Journal of Korean Academy of Nursing

Review Paper

Effects of Early Oral Feeding versus Delayed Oral Feeding on Bowel Function, Gastrointestinal Complications and Surgical Recovery after Cesarean Section under Regional Anesthesia: Systematic Review and Meta-Analysis: Kim, HyoJin , Jeon, YeongKyung , Yoon, SoYoung , Lee, GeumMoon; J Korean Acad Nurs 2021;51(6):732-745. Published online December 31, 2021; DOI: https://doi.org/10.4040/jkan.21127

Purpose
This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery.
Methods
A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs).
Results
Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85).
Conclusion
This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

Citations

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Effect of Early vs Delayed Oral Feeding Following Cesarean Delivery: A Randomized Controlled Trial
Anuradha Murugesan, Dharani Saravanan, Karthiga Prabhu, Shanmugapriya Chandrasekaran, Prithiv Raj
Journal of South Asian Federation of Obstetrics and Gynaecology.2025; 16(S3): S158. CrossRef
The awareness of enhanced recovery after surgery (ERAS) cesarean delivery guidelines among anesthesiology and reanimation assistants in Turkey; a questionnaire study
Zeliha Dedebagı, Eyyüp Sabri Özden, Mustafa Soner Özcan, Filiz Alkaya Solmaz, Pakize Kırdemir
BMC Anesthesiology.2024;[Epub] CrossRef
Factors affecting gastrointestinal function recovery after cesarean section among Chinese mothers: A cross-sectional study
Yi Liu, Jie Xiang, Jianhua Ren, Li Gu, Yu Wang, Xiuping Liu, Jiao Wen
Medicine.2023; 102(38): e35200. CrossRef

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Original Articles

A Study of the Fluid Balance of the Patients on Soft Diets: Young Hee Yang, Kwon Smi Choi, Eun Kyoung Kim, Il Soon Sung; Journal of Nurses Academic Society 1996;26(3):688-696. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1996.26.3.688

Abstract PDF

The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age lor the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581ml while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701ml whereas urine output was 2253ml and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group, the difference between fluid intake and output was 1238ml after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.

Citations

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Measuring Fluid Balance in Patients with Cancers: Comparison between Cumulative Intake and Output Records and Body Weight Change
Jin Hong Lee, Hee Jung Park, Jeong Hwa Kim, Eun-Young Suh
Journal of Korean Oncology Nursing.2011; 11(3): 247. CrossRef

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The Prevalence of Defecation Difficulty and Bowel Habits in University Students: You Joung Kim, Deok Jin Ban; Journal of Korean Academy of Nursing 2002;32(7):1009-1016. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.1009

Abstract PDF: To determine bowel patterns and the prevalence of defecation difficulty in young university students, we administered a self-reported questionnaire to 1,617 college students about their bowel habits and eating patterns and obtained the following: 83.7% showed defecation frequency between 2 times per day and 3 times per week, and 33.4% reported difficulty in defecation. Among the subjects with defecation difficulty, 69% complained of constipation and 31% of diarrhea. It was also shown that the prevalence of self-reported defecation difficulty varied by sex. Women were more likely to have defecation difficulty than men (OR=2.5; 95% CI: 2.005-3.149). There were also differences between men and women in respect to the bowel habits (frequency, regularity, thickness, volume, form and time required) and food preferences. Men reported a higher frequency of defecation than women (p<.001). The dietary fiber intake volume of the subjects with defecation difficulty was smaller than subjects without the problem (OR=0.83, CI; 0.706-0.978). Moreover, those whose favorite food was meat were more likely to have defecation difficulty than those preferred vegetables (OR=1.39; 95% CI: 1.058-1.820). Irregular defecation was reported in 44.5% of the students, especially non-residents of Cheolla province (OR=1.2; 95% CI: 1.007-1.480). Non-residents ate dietary fiber significantly less than residents and there were some differences in diet habits and also in bowel habits.

