한국식품과학회지 (Korean Journal of Food Science and Technology)

한국식품과학회 (Korean Society of Food Science and Technology)
권호 표지
DOI QR코드

DOI QR Code

전국 요양시설과 장애인시설의 연하장애 환자를 위한 식사 실태조사

Survey of dysphagia meal management for the elderly and the disabled

  • 이현정 (한양대학교 식품영양학과) ;
  • 최귀정 (한양대학교 식품영양학과) ;
  • 박영숙 (한양대학교 식품영양학과) ;
  • 신원선 (한양대학교 식품영양학과)
  • 투고 : 2021.10.20
  • 심사 : 2022.01.26
  • 발행 : 2022.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 논문은 연하장애 환자를 위한 식사실태를 조사하기 위하여 전국 요양시설과 장애인 시설의 영양사를 대상으로 설문조사를 실시하였다. 설문지의 구성은 시설의 일반 현황, 영양사 일반 사항 및 지식수준, 연하장애 환자를 위한 식사 제공 실태와 점도증진제 사용 현황, NCP 직무 표준의 업무내용 수행수준으로 이루어졌으며, 온라인 링크를 통해 총 268개의 설문지가 응답되었다. 그동안 기존 선행연구들에서는 점도증진제의 사용에 관한 내용이 미흡하였고, 장애인 시설의 연하장애를 겪고 있는 입소자를 대상으로 한 식사에 대한 조사 또한 찾아보기 어려웠다. 따라서 본 연구에서 살펴본 영양사의 연하장애 환자를 위한 업무의 중요도-수행도 분석을 통하여 최우선 개선 영역을 확인할 수 있었고, 그에 따라 연하장애 환자 영양관리에 있어 업무의 우선 순위와 필요한 지원을 파악하였다. Lee와 Lim(2020)에 따르면 요양병원의 연하장애 환자의 의료 비용은 타 의료기관에 비해 높게 측정되고 있으며 연하장애 환자 중 영양불량이 동반된 경우, 재원일수와 의료 비용이 더 높은 결과를 보였다. 결과적으로 연하장애 환자들의 예후와 삶의 질 개선을 위해 적극적인 연하장애 환자를 위한 식사 관리가 필요하며, 영양사 인력 확충과 연하장애 환자 관리에 필수적인 영양 교육 등의 지원이 필요하다. 본 연구결과는 의료기관에서 연하장애 환자 영양관리 개선을 위한 기초자료로 활용될 수 있다. 하지만 연하장애 환자의 영양관리 실태조사가 요양시설 및 장애인시설에 국한되어 있어, 추후 다양한 병원급에서 추가 조사가 필요할 것으로 보인다.

A survey was conducted to investigate the conditions of meal management and the use of thickening agents for dysphagia in long-term institutions and welfare centers in Korea. The online questionnaire for the survey comprised six questions on the general characteristics of subjects, 16 on meal management, 10 on dietitians' knowledge, and 30 on dietitians' perceived performance and importance of meal management for dysphagia. The complete data from 268 questionnaires were analyzed, and Importance-Performance Analysis (IPA) was conducted. The results of the survey indicated frequent, "difficulties due to no specific guidance on managing dysphagia meal," "lack of caregiver understanding of the importance of dysphagia meal," "lack of opportunity and time for meal education/counseling," "difficulties with management due to dietitians' lack of experience and awareness of dysphagia," and "limited understanding of cooking staff in preparing dysphagia meal." Importantly, these five parts were categorized in the low-priority region in an IPA of the performance.

키워드

과제정보

본 연구는 2020년 대상(주)의 연구비 지원을 받아 수행되었으며, 이에 감사드립니다.

