Korean J Community Nutr.  2019 Dec;24(6):512-524. 10.5720/kjcn.2019.24.6.512.

Food Allergy-related Awareness and Performance of Dietitians at Children's Hospitals in Korea: Comparison of Certificate Possession among Clinical Dietitians

• Shin HR
• Kim SB

• KMID: 2467443
• DOI: http://doi.org/10.5720/kjcn.2019.24.6.512

Abstract

OBJECTIVES
The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate.
METHODS
A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification.
RESULTS
The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, "˜needs to provide nutrition counseling in children's hospitals', "˜providing nutrition counseling services in working hospitals', and "˜whether there is a nutrition counseling room' scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, "˜self-assessment of food allergy knowledge understanding level', "˜awareness of open oral food challenge (OFC)', "˜recognition of the need for education and counseling on food allergy for patients/guardians', and "˜food allergy related educational experience' scored higher among holders of clinical dietitians certificates than in non-holders.
CONCLUSIONS
Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.

Keyword

children's hospital dietitian; clinical dietitian certificate; food allergy; nutrition counseling

MeSH Terms

Certification
Counseling
Education
Food Hypersensitivity
Hypersensitivity
Korea*
Nutritionists*

Reference

1. Du GT, Sampson HA, Plaut M, Burks AW, Akdis CA, Lack G. Food allergy: Update on prevention and tolerance. J Allergy Clin Immunol. 2018; 141(1):30–40.

2. Kim YH, Lee SY, Lee E, Cho HJ, Kim HB, Kwon JW, et al. The change in food allergy prevalence of elementary school children in Seoul since the last 20 years and the risk factor analysis. Allergy Asthma Respir Dis. 2016; 4(4):276–283.

3. Dunlop JH, Keet CA. Epidemiology of food allergy. Immunol Allergy Clin North Am. 2018; 38(1):13–25.

4. Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A. Second symposium on the definition and management of anaphylaxis: summary report-second National Institute of Allergy and Infectious Disease/food allergy and anaphylaxis network symposium. J Allergy Clin Immunol. 2006; 117(2):391–397.

5. Boyce JA, Assa AD, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010; 126(12):S1–58.

6. Eigenmann PA, Akdis C, Bousquet J, Grattan CE, Hoffmann-Sommergruber K, Hellings PW, et al. Highlights and recent developments in food and drug allergy, and anaphylaxis. Pediatr Allergy Immunol. 2018; 29(8):801–807.

7. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, et al. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci. 2004; 19(5):716–723.

8. Kwak TK. The manual of school lunch food allergen labeling. Sejong: Ministry of Education;2012.

9. National Health Insurance Service. Major allergic diseases, children. Adolescence (under 12) occur a lot. Wonju: National Health Insurance Service;2016.

10. Lee SY, Kim KW, Lee HH, Lim DH, Chung HL, Kim SW, et al. Incidence and clinical characteristics of pediatric emergency department visits of children with severe food allergy. Korean J Asthma Allergy Clin Immunol. 2012; 32(3):169–175.

11. Han SM, Heo YR. Changes of prevalence of food allergy in elementary school student and perception of it in school nutritionist in Korea, 1995-2015. J Nutr Health. 2016; 49(1):8–17.

12. Kim YH, Lee SY, Lee E, Cho HJ, Kim HB, Kwon JW, et al. The change in food allergy prevalence of elementary school children in Seoul since the last 20 years and the risk factor analysis. Allergy Asthma Respir Dis. 2016; 4(4):276–283.

13. Lee AH, Kim KE, Lee KE, Kim SH, Wang TW, Kim KW, et al. Prevalence of food allergy and perceptions on food allergen labeling in school food service among Korean students. Allergy Asthma Respir Dis. 2013; 1(3):227–234.

14. Lee SY. A study for prevention and control of food allergy. Cheongju: Korea Ministry of Food and Drug Safety;2015.

15. Kim SB, Kim JH. Food allergy awareness and nutritional management by the parents of preschool children. Korean J Community Nutr. 2016; 21(5):426–439.

