements in anthropometric parameters, glycemic control and lipid profile. Interestingly, LA-I group showed significant increases in glucose, insulin, C-peptide and insulin resistance. In conclusion, a shift from overweight/obesity to healthy weight can be accomplished by high adherence to personalized diet modification, not by EI reduction.
Adipose Tissue ; Adult ; Body Weight ; C-Peptide ; Cholesterol ; Compliance ; Diet ; Education ; Energy Intake ; Food Habits ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Lipoproteins ; Male ; Nutritionists ; Obesity ; Overweight ; Recommended Dietary Allowances ; Waist Circumference ; Weight Loss

This study aimed to examine nutrition care management for in-patients with dysphagia and to evaluate knowledge on nutrition care related to dysphagia among dietitians in clinical settings. A total of 554 questionnaires were distributed to dietitians at hospitals located in Seoul and Gyeonggi Province in Korea, and 147 responses were used for data analysis after excluding responses with significant missing data. Study participants worked at general hospitals (37.2%), long-term care hospitals (24.3%), hospitals (19.2%), and tertiary hospitals (11.5%). Prior education and training related to dysphagia was received by 69.9% of the respondents. The percentage of hospitals that had diet guidelines for dysphagia was 68.0%. Dysphagia diets of 2 levels and 3 levels were provided in 55.1% and 34.7% of the hospitals, respectively. Overall 74.7% of the dietitians responded that they provided information on dysphagia diets to in-patients and caregivers, but only 45.7% of dietitians did so in the long-term care hospitals. Among the respondents who used commercial thickening agents, 77.2% used only one type of commercial thickening agent. Patients or caregivers (75.7%) or nurses (34.5%) were reported to modify viscosity of liquid. Dietitians showed low levels of knowledge on nutrition care related to dysphagia (a mean of 5.14 based on possible scores from 0 to 10 points). To promote nutritional consumption and prevent malnutrition and aspiration, hospitals need the standardized diet guidelines, and dietitians should improve their expertise in nutritional care for patients with dysphagia.
Caregivers ; Deglutition Disorders ; Diet ; Education ; Gyeonggi-do ; Hospitals, General ; Humans ; Korea ; Long-Term Care ; Malnutrition ; Nutritionists ; Seoul ; Statistics as Topic ; Surveys and Questionnaires ; Tertiary Care Centers ; Viscosity

BACKGROUND: The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most. METHODS: We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities. RESULTS: We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%). CONCLUSION: These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.
Caregivers ; Food Services ; Health Expenditures ; Humans ; Insurance ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Nutritionists ; Quality of Life

OBJECTIVES: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate.METHODS: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification.RESULTS: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, ‘needs to provide nutrition counseling in children's hospitals’, ‘providing nutrition counseling services in working hospitals’, and ‘whether there is a nutrition counseling room’ scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, ‘self-assessment of food allergy knowledge understanding level’, ‘awareness of open oral food challenge (OFC)’, ‘recognition of the need for education and counseling on food allergy for patients/guardians’, and ‘food allergy related educational experience’ scored higher among holders of clinical dietitians certificates than in non-holders.CONCLUSIONS: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.
Certification ; Counseling ; Education ; Food Hypersensitivity ; Hypersensitivity ; Korea ; Nutritionists