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Research Papers
Association between Visual Impairment and Nutritional Risk among Older Adults with Diabetes: A Population-Based Cross-Sectional Study
Yang, Eunjin , Lee, Kyung Hee
J Korean Acad Nurs 2023;53(2):167-176.   Published online April 30, 2023
DOI: https://doi.org/10.4040/jkan.22141
AbstractAbstract PDF
Purpose
Despite the high prevalence of visual impairment caused by diabetic retinopathy and nutritional problems among older adults with diabetes, evidence regarding factors related to nutritional risk in this population is limited. Therefore, this study aimed to identify the correlates of nutritional risk among older adults with diabetes, focusing on visual impairment.
Methods
This study was a secondary data analysis of the 2020 National Survey of Older Koreans aged 65 years and above. The sample comprised 2,376 older adults with diabetes, and complex sample ANOVA and Rao–Scott chi-square tests were used to compare the groups according to visual impairment. Complex-sample logistic regression analyses were conducted to verify the association between visual impairment and nutritional risk.
Results
Older adults with diabetes, who also have severe visual impairment, are more likely to have nutritional risk status than those without impairment after controlling for covariates (odds ratio [OR] = 2.44, 95% confidence interval [CI] 1.16~5.13). Among the covariates, depression (OR = 3.58, 95% CI 2.60~4.94), dependent activities of daily living status (OR = 2.79, 95% CI 1.60~4.86), and experience of hospitalization during the past year (OR = 2.51, 95% CI 1.57~4.03) were strongly associated with nutritional risk.
Conclusion
Severe visual impairment increases the nutritional risk among older adults with diabetes. Therefore, it is essential to prevent visual impairment due to exacerbation of diabetes through appropriate management. Additionally, tailored nutritional interventions for visually impaired older adults with diabetes that consider visual characteristics are required.
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Factors Affecting the Quality of Life in Low-Income Older Adults with Sarcopenia: A Cross-Sectional Study
Nho, Ju-Hee , Kim, Eun Jin
J Korean Acad Nurs 2023;53(1):1-11.   Published online February 28, 2023
DOI: https://doi.org/10.4040/jkan.22126
AbstractAbstract PDF
Purpose
This study aimed to identify the factors influencing quality of life (QoL) of low-income older adults (LOAs) with sarcopenia.
Methods
A convenience sample of 125 older adults was recruited from Jeonbuk Province, South Korea. Data were collected using a self-report questionnaire that included nutritional status, the Depression Anxiety Stress Scale-21, and the World Health Organization Quality of Life Instrument-Older Adults Module. Additionally, grip strength and appendicular skeletal muscle mass, were evaluated, along with the short physical performance battery.
Results
Sarcopenia and severe sarcopenia were observed in 43.2% and 56.8% of participants, respectively. Using multiple regression analysis, depression (β = - .40, p < .001), nutritional status (β = .24, p = .003), and anxiety (β = - .15, p = .042) were identified as factors affecting the QoL of the older adults in low-income groups with sarcopenia, the explanatory power of these variables was 44%.
Conclusion
The results of this study can be used to develop a nursing intervention program and establish policies to improve depression, anxiety, and nutritional status to enhance QoL of LOAs with sarcopenia.
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Original Articles
Nutritional Status of Liver Transplantation Recipients and Factors Influencing Nutritional Status
SinYoung Hwang, Smi Choi-Kwon
J Korean Acad Nurs 2019;49(3):340-348.   Published online January 15, 2019
DOI: https://doi.org/10.4040/jkan.2019.49.3.340
AbstractAbstract PDF
Abstract Purpose

This study aimed to investigate the nutritional status of liver transplantation (LT) recipients and explore certain factors that influence nutritional status, including dietary patterns and physical activities.

Methods

This was a cross-sectional, descriptive study. The subjects included 211 LT recipients at a medical center outpatient clinic located in Seoul, Korea. The nutritional status, dietary patterns, and physical activities of each subject were measured using the body mass index (BMI), Mini Dietary Assessment (MDA), and Global Physical Activity Questionnaire. Independent t-test, one-way analysis of variance, and multiple linear regression analysis were used to analyze the data.