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The Effects of Sasang Constitutional Diet for Essential Hypertension on Blood Pressure, Fat, and Serum Lipid: on the subjects with aerobic exercise and low salt diet at the same time: Eun Young Jeon; Journal of Korean Academy of Nursing 2002;32(5):673-683. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.5.673

Abstract PDF

PURPOSE: This study was conducted to evaluate the effects of SaSang constitutional diet for essential hypertension on blood pressure, fat, and serum lipid on the subjects with aerobic exercise and low salt diet at the same time. METHOD: A non-equivalent control group time-series design was used. For the experimental group, aerobic exercise and SaSang constitutional diet were taught by researcher at health center. Test for hypothesis was done by repeated measured ANOVA. RESULT: There was significant decrease in systolic, diastolic, and MAP between the experimental group and control group over three different times. There was significant decrease in body weight, BMI, and body composition over three different times. But, there was no significant difference between groups and interaction by groups or over time. There was significant decrease in T/G and cholesterol over three different times. But, there was no significant difference in T/G, HDL, LDL, and total cholesterol between groups and interaction by groups or over time. CONCLUSION: Findings indicate that this study will contribute to develop nursing strategies for the regulation of the blood pressure as a means of alternative- complementary nursing intervention.

Citations

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Machine Learning Applications for the Development of a Questionnaire to Identify Sasang Constitution Typology
Soon Mi Kim, Jeongkun Ryu, Eunhye Olivia Park
International Journal of Environmental Research and Public Health.2022; 19(18): 11820. CrossRef
The Effects of the Woorichum Exercise on Metabolic Syndrome Risk Factors, Brain Growth Factor in Obese Elderly Women According to Sasang Constitution
Kwak, Hyun-Mi, Han-joon Lee
Official Journal of the Koeran Society of Dance Science.2016; 33(4): 149. CrossRef
Clinical Practice Guideline for Sasang Constitutional Medicine: Prevention and Risk Fators of Sasangin Disease
Na-Young Bae, Eui-Ju Lee
Journal of Sasang Constitutional Medicine.2015; 27(1): 82. CrossRef
General Characteristics, Antherpometric Values and Health-Related Factors according to Sasang Constitution among Elderly People in Rural Areas
Kyung-Mi Yang
Journal of the Korean Home Economics Association.2012; 50(2): 39. CrossRef
A Study on Yangsaeng (Health Management) of Korean Older Adults by 4 Constitution Types
Jeong Suk Kim, Sohyune R. Sok
Holistic Nursing Practice.2012; 26(6): 317. CrossRef
The effects of Aroma foot reflexology and foot reflexology on blood pressure, pulse rate and blood lipid level of elderly essential hypertensive patients in a rural area
Hyeon-Soon Lee, Dong-Oak Kim
Journal of the Korea Academia-Industrial cooperation Society.2012; 13(9): 4053. CrossRef

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The Effects of Brisk Walking versus Brisk Walking Plus Diet on Triglycerides and Apolipoprotein B Levels in Middle-aged Overweight/obese Women with High Triglyceride Levels: Mi Ra Lee, Wan Soo Kim; Journal of Korean Academy of Nursing 2006;36(8):1352-1358. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.8.1352

Abstract PDF

Purpose

The purpose of this study were to investigate the effects of a 12-week brisk walking program on triglycerides (TG) and apolipoprotein B (Apo B) and to compare these effects to those of a brisk walking plus diet program in middle-aged overweight/obese (BMI≥ or =23) Korean women with hypertriglyceridemia.

Method

This analysis was done with nineteen middle-aged overweight/obese Korean women who completed either the brisk walking program (9 women) or the brisk walking plus diet program (10 women) for 12 weeks. The brisk walking consisted of walking for 20 to 50 minutes/day at an intensity of 40 to 70% of heart rate reserve (HRR) for 3 to 6 days/week. The diet consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling every week. TG and Apo B were assessed pre- and post-intervention.

Results

TG and Apo B decreased significantly after the brisk walking program (Z = -2.31, p = 0.021; Z = -2.59, p = 0.009). TG and Apo B lowering effects of the brisk walking program were not significantly different from those of the brisk walking plus diet program (U = 37.0, p = 0.549; U = 42.0, p = 0.842).

Conclusion

walking can be an effective intervention for overweight/obese middle-aged women with hypertriglyceridemia in reducing cardiovascular risk by lowering TG and Apo B levels. Adding diet to brisk walking may have no additional significant effects on changes in TG and Apo B.