참고문헌

  1. Brody RA, Touger-Decker R, Von Hagen S, Maillet JO. Role of registered dietitians in dysphagia screening. J Am Diet Assoc. 100: 1029-1037 (2000) https://doi.org/10.1016/S0002-8223(00)00302-3
  2. Cha JA, Kim KE, Kim EM, Park MS, Park YK, Baek HJ, Seo JS. Development of job description of clinical dietitians in hospitals by the DACUM method. J Korean Diet Assoc. 19: 265-286 (2013) https://doi.org/10.14373/JKDA.2013.19.3.265
  3. Chadwick D, Jolliffe J, Goldbart J, Burton H. Barriers to caregiver compliance with eating and drinking recommendations for adults with intellectual disabilities and dysphagia. J Appl Res Intellect. 19: 153-162 (2006) https://doi.org/10.1111/j.1468-3148.2005.00250.x
  4. Chan HK. Dysphagia management of elderly in nursing home: skills and knowledge of frontline staff. J Korean Diet Assoc. 12: 313-328 (2013)
  5. Cho EH, Chang HJ, Kwak TK. Analysis of the job activities and demand of dietitian in the elderly health-care facilities. J Korean Diet Assoc. 12: 313-328 (2006)
  6. Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR, Locke GR 3rd, Talley NJ. Prevalence and risk factors for dysphagia: a USA community study. J Neurogastroenterol. 27: 212-219 (2015) https://doi.org/10.1111/nmo.12467
  7. Crary MA, Groher ME. Introduction to adult swallowing disorders. Butterworth-Heinemann Medical, PA, USA (2003)
  8. Go SM, Lim SR. Oral hygiene care for elderly in care facility. J Korean Acad Conserv Dent. 53: 678-687 (2015)
  9. GoatesS, Du K, BraunschweigCA, Arensberg MB. Economic burden of disease-associated malnutrition at the state level. PLoS One. 11: 1-15 (2016)
  10. Hamlet S, Choi J, Zormeier M, Shamsa F, Stachler R, Muz J. Normal adult swallowing of liquid and viscous material: scintigraphic data on bolus transit and oropharyngeal residues. Dysphagia. 11:41-47 (1996) https://doi.org/10.1007/BF00385799
  11. Han GS, Yang EJ. Status of health and nutritional intake of the elderly in long-term care facilities: focus on Gwangju metropolitan city. J Nutr Health Aging. 53: 27-38 (2020) https://doi.org/10.4163/jnh.2020.53.1.27
  12. Hong SY, Seo S. Job performance frequency and the training needs of dietitians in elderly healthcare facilities. J Korean Diet Assoc. 16: 160-177 (2010)
  13. Huckabee ML, Pelletier CA. Management of adult neurogenic dysphagia. Singular Publishing Group, CA, USA. pp. 51-73 (1999)
  14. Kang HS, Lee YK, Chae IS. Job importance, job performance, and job satisfaction in dietitians at geriatric hospitals or elderly healthcare facilities in Jeju. J Nutr Health Aging. 49: 189-200 (2016) https://doi.org/10.4163/jnh.2016.49.3.189
  15. Kim HJ. A study on catastrophic burden of health expenses of elderly households with chronic diseases. Studies on Life and Culture. 53: 51-74 (2019)
  16. Kim YS, Kim KN, Chang NS. Foodservice management in institutions for the disabled in Korea. J Korean Soc Food Cult. 16: 187-193 (2001)
  17. Kim HJ, Kim EM, Kee GJ, Lee JJ, Lim JH, Lee JM, Leon HJ, Lee HY. Clinical nutrition service at medical centers in Seoul. J Korean Diet Assoc. 17: 176-189 (2011) https://doi.org/10.14373/JKDA.2011.17.2.176
  18. Kim HR, Lee JH. Research trends of thickened diet for dysphagia patients. J Korean Soc Food Sci Nutr. 21: 32-35 (2016)
  19. Kim SH, Lee YS, Heo SY. Senior-friendly food market and its vitalization. KREI. 10: 1-319 (2017)
  20. Kuhlemeier KV, Palmer JB, Rosenberg D. Effect of liquid bolus consistency and delivery method on aspiration and pharyngeal retention in dysphagia patients. Dysphagia. 16: 119-122 (2001) https://doi.org/10.1007/s004550011003
