Suchergebnisse

The primary purpose of this study was to develop and test a model for the process of making the decision to select/not select cook-chill for hospital food services. A second purpose was to determine the nature of the decision strategy, analytical versus intuitive, most predictive of satisfaction with cook-chill. A generic decision model was developed based on an extensive review of literature on decision making. Due to the lack of research on food service systems, a modified Delphi technique was used to identify 1) the factors critical in the process of making the decision to select/not select cook-chill and 2) the characteristics of a successful hospital cook-chill operation. The information gathered from the Delphi technique was used to develop a questionnaire which would measure the applicability of the generic model to the decision to select/not select cook -chill food production. The generic model was composed of five decision components and one satisfaction component. Using the model as a framework, a questionnaire was developed to test the relationships between the components of the model. Correlations between these components revealed that the use of the model was significantly related with satisfaction with the decision to select/not select cook-chill. A "Checklist for the Process of Making the Decision to SelectINot Select Cookchill Food Production for Hospital Foodservices" was developed using the model and questionnaire as frameworks. The Checklist consists of 136 questions: 101 questions measuring the decision process and 35 questions measuring satisfaction with the decision. For the purposes of this study, analytical decision making was defined as a process where objective, as opposed to subjective information, was available and was used in the process of making the decision. The Checklist consisted of questions to which there was a "yes" or "no" response. The higher the number of "yes" responses on the decision component questions, the more analytical the decision process and the higher the correlation with satisfaction. It was statistically determined that 37 "yes" responses resulted in satisfaction with the decision process. The lower the number of "yes" responses on the decision component questions, the more intuitive the decision process and the lower the correlation with satisfaction. The results of this study are significant in that an extensive review of literature between 1950 and 1990 showed that there was little empirically based research on foodservice systems. The existing research prior to this study did not provide enough information to develop a model for the process of making the decision to select/not select cook-chill production for any foodservice operation. The model developed and tested in this research is generic in nature and should apply equally well in a variety of types of foodservices. It may be necessary to make minor adaptations to the Checklist to address the unique nature of various types of foodservices such as schools, college/universities, military, prisons, hotels, and restaurants. ; Ph. D.

Purpose. To track the 2-year movement of cardiac rehabilitation patients through the stages of change for dietary fat reduction and increasing fruit and vegetable intake. Design. A cross-sectional, longitudinal evaluation of a convenience sample of cardiac rehabilitation patients. Setting. Department of Pulmonary and Cardiac Rehabilitation, Moses H. Cone Memorial Hospital, Greensboro, North Carolina. Subjects. Subjects (n = 118) were predominately white, overweight, married men with a history of tobacco use. Intervention. Group nutrition education sessions for 12 weeks. Measures. Stage of change assessments for dietary fat reduction and increasing fruit and vegetable intake were performed at the start (baseline), conclusion (3 months), and 2 years after cardiac rehabilitation. Results. Baseline staging demonstrated patients' efforts to reduce dietary fat intake (preparation, 10.2%; action, 35.6%; maintenance, 47.5%). The assessment at 2 years staged 87.3% of the population in the maintenance stage. In contrast, the precontemplation (30.0%), contemplation (7.6%), and preparation (49.2%) stages dominated baseline staging for modifying fruit and vegetable intake. Patients in the precontemplation and contemplation stages increased to 58.5% at 2 years. Conclusions. Cardiac rehabilitation patients are in different stages for two food behaviors linked to the same illness. Results support the appropriateness of nutrition education that emphasizes instrumental information for affecting fat reduction behaviors. Modifying fruit and vegetable intake behaviors is more appropriately addressed with noninstrumental interventions that emphasize health benefits and barriers to change.

Purpose. To determine the stages of change for dietary fat and fruit and vegetable intake of cardiac patients entering a rehabilitation program. Design. A cross-sectional study using a convenience sample of newly admitted cardiac rehabilitation patients. Setting. Department of Pulmonary and Cardiac Rehabilitation, Moses H. Cone Memorial Hospital, Greensboro, North Carolina. Subjects. Subjects (n = 226) were predominantly men, Caucasian, married, smokers with 9 to 12 years of education, and with primary diagnoses of coronary artery bypass graft. Measures. Stages of change and food frequency questionnaires were completed by subjects upon admission to cardiac rehabilitation. Results. Subjects in action and maintenance stages for dietary fat reduction comprised 78.7% of the population. Subjects' percentage of energy from fat decreased linearly from the precontemplation stage (38.8%) to the maintenance stage (30.9%). Eighty-one percent of subjects were in precontemplation/contemplation for increasing fruit and vegetable intake. Daily servings of fruits and vegetables ranged from 2.6 for precontemplation to 5.1 for maintenance subjects. Age, body mass index (BMI), education, and family history for coronary disease were unrelated to stage of change for the dependent variables. Conclusions. Patients were in different stages of change for two nutritional behaviors linked to the same disease. Results support the need to assess patients for food behaviors and apply different educational interventions for each food behavior.