Results

The percentages of living and deceased donor LTs were 81.0% and 19.0%, respectively. The mean BMIs pre- and post-LT were 23.88 and 23.16 kg/m2, respectively, and the average MDA score was 36.55. More than 60.0% of the subjects had a moderate or high level of physical activity. In multivariate analysis, a higher BMI before LT (β=.72, p<.001), a lower Model for End-stage Liver Disease (MELD) score (β=-.18, p<.001), and being male (β=-.10, p=.024) contributed to better nutritional status post-LT. Patients within six months of LT were less engaged in muscle exercises than those post six months of LT (p=.020).

Conclusion

LT recipients in Korea have good nutritional status and a good level of physical activity. To improve recipients’ post-LT nutritional status, the pre-LT nutritional status should be considered, particularly in those with a higher MELD score. In addition, physical activity including muscle-strengthening exercises should be encouraged from an earlier stage.

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Changes in Nutritional Status of General Medical Patients During Hospitalization
Young Hee Yang, S Mi Choi-Kwon, Eun Kyung Kim
Journal of Nurses Academic Society 1997;27(1):49-60.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.1.49
AbstractAbstract PDF

The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular, renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment ; patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of day of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements, including weight, body mass index, lean body mass, body fat, and skin fold thickness, were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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Assessment of Nutritional Status in Elderly Dialysis Patients
YouJa Ro, Hae Jung Ha, Hoe Young Ko, Ok Soon Park
Journal of Nurses Academic Society 1996;26(2):304-319.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.304
AbstractAbstract PDF

It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calroie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis, which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon -rank sums test, Scheffe test, Kruskal -Wallis test and Pearson correlation coefficients. The results are following; 1. There was no significant difference in the calorie and proten intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index, triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea mtrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine incresed significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However, each of biochmical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status mearsured with protein and calroie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

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The Longitudinal Study on the Calorie and Protein Intakes and Food Choices in Gastrectomy Patients who Receiving Adjuvant Chemotherapy
Myung Hee Jun, Soo Gyung Wang
Journal of Korean Academy of Nursing 2002;32(2):206-218.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2002.32.2.206
AbstractAbstract PDF

This study was conducted to investigate nutrient and food choices in gastric cancer patients receiving Cisplatin after surgery. Ten patients were followed from the fist day of the first cycle to the last date of the 6th the cycle of the chemotherapy. The subjects kept daily self record of dietary intake and the period of nausea/vomiting during 6 cycles. Using Computer Aided Nutritional Analysis Program, the degree of Calorie, carbohydrate, protein, fat and fluid intakes according the chemotherapy period. The reseacher developed food intake rating scale, and then three dietitians analysed the oral intakes according to the type of foods. As the results of this study, during the chemotherapy cancer patients are intakes much fewer calorie, protein and fluids than recommended dietary allowance. Oral intake was worsen as treatment proceed. During the chemotherapy periods most of the patients choose fruits, vegitables, steam rice, porridge, yogurt and the beam soup to overcome nausea and vomiting. In order to promote oral intake for chemotherapy patients, the researcher strongly suggest that indiviual food preform should be considered.

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The Nutritional Status of the Patients with Cancer during the Chemotherapies
Young Hee Yang, Sung Joon Kwon, Chang Imc Kim
Journal of Korean Academy of Nursing 2001;31(6):978-987.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2001.31.6.978
AbstractAbstract PDF

PURPOSE: The purpose of this study was to determine the changing patterns of nausea, vomiting, anorexia and calorie intake. To examine the influence of those variables on the nutritional status of the cancer patients receiving chemotherapy.
METHOD
To assess nutritional status, anthropometry and blood test were performed on 94 stomach cancer patients receiving postoperational chemotherapy on the daily basis. NVA and calorie intake were measured during chemotherapy.
RESULT
93% of subjects had low level of hemoglobin and 45.7% was below the lymphocyte count. 57% of subjects lost 10% of usual weight. The value of anthropometry was reduced but the difference between pre- and post-chemotherapy did not reach any statistical significance. 27% of subjects was grouped into the malnutritional state. During chemotherapy, the higher the degree of NVA, the less calorie intake. The significant predictors for nutritional status were nausea and calorie intake.
CONCLUSION
The chemotherapy affected the food intake of cancer patients through NVA. Though the influence of chemotherapy on anthropopmetry was not significant in this research, nausea and food intake were the most affecting factors for nutrition of cancer patients. Therefore we need to assess nutritional status and support for cancer patients receiving chemotherapy and to develop an intervention for improvement of symptoms and food intake.