16. Ministry of Education. Perception of allergenic school food manual. Sejong: Ministry of Education;2012.

17. Chung SJ, Han YS, Chung SW, Ahn KM, Park HY, Lee SI, et al. Marasmus and kwashiorkor by nutritional ignorance related to vegetarian diet and infants with atopic dermatitis in South Korea. J Nutr Health. 2004; 37(7):540–549.

18. Isolauri E, Sütas Y, Salo MK, Isosomppi R, Kaila M. Elimination diet in cow's milk allergy. J Pediatr. 1998; 132(6):1004–1009.

19. Palit A, Handa S, Bhalla AK, Kumar B. A mixed longitudinal study of physical growth in children with atopic dermatitis. Indian J Dermatol Benereol Leprol. 2007; 73(3):171–175.

20. Seo SJ, Shin HS. A study on eating behavior, developmental outcomes of young children, and nutritional attitude and knowledge levels of mothers. J East Asian Soc Diet Life. 2009; 19(6):839–845.

21. Park SJ, Lee JS, Ahn KM, Chung SJ. The comparison of growth and nutrient intakes in children with and without atopic dermatitis. Korean J Community Nutr. 2012; 17(3):271–279.

22. Sicherer SH, Sampson HA. Food allergy recent advances in pathophysiology and treatment. Annu Rev Med. 2009; 60:261–277.

23. Venter C, Laitinen K, Vlieg-Boerstra B. Nutritional aspects in diagnosis and management of food hypersensitivity: The dietitians role. J Allergy Clin Immunol. 2012; 120(2):11–22.

24. Kris-Etherton PM, Akabas SR, Bales CW, Bistrian B, Braun L, Edwards MS, et al. The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness. Am J Clin Nutr. 2014; 99(5):1153S–1166S.

25. Maslin K, Meyer R, Reeves L, Mackenzie H, Swain A, Stuart-Smith W, et al. Food allergy competencies of dietitians in the United Kingdom, Australia and United States of America. Clin Transl Allergy. 2014; 4(1):37.

26. Groetch ME, Christie L, Vargas PA, Jones SM, Sicherer SH. Food allergy educational needs of pediatric dietitians: A survey by the consortium of food allergy research. J Nutr Educ Behav. 2010; 42(4):259–264.

27. Franz MJ, Boucher JL, Evert AB. Evidence-based diabetes nutrition therapy recommendations are effective: the key is individualization. Diabetes Metab Syndr Obes. 2014; 24(7):65–72.

28. Ministry of Health and Welfare. National nutrition management law [Internet]. Ministry of Health and Welfare;2015. Updated 2015 Jan 5. cited 2017 Jan 11. Available from: http://www.law.go.kr.

29. Kim YJ. Comparison of the perception for food allergy between nutrition teachers and children in elementary and middle school [Master's thesis]. Chung-Ang University;2010.

30. Kim YS, Park EJ, Lim YS. A study on food allergy practices of dietitians at schools in Korea. J Korea Soc Wellness. 2014; 9(4):251–261.

31. Kim YM, Heo YR, Ro HK. Perception and practices regarding food allergy of elementary and middle school nutritionists in the Jeonnam area. J Korean Soc Food Sci Nutr. 2013; 41(1):151–161.

32. Seoul Metropolitan Government. Guidelines for education and food service management of food allergies [Internet]. Seoul Metropolitan Government;2004. cited 2017 Jan 3. Available from: http://fsi.seoul.go.kr/front/bbs/bbsView.do?currPage=1&listSize=10&searchType=titles&searchValu=&bbsCode=1021&bbsSeq=1350.

33. Ministry of Food and Drug Safety. Knowing food allergy. Ministry of Food and Drug Safety;;2016. 2016 Mar 4. Available from: https://www.foodsafetykorea.go.kr/main.do.

34. Health Insurance Review & Assessment Service. Inpatient meal [internet]. 2016. updated 2016 Jun 14. cited 2017 Feb 3. Available from: http://rulesvc.hira.or.kr/lmxsrv/law/joHistoryContent.srv?SEQ=57&SEQ_CONTENTS=48433&DATE_START=20060525&DATE_END=20161230&PAGE_MODE=print.