Citations

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The Effects of Urban Forest-walking Program on Health Promotion Behavior, Physical Health, Depression, and Quality of Life: A Randomized Controlled Trial of Office-workers
Kyung-Sook Bang, In-sook Lee, Sung-Jae Kim, Min Kyung Song, Se-Eun Park
Journal of Korean Academy of Nursing.2016; 46(1): 140. CrossRef

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An Ethnographic Study on Eating Styles of Adult Diabetics in Korea: Yong Hae Hong, Myung Ok Cho, Young Sook Tae; Journal of Korean Academy of Nursing 2005;35(2):313-322. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.2.313

Abstract PDF

Purpose

The purpose of this study was to explore adult diabetics' eating styles and factors which influence them.

Method

The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique.

Result

The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered.

Conclusion

A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.

Citations

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Nutritional patterns of Korean diabetic patients: an exploratory study
H. Lee, M. Kim, B.J. Daly
International Nursing Review.2008; 55(4): 442. CrossRef

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Association of Diet with Menopausal Symptoms in Korean Middle-aged Women: Young Joo Park, Hee Young Paik, Young Joo Kim, Sung Sook Hong, Mi Jin Kim, Ji Won Yoon, So Hyun Moon; Journal of Korean Academy of Nursing 2003;33(3):386-394. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.3.386

Abstract PDF

Purpose

This study was designed to explore the association of diet with menopausal symptoms in Korean women.

Method

For this cross-sectional survey, 276 women aged between 45-55 years visiting two branches of K-university hospital located in Seoul and Ansan of Kyunggi province were recruited from April to July, 2002. A menopause-specific quality-of-life questionnaire and a food frequency questionnaire were used to measure menopause-related symptoms and the intake of 28 types of foods.

Result

No differences were found in the levels of bothersome total menopausal symptoms, physical symptoms, psychosocial symptoms, and sexual symptoms according to the intake of each food. Only higher intake of fishes, seaweeds, and vegetable oils were inversely associated with bothersome levels of vasomotor symptoms. Women with higher intake of yellow-green vegetables and lower intake of coffee, confectionery, and processed foods reported lower hot flush rate.

Conclusion

The results suggest that higher intake of yellow-green vegetables and lower intake of coffee, confectionery and processed foods may relieve hot flushes. Further study needs to be pursued to study the relationship with nutrients of these foods and hot flushes.

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Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study
Maryam Safabakhsh, Fereydoun Siassi, Fariba Koohdani, Mostafa Qorbani, Shahla Khosravi, Maryam Abshirini, Zahra Aslani, Farahnaz Khajehnasiri, Gity Sotoudeh
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Menopausal Symptoms and Depression Among Midlife Women
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Journal of Korean Academy of Community Health Nursing.2010; 21(4): 429. CrossRef

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Review Article

Effects of Dietary and Physical Activity Interventions on Metabolic Syndrome: A Meta-analysis: Guna Lee, Hye-Young Choi, Sook-Ja Yang; J Korean Acad Nurs 2015;45(4):483-494. Published online August 31, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.4.483

Abstract PDF

Purpose

This study identified effects of dietary and physical activity interventions including dietary interventions or physical activity interventions alone or combined dietary-physical activity interventions to improve symptoms in metabolic syndrome including abdominal obesity, high triglycerides, low high density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose through meta-analysis.

Methods

Articles on metabolic syndrome X published from 1988 to 2013 were searched through electronic databases, Google Scholar, and reference reviews. Methodological quality was assessed by the checklist, SIGN (Scottish Intercollegiate Guidelines Network).

Results

In the meta-analysis, there were 9 articles reporting 13 interventions with 736 participants. Using random effect models, the dietary and/or physical activity interventions showed a lower mean difference in waist circumference ( - 1.30 cm, 95% CI: - 2.44~ - 0.15, p =.027). The combined dietary-physical activity interventions showed a lower mean difference in waist circumference ( - 2.77 cm, 95% CI: - 4.77~ - 0.76, p =.007) and systolic blood pressure ( - 5.44 mmHg, 95% CI: - 10.76~ - 0.12, p =.044). Additionally, interventions of over 24 weeks yielded a lower mean difference in waist circumference ( - 2.78 cm, 95% CI: - 4.69~ - 0.87, p =.004) and diastolic blood pressure ( - 1.93 mmHg, 95% CI: - 3.63~ - 0.22, p =.026).