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The Relationship of Anorexia, Nausea, Vomiting, Oral Intake and Nutritional Status in Patients Receiving Chemotherapy
Young Hee Yang, Dong Sun Lee
Journal of Korean Academy of Nursing 2000;30(3):720-730.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.3.720
AbstractAbstract PDF

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

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Assessment of Appetite and Nutritional Status in Cancer Patients Undergoing Radiation Therapy: A Prospective Study
Hyang Sook So
Journal of Korean Academy of Nursing 1999;29(6):1179-1191.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.6.1179
AbstractAbstract PDF

This study was conducted to identify appetite and nutritional status of 48 cancer patients who have been irradiated over 150 cm2 on chest or pelvic area over the three-month period. The data were gathered 3 phases, Each from initiation to completion of radiotherapy through the questionnaires of anorexia, the anthropometric and biochemical measures were used such as weight, TSF, MAC, MAMC, serum albumin and hemoglobin, TLC. Using SAS program, data were analyzed by percentage, Mean+/-SD, and two-way repeated measures ANOVA. The results were summarized as follows: 1. Eighty five percent(85%) of the subjects were aged from fifties to sixties. Cancers in the chest area occurred in 100% of men, 56% of the all subjects. The other 44% were pelvic cancer and 71% of the pelvic cancer occurred in women. 2. There were no significant differences in the appetite scores by all groups(characteristics). Changes of the appetite score over time were statistically significant by age, sex, cancer areas staging, treatment modality, and radiation dosage (F=4.0, p=.022; t=6.09, p=.003; t=4.90, p=.009; F=3.28, p=.042; t=5.04, p=.0084; t=4.76, p=.011). The appetite score on the 2nd phase (4 weeks after initiating radiotherapy) decreased from the 1st phase (initiating irradiation), and then increased on the 3rd phase (completing irradiation). 3. There were no significant differences in the body weight and MAMC by all characteristics, and no changes in the body weight and MAMC over time. However there were significant differences of TSF, MAC, level of hemoglobin, level of albumin, and TLC by all characteristics during the three phases. TSF of the men and the chest cancer were lower than those of the women and the pelvic cancer (t=73.20, p=.0001; t=22.91, p=.0001). And there was significant difference by cancer staging(F=3.19, p=.050). But there was no change in TSF over time. MAC of the men and the chest cancer were lower than those of the women and the pelvic cancer each(t=9.23, p=.004; t=17.85, p=.0001). But no change in MAC over time. Levels of hemoglobin had significant differences by age, sex and cancer areas; levels of hemoglobin of older than the fifties, men, and chest area were higher than those on the others(F=3.82, p=.029; t=21.75, p=.0001; t=8.71, p=.005). Levels of albumin were significant differences by sex and cancer areas; levels of albumin on women, and pelvic area were higher than those on the others(t=6.34, p=.015; t=15.23, p=.0003). While the levels of hemoglobin were changed over time, levels of albumin were not changed and within normal limit. TLC of the men was higher than women(t=5.05, p=.029). Changes in the level of hemoglobin over time were statistically significant according to sex, cancer areas, and radiation dosage(t=3.49, p=.035; t=3.36, p=.039; t=4.04, p=.021).

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Nutritional Status of Cancer Patients upon Admission
Eun Kyung Kim, Young Hee Yang, Smi Choi-Kwon
Journal of Korean Academy of Nursing 1999;29(2):271-280.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.2.271
AbstractAbstract PDF

The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malutrition among these patients. The study was performed from May to July 1996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured. The results were as follows : 1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more then 2 weeks. 2) There was a statistically significant difference in nutritional status(lympocyte : p=.002 ; skinfold thickness in four areas : p<0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients. 3) There was correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.

