[논문]당뇨병 환자의 임상영양치료를 위한 임상영양사의 직무표준 개발

권수진; 우미혜; 주달래; 김은미; 박미선; 손정민; 위경애; 이송미; 차진아; 서정숙

doi:10.14373/jkda.2015.21.1.37

당뇨병 환자의 임상영양치료를 위한 임상영양사의 직무표준 개발
Development of Job Standards for Clinical Dietitians Administering Clinical Nutrition Therapy to Diabetic Patients in Hospitals 원문보기

대한영양사협회 학술지 = Journal of the Korean dietetic association, v.21 no.1, 2015년, pp.37 - 56

권수진 (영남대학교 식품영양학과) , 우미혜 (경희대학교병원 영양팀) , 주달래 (서울대학교병원 급식영양과) , 김은미 (강북삼성병원 영양실) , 박미선 (서울대학교병원 급식영양과) , 손정민 (원광대학교 식품영양학과) , 위경애 (국립암센터 임상영양실) , 이송미 (강남세브란스병원 영양팀) , 차진아 (전주대학교 한식조리학과) , 서정숙 (영남대학교 식품영양학과)

Abstract ▼ AI-Helper

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

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질의응답

핵심어	질문	논문에서 추출한 답변
	2010년 국민영양관리법에 의거하여 임상영양사제도가 법제화됨에 따라 어떤 요구가 커지게 되었는가?	이러한 국제적인 흐름과 함께 우리나라에서도 2010년 국민영양관리법에 의거하여 임상영양사제도가 법제화되었고 2012년부터 국가자격의 임상영양사를 배출할 수 있게 되었다(Kim 2011). 따라서 의료 기관 현장에서 수행되는 임상영양서비스의 질적 수준을 향상시키기 위한 업무 표준화의 요구가 커지게 되었다. 우리나라의 경우 Moon 등(2001)의 연구에서 급식관리와 영양서비스 분야로 구분하여 영양사의 직무분석을 실시하였으며, 업무 분야 외에 근무하고 있는 직종에 따라 영양교사, 보건소 영양사 등을 대상으로 직무분석 및 직무기술서를 작성하였다(Kwon 1999; Moon & Jang 2002a; Moon & Jang 2002b; Moon & Jang 2002c; Cha 등 2008).
	근거 중심의 실무란?	최근 환자에게 의료서비스를 수행함에 있어 경험 중심이 아니라 근거 중심의 실무가 강조되고 있다. 근거 중심의 실무란 업무 수행을 결정하는 과정에서 임상 업무의 전문가적인 경험과 직접적인 과학적 정보를 결합한 것으로(Park 2012) 임상영양서비스를 수행하는데 필요한 직무 구성에도 이러한 관점이 중요시되고 있다. 본 연구에서는 당뇨병 임상영 양사가 수행할 근거 중심의 직무를 도출하기 위하여 DACUM 기법을 통해 임상영양 업무를 위한 과업과 과업요소를 구성하였다.
	합병증 예방을 위한 약물치료외에 중요한 자가관리 방법은?	만성질환 중 당뇨병은 혈당관리를 소홀히 할 경우 심각한 합병증을 동반하게 되므로(Choi & Song 2010) 합병증 예방을 위하여 약물치료 외에 식사요법, 운동요법 등의 자가관리가 중요한 질병이다(Jun 1996; Choi & Song 2010). 당뇨병 환자의 식습관 변화만으로도 혈당이 조절되는 효과(Schulze 등 2007; Ma 등 2008)와 당뇨병 관련 교육을 통해 당화혈색소(HbA 1 c)의 감소 등 임상적 효과를 나타내었다는 보고가 있다(Robbins 등 2008; Coppell 등 2010).

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