  21. Kyle UG, Kossovsky MP, Karsegard VL, Pichard C. Comparison of tools for nutritional assessment and screening at hospital admission: A population study. J Clin Nutr. 25: 409-417 (2006) https://doi.org/10.1016/j.clnu.2005.11.001
  22. Lee BR, Lim HS. Prevalence and medical cost under malnutrition in dysphagia patients of Korea: Based on health insurance review & assessment service (HIRA) Data. J Korean Dysphagia Soc. 10: 97-106 (2020) https://doi.org/10.34160/jkds.2020.10.1.012
  23. Lee HS. Nutritional status of the hospitalized patients with high risk of dysphagia in Korea. J Korean Dysphagia Soc. 1: 75-79 (2011) https://doi.org/10.34160/jkds.2011.1.2.005
  24. Lee KE, Kim DS. Importance and performance of nutrition management for in-patients with fysphagia perceived by dietitians at clinical settings in Seoul and Gyeonggi areas. J East Asian Soc Diet Life. 29: 421-435 (2019) https://doi.org/10.17495/easdl.2019.10.29.5.421
  25. Lee SJ, Park EJ. Importance-performance analysis of clinical nutrition management in convalescent hospitals in the Gyeongnam area. J Korean Diet Assoc. 22: 53-69 (2019) https://doi.org/10.14373/JKDA.2016.22.1.53
  26. Moses FM. Squamous cell carcinoma of the esophagus. Gastroenterol Clin N Am. 20: 703-716 (1991) https://doi.org/10.1016/S0889-8553(21)00583-5
  27. Oh H. Revisiting importance-performance analysis. Tour manag. 22: 617-627 (2001) https://doi.org/10.1016/S0261-5177(01)00036-X
  28. Park SJ. Dysphagia risk and associated factors among community-dwelling elders. J Korean Soc Food Sci Nutr. 44:49-56 (2015) https://doi.org/10.3746/JKFN.2015.44.1.049
  29. Park SJ, Kim JS, Jung EK. Institutional foodservice personnel's perception and use of care foods for elderly individuals' chewing and swallowing ability. J Korean Soc Food Sci Nutr. 47: 186-194 (2018) https://doi.org/10.3746/jkfn.2018.47.2.186
  30. Park MS, Lyu ES. Importance and performance of dietitian's task at long term care hospital foodservice in Busan.Kyungnamarea. Korean J Community Nutr. 16: 602-612 (2011) https://doi.org/10.5720/kjcn.2011.16.5.602
  31. Shim JS, Oh BM, Han TR. Factors associated with compliance with viscosity-modified diet among dysphagic patients. Ann Rehabil Med. 37: 628-632 (2013) https://doi.org/10.5535/arm.2013.37.5.628
  32. Statistics Korea. Statistics about the elderly. Press release. (2020)
  33. Um MH, Lyu ES, Lee SM, Lee SM, Lee E, Cha JA, Park MS, Lee HS, Rha MY, Park YK. Clinical nutrition services of a long-term care hospital in Korea. Korean J Community Nutr. 20: 220-235 (2015) https://doi.org/10.5720/kjcn.2015.20.3.220
  34. Whang MJ. A study on care services for vulnerable groups: Focusing on enhancing consumer-orientation of long-term care services for the elderly. Policy research report. 1-298 (2016)
  35. White JV, Young E, Lasswell A. Position of theAmerican dietetic association: nutrition an essential component of medical education. J Am Diet Assoc. 94: 555-557 (1994) https://doi.org/10.1016/0002-8223(94)90225-9
  36. Yoon JH, Lee HJ. Perceptions on evaluation and treatment of swallowing disorders in speech-language pathologists. Phonetics Speech Sci. 5: 43-51 (2013) https://doi.org/10.13064/KSSS.2013.5.4.043
  37. Yoon M, Moon H, Jeon J, Sohn C. Nutritional management by dietitian at elderly nursing homes in gyeonggi-do. J Korean Diet Assoc. 19: 400-415 (2013) https://doi.org/10.14373/JKDA.2013.19.4.400