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The Risk of Malnutrition, Depression, and the Perceived Health Status of Older Adults
Yeon Hwan Park, Eunyoung E Suh
Journal of Korean Academy of Nursing 2007;37(6):941-948.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.6.941
AbstractAbstract PDF

PURPOSE: The purpose of this study was to investigate the risk of malnutrition and its relationship with depression and perceived health status. METHODS: A total number of 154 elderly over 60 years participated in the study through a community elderly center. The risk of malnutrition was measured by NSI (Nutritional Screening Initiative), depression by CES-D, and health status by a self-rated Likert scale. RESULTS: About one fourth (22.7%) of the subjects had a high risk, and 31.2% had a moderate risk of getting malnutrition. Regarding depression, 34.4% (53 elderly) of the subjects had a high risk. Overall health status had a mean of 3.46 within the range of 1 to 5. In relation to demographic factors, female elderly (chi-square=6.68, p= .04), aged younger than 75 years old (chi-square=8.60, p= .01), and having co-morbidity (F=9.81, p= .001) were significantly related to a high risk of malnutrition. Having a higher depression score, higher number of co-morbidity, and lower perceived health status were significantly related to a higher risk of becoming malnourished. CONCLUSION: The elderly's risk of getting malnutrition was significantly related to their depression and perceived health status. With these findings nursing interventions focusing on these factors should be developed in order to improve the elderly's multidimensional well-being.

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Development of a Nutritional Assessment Tool for Home Care Centers
Kyoung Rye Kim
Journal of Korean Academy of Nursing 2004;34(6):1014-1024.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.6.1014
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a tool for nutritional assessment, so that home care nurses can make early assessment of patients' nutritional status.

Method

The study was done in two partsfirst a tool was developed to assess nutrition, and second the content validity and clinical validity of the categories and indices were verified.

Result

The results of this study are summarized in two ways. First,the nutritional assessment tool was classified into 3 areas, physical measurement, nutritional survey and clinical survey, and into 11 categories with 22 indices. Second, when 5 of the 11 categories were positive, nutritional status was considered to be poor.

Conclusion

By developing a clinically useful nutritional assessment tool for patients receiving home care, which was developed in this study, the quality of life for these patients will improve and contribution to the development of a more effective clinical home nursing practice will occur.

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Comparison of Cognitive Levels, Nutritional Status, Depression in the Elderly according to Living Situations
Young Mi Jung, Ju Hee Kim
Journal of Korean Academy of Nursing 2004;34(3):495-503.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2004.34.3.495
AbstractAbstract PDF
Purpose

The purpose of this study was to compare the degree of cognitive level, nutritional status and depression in elderly according to living situations.

Method

The subjects consisted of 173 elderly classifying three groups(living alone, living with spouse, living with children). Data was collected from March to June, 2003 by a structured questionnaire that included general characteristics, MMSE-K, nutritional status and depression scale. The collected data was analyzed by the SPSS program including descriptive statistics, χ2-test, ANCOVA, Scheffe test and Pearson Correlation Coefficient.

Result

In MMSE-K, the living alone group showed suspicious dementia while the other groups were normal. The living alone group showed a high nutritional risk and all three groups showed depression. In MMSE-K, the nutritional status and depression were statistically significant by the living situation. In each group except living with spouse, MMSE-K indicated a significantly negative correlation to depression and nutritional status, while nutritional status showed a significantly positive correlation to depression.

Conclusion

It is necessary to develop supportive programs for decreasing the risk of bad health in the elderly and an individual approach according to their living situation. Especially, more concern and intervention is necessary for the solitary elderly.

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Relationship Between Fatigue and Nutritional Status in Patients with Cancer Undergoing Radiotherapy
Young Hee Yang
Journal of Korean Academy of Nursing 2003;33(4):478-487.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.4.478
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy.

Design

A correlational and crossectional study design was used.

Method

One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index.

Results

The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. Conclusion: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

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The Relationships among Chemotherapy-Induced Nausea and Vomiting (CINV), Non-Pharmacological Coping Methods, and Nutritional Status in Patients with Gynecologic Cancer
Haerim Lee, Smi Choi-Kwon
J Korean Acad Nurs 2017;47(6):731-743.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.6.731
AbstractAbstract PDF
Abstract Purpose

Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, nonpharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients.

