임상영양서비스에 대한 의사의 인식

Abstract

Doctor's Perception on Clinical Nutrition Services

Yun-Mi Song

Dept of Food Science & Nutrition The Graduate School Pukyong National University

Abstract

The purpose of the study was to evaluate the perception of doctors regarding clinical nutrition services. A cross-sectional survey design was used. A questionnaire was developed and administered from 15 September to 15 October, 2013 to 311 doctors at 43 tertiary hospitals and 20 general hospitals. The analysis of the data collected from the questionnaires showed the following: 30 years of age, 49.8%; bachelor's degree, 40.5%; medical specialists, 54.3%; more than 10 years of clinical experience, 35.0%; who were in internal medicine, 53.1%; in a tertiary hospital, 83.0%; in a capital hospital, 69.5%; recognized the clinical dietitian national certification, 39.0%. The mean scores of the perceived usefulness of clinical nutrition services and implementation of clinical nutrition services were 4.30/5.00 and 3.89, respectively. Perceived usefulness differed significantly: medical specialist (p < 0.01); experience over 10 years (p < 0.001); recognition of clinical dietitian's national certification (p < 0.05). In addition, the implementation differed significantly: 20 years of age (p < 0.01); doctoral degree (p < 0.05); medical specialist (p < 0.01); over 2 years of experience (p < 0.01); recognition of clinical dietitian national certification (p < 0.001). General hospitals showed significantly (p<0.05) higher scores than tertiary hospitals did regarding the implementation of clinical nutrition services. Capital hospitals showed significantly (p<0.01) higher scores than local hospitals did regarding the usefulness and implementation of clinical nutrition services. The mean score for the perceived necessity of disease specific clinical nutrition dietitians was 4.32/5.00. Doctors perceived the necessity of disease specific clinical nutrition dietitians for the following: diabetes (84.3%), kidney disease (72.5%,), obesity (50.5%), cancer (48.5%), cardiovascular disease (35.4%), infant and childhood disease (33.4%), senile disease (21.6%). General hospitals (44.2%) showed a significantly (p<0.01) higher rate of perception of its necessity in cancer disease than tertiary hospitals did (32.9%). The results showed the following percentages: participation in group education, 38.6%; participation in group education specific to diabetic diseases (27.1%); cancer (10.6%); chronic kidney disease (3.5%,); hypertension (2.9%); hyperlipidemia (1.3%). General hospitals (59.6%) showed significantly (p<0.01) higher scores than tertiary hospitals did (34.4%) regarding participation in group education. There was no significant difference in the region. The total mean score for the importance of clinical nutrition service was 4.25/5.00. The mean score of the importance of clinical nutrition service was 4.42/5.00 for “individual consultation according to disease status”; 4.41 for “nutrition management of enteral nutrition (EN) patients”; 4.38/5.00 for “group nutrition education according to disease”; 4.34 for “nutrition management of parenteral nutrition (PN) patients.” The mean score for the low importance of clinical nutrition services was 3.93 for “presentation of nutrition management principles or examples to medical team.” General hospitals showed significantly (p<0.01) higher scores than tertiary hospitals did regarding the importance of “individual consultation according to disease status” and “presentation of nutrition management principles or examples to medical team.” The results indicated that the doctors who participated in the study perceived the importance of clinical nutrition. Based on these findings, clinical dietitian services should be improved and an institutional apparatus to implement clinical nutrition services should be developed.