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

From the early stage of diabetes diagnosis, it may necessary to modify lifestyle including nutrition and physical activity. Self-management instruction and support can result in healthy eating habits for effective blood sugar management. Clinical nutritionists must conduct accurate nutritional assessments for successful dietary change and patient health. They must also diagnose and prioritize the nutritional problems to be addressed. Through medical nutrition therapy, nutritionists must instruct and encourage patient self-management skills based on evidence-based nutritional guidelines and education about viable strategies. For this purpose, educators should strive continuously to acquire knowledge and professional training.
Blood Glucose ; Diagnosis ; Eating ; Education ; Humans ; Life Style ; Motor Activity ; Nutrition Assessment ; Nutrition Therapy ; Nutritionists ; Self Care

BACKGROUND: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. RESULTS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. CONCLUSION: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
Acute Coronary Syndrome ; Cardiovascular Diseases ; Cause of Death ; Consultants ; Coronary Disease ; Delivery of Health Care ; Heart ; Hospitals, General ; Hospitals, University ; Humans ; Insurance Benefits ; Korea ; Life Style ; Methods ; Mortality ; Myocardial Infarction ; Nutritionists ; Physical Therapists ; Preventive Medicine ; Recurrence ; Rehabilitation ; Secondary Prevention ; Specialization ; Sports Medicine ; Surgeons

Patient education is important for successful management of atopic dermatitis; however, due to limited time and resources, patient education remains insufficient. This study aimed to investigate the current state of education provided by Korean dermatologists, pediatric allergists, and allergists to patients with atopic dermatitis. A questionnaire survey consisting of items regarding educational programs for patients with atopic dermatitis was conducted via e-mail. In total, 153 participants responded to the questionnaires, and 26.8% indicated that they have had separate educational programs. The workforce involved in the educational program included nurses, residents or fellows, dieticians, pharmacists, and clinical psychologists. Most education protocols addressed the characteristics and natural course of atopic dermatitis and environmental management. Overall, 96.7% of the participants replied that an additional charge is needed for education; moreover, additional assistance from an academic society or association, in the form of medical staff, organized data, and advertisement, is required to develop and provide a well-structured educational program. A standardized education protocol will effectively provide appropriate education for patients with atopic dermatitis. Arrangement of education fees, covered by the National Health Insurance Service, will lead to the establishment of a structured educational program and participation of an additional medical workforce.
Dermatitis, Atopic ; Education ; Electronic Mail ; Fees and Charges ; Humans ; Korea ; Medical Staff ; National Health Programs ; Nutritionists ; Patient Education as Topic ; Pharmacists ; Psychology

OBJECTIVE: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and three additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. METHODS: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and two general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, three rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. PRINCIPAL CONCLUSIONS: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.
Acute Coronary Syndrome ; Cardiovascular Diseases ; Cause of Death ; Consultants ; Coronary Disease ; Delivery of Health Care ; Heart ; Hospitals, General ; Hospitals, University ; Humans ; Insurance Benefits ; Korea ; Life Style ; Methods ; Mortality ; Myocardial Infarction ; Nutritionists ; Physical Therapists ; Preventive Medicine ; Recurrence ; Rehabilitation ; Secondary Prevention ; Specialization ; Sports Medicine ; Surgeons

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