Methods

Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters.

Results

Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (b=1.57, p=.023) and did not use physical measures (b= -1.23, p=.041) as coping methods were under the high risk of nutritional disorders.

Conclusion

Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

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Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer
Hyunjin An, Ju-Hee Nho, Sunyoung Yoo, Hyunmin Kim, Minji Nho, Hojeong Yoo
J Korean Acad Nurs 2015;45(6):812-822.   Published online December 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.6.812
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer.

Methods

A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks.

Results

Significant group differences were found for fatigue (p=.037), nutritional status (p=.034) and social/family well-being (p=.035) in these patients with gynecologic cancer.

Conclusion

Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

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Nutritional Status and Risk Factors for Malnutrition in Low-income Urban Elders
Hye Sun Hyun, Insook Lee
J Korean Acad Nurs 2014;44(6):708-716.   Published online December 31, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.6.708
AbstractAbstract PDF
Purpose

The purpose of this study was to evaluate the nutritional status of low-income urban elders by diversified ways, and to analyze the risk factors for malnutrition.

Methods

The participants in this study were 183 low-income elders registered at a visiting healthcare facility in a public health center. Data were collected using anthropometric measurements, and a questionnaire survey. For data analysis, descriptive statistics, χ2-test, t-test, Fisher's exact test, multiple logistic regression analysis were performed using SPSS 20.0.

Results

Regarding the nutritional status of low-income elders as measured by the Mini Nutritional Assessment (MNA), 10.4% of the elders were classified as malnourished; 57.4% as at high risk for malnutrition; and 32.2% as having normal nutrition levels. The main factors affecting malnutrition for low-income elders were loss of appetite (OR=3.34, 95% CI: 1.16~9.56) and difficulties in meal preparation (OR=2.35, 95% CI: 1.13~4.88).

Conclusion

In order to effectively improve nutrition in low-income urban elders, it is necessary to develop individual intervention strategies to manage factors that increase the risk of malnutrition and to use systematic approach strategies in local communities in terms of a nutrition support system.

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Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke
Sung-Hee Yoo, So-Sun Kim
J Korean Acad Nurs 2014;44(3):280-293.   Published online June 30, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.3.280
AbstractAbstract PDF
Purpose

The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes.

Methods

A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol.

Results

In the EN protocol group, the percentage of caloric goals achieved (R2=.24, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group.

Conclusion

Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

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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
AbstractAbstract 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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Structural Equation Modeling on Quality of Life in Pre-dialysis Patients with Chronic Kidney Disease
Hye Won Kim, Smi Choi-Kwon
J Korean Acad Nurs 2012;42(5):699-708.   Published online October 12, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.5.699
AbstractAbstract PDF
Purpose

This study was designed to test structural equation modeling of the quality of life of pre-dialysis patients, in order to provide guidelines for the development of interventions and strategies to improve the quality of life of patients with Chronic Kidney Disease (CKD).

Methods

Participants were patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic factors, social support, nutritional status, physical factors and biobehavioral factors and quality of life were collected between March 4 and March 31, 2011.

Results

In the final analysis 208 patients were included. Of the patients 42% were in a malnourished state. Anxious or depressed patients accounted for 62.0%, 72.6%, respectively. Model fit indices for the hypothetical model were in good agreement with the recommended levels (GFI= .94 and CFI= .99). Quality of life in pre-dialysis patients with CKD was significantly affected by demographic factors, social support, nutritional status, physical factors and biobehavioral factors. Biobehavioral factors had the strongest and most direct influence on quality of life of patients with CKD.

Conclusion

In order to improve the quality of life in pre-dialysis patients with CKD, comprehensive interventions are necessary to assess and manage biobehavioral factors, physical factors and nutritional status.

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Structural Equation Modeling on Quality of Life in Stroke Survivors
Minhee Suh, Smi Choi-Kwon
J Korean Acad Nurs 2010;40(4):533-541.   Published online August 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.4.533
AbstractAbstract PDF
Purpose

This study was designed to test structural equation modeling of the quality of life of stroke survivors in order to provide guidelines for development of interventions and strategies to improve their quality of life.