Conclusion

The findings indicate that dietary and/or physical activity interventions for metabolic syndrome reduce central obesity with no adverse effects. This finding provides objective evidences for dietary and physical activity management on metabolic syndrome as an efficient intervention.

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Original Articles

Implementation of Ontology-based Clinical Decision Support System for Management of Interactions Between Antihypertensive Drugs and Diet: Jeong-Eun Park, Hwa-Sun Kim, Min-Jung Chang, Hae-Sook Hong; J Korean Acad Nurs 2014;44(3):294-304. Published online June 30, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.3.294

Abstract PDF: Purpose
The influence of dietary composition on blood pressure is an important subject in healthcare. Interactions between antihypertensive drugs and diet (IBADD) is the most important factor in the management of hypertension. It is therefore essential to support healthcare providers' decision making role in active and continuous interaction control in hypertension management. The aim of this study was to implement an ontology-based clinical decision support system (CDSS) for IBADD management (IBADDM). We considered the concepts of antihypertensive drugs and foods, and focused on the interchangeability between the database and the CDSS when providing tailored information.
Methods
An ontology-based CDSS for IBADDM was implemented in eight phases: (1) determining the domain and scope of ontology, (2) reviewing existing ontology, (3) extracting and defining the concepts, (4) assigning relationships between concepts, (5) creating a conceptual map with CmapTools, (6) selecting upper ontology, (7) formally representing the ontology with Protégé (ver.4.3), (8) implementing an ontology-based CDSS as a JAVA prototype application.
Results
We extracted 5,926 concepts, 15 properties, and formally represented them using Protégé. An ontology-based CDSS for IBADDM was implemented and the evaluation score was 4.60 out of 5.
Conclusion
We endeavored to map functions of a CDSS and implement an ontology-based CDSS for IBADDM.

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Effects of Individualized Nutritional Education Programs on the Level of Nutrient Intake and Nutritional Status of Colorectal Cancer Patients Undergoing Palliative Chemotherapy: Kwi Ock Park, Smi Choi-Kwon; J Korean Acad Nurs 2012;42(6):799-809. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.6.799

Abstract PDF

Purpose

The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

Methods

Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using χ²-test and t-test with the SPSS program 17.0.

Results

Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups.

Conclusion

Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

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Effectiveness of the nutrition referral system in a multidisciplinary pancreatic cancer clinic
Sydnee C. Wong, Abhinav V. Reddy, Amy Hacker-Prietz, Laura Kress, Priya Pathak, Colin S. Hill, Timothy A. Lin, Joseph M. Herman, Jin He, Lei Zheng, Mary-Eve Brown, Amol K. Narang
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Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery
Jina Son, Ha I Kang, Eun young Jung, Hae won Ryu, Kyung-Ha Lee
Clinical Nutrition Research.2023; 12(2): 99. CrossRef
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Impact of Life Style Characteristics on Prevalence Risk of Metabolic Syndrome: Ji-Soo Yoo, Jeong In Jeong, Chang Gi Park, Se Won Kang, Jeong-Ah Ahn; J Korean Acad Nurs 2009;39(4):594-601. Published online August 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.4.594

Abstract PDF

Purpose

The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS).

Methods

A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records.

Results

The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5≤age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits.

Conclusion

This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

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Nomogram for screening the risk of developing metabolic syndrome using naïve Bayesian classifier
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Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease: Kyoungok Ju, Heeyoung So; Journal of Korean Academy of Nursing 2008;38(1):64-73. Published online February 28, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.1.64

Abstract PDF

Purpose

This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD).

Method

Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by X²-test and independent t-test using the SPSSWIN 11.5 program.

Result

Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group.

Conclusion

A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.

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Effects of a Network Program for Preventing Obesity of Patients Taking Antipsychotics or Antidepressants: Soyaja Kim, Kyung Mi Sung, Young Sin Hwang, Sook Ja Kim; Journal of Korean Academy of Nursing 2005;35(3):526-534. Published online June 30, 2005; DOI: https://doi.org/10.4040/jkan.2005.35.3.526

Abstract PDF

Purpose

This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants.

Method

Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group (16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program.

Result

There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before.

Conclusion

The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.

Citations

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Journal of Korean Academy of Nursing.2008; 38(4): 533. CrossRef

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