Methods

The participants in the study were patients who visited the neurology outpatient department of a tertiary hospital in Seoul between June 25 and October 15, 2009. Data collection was carried out through one-on-one interviews. Demographic factors, functional independence, social support, nutritional status, post-stroke biobehavioral changes and quality of life were investigated.

Results

The final analysis included 215 patients. Fitness of the hypothetical model was appropriate (χ2=111.5, p=.000, GFI=.926, AGFI=.880, RMSA=.068, NFI=.911, CFI=.953). Functional dependency, social support and post-stroke biobehavioral changes were found to be significant explaining variance in quality of life. Post-stroke biobehavioral changes had the strongest direct influence on quality of life. Nutritional status had an indirect effect on the quality of life.

Conclusion

To improve the quality of life of stroke survivors, comprehensive interventions are necessary to manage post-stroke biobehavioral changes, and strengthening social support networks that can contribute to enhancing the quality of life of stroke survivors.

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Development and Application of a Feeding Program for Infants Postoperatively following Cardiac Surgery
Ju Ryoung Moon, Yong Ae Cho, Sun In Min, Ji-Hyuk Yang, June Huh, Yeon Yi Jung
J Korean Acad Nurs 2009;39(4):508-517.   Published online August 31, 2009
DOI: https://doi.org/10.4040/jkan.2009.39.4.508
AbstractAbstract PDF
Purpose

Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program.

Methods

A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea.

Results

Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea.

Conclusion

The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.

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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
AbstractAbstract 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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The Relationship of Perceived Health Status, Activities of Daily Living and Nutrition Status in the Community-Dwelling Korean Elderly
Younhee Kang, Miyoung Kim, Eliza Lee
Journal of Korean Academy of Nursing 2008;38(1):122-130.   Published online February 28, 2008
DOI: https://doi.org/10.4040/jkan.2008.38.1.122
AbstractAbstract PDF
Purpose

This study aimed to identify the associated factors of the perceived health status of the elderly in Korea and to provide basic data for developing nursing interventions for the elderly's health management.

Methods

This study used a descriptive correlational research design. The subjects of this study were 335 elderly people over 60 yr living in an urban city. Data were collected through personal interviews using questionnaires from September 2006 to March 2007. Empirical indicators of perceived health status were measured by SF-36, nutritional screening initiative (NSI), activities of daily living (ADL) Index, and instrumental activities of daily living (IADL) scale. The collected data were analyzed by descriptive statistics, Pearson's correlation, and hierarchical regression.

Results

The mean age of the subjects was 72.8 and 57.0% of subjects were female. 41.5% of variance in physical health was explained by nutrition, ADL, IADL, and the number of years attending school. Among them the most important factor was ADL. 13.2% of variance in mental health was explained by the number of family, nutrition, and IADL. Among them the most important factor was nutrition.

Conclusion

It is necessary to develop supportive interventions for improving the perceived health status of elderly people by considering the most important factors shown in this study.

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The Effects of a PMS Nutritional Education Program for College Students
Hae Won Kim
Journal of Korean Academy of Nursing 2006;36(7):1164-1174.   Published online December 31, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.7.1164
AbstractAbstract PDF
Purpose

This study was conducted to identify the effects of a PMS nutritional education program for college nursing students.

Method

Subjects consisted of nursing students(experimental group: 29, control group: 27). The experimental group participated in a PMS nutritional education program for 8 weeks (including group and individual involvement). Data was collected before and after the education, and measurement tools were premenstrual symptoms, PMS knowledge, and self health behavior.

Results

After the intervention, the experimental group showed a significant increase in PMS knowledge(Z=6.32, p=.000) and self health behavior(t=3.00, p=.004) compared to the control group. After the intervention the experimental group showed a significant increase in PMS knowledge(Z=-4.64, p=.000) and self health behavior(t=-3.04, p=.005) than before the intervention.

Conclusions

These results suggest that the short term effects of a PMS nutritional education program for nursing students was proven useful and the program should be applied to PMS nutrition education for PMS clients as well as health professionals.

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