Kawakami Junko, Suzuki Yoshio, Ebata Midori, Kawaguchi Yasuko, Oonaka Yoshiko, Urashima Chizuko
Department of Life Sciences, Sagami Women's Junior College, 2-1-1 Bunkyo, Sagamihara, Kanagawa 228-0807, Japan.
Clin Exp Nephrol. 2004 Dec;8(4):344-50. doi: 10.1007/s10157-004-0315-x.
Many studies have indicated the effectiveness of medical nutrition therapy for kidney diseases in various stages. However, compliance with dietary therapy over a long period is not easy for patients living alone, elderly patients, and disabled patients, and the concern of registered dietitians working at medical facilities has become increased. Our activities started in the form of social services, developing recipes for cook-chilled foods, collaborating with a firm that had been providing a meal-delivery service, for patients with kidney diseases.
Our subjects were outpatients with renal failure at the conservative treatment stage, patients at the dialysis stage, and those with diabetic nephropathy. To develop recipes, the nutritional amounts of energy, protein, potassium, phosphorus, salt, and water content in the diet were determined on the basis of the guidelines of the Japanese Society of Nephrology. In 2000, a survey was conducted of 140 regular users of the cook-chilled and delivered foods. The items surveyed were: age, sex, duration of the use of the service, degree of satisfaction with the meals, palatability of menu items, opinions and requests, and reasons for the use of the service.
Between February 1996 and August 2000, recipes for cook-chilled foods for patients with kidney diseases at the conservative-treatment stage, those at the dialysis stage, and those with diabetic nephropathy were gradually developed. As of July 2003, the total number of recipes was 946. Of the 140 users surveyed, we obtained valid responses from 91 (65.0%). Regarding duration of usage of the service (n = 91): it was 1 year or more in 38.6%, 6-12 months in 15.7%, 3-6 months in 22.9%. 1-3 months in 12.3%, and 1 month or less in 10.8%. Regarding degree of satisfaction with the meals (n = 91), it was very good or good in 58%, fair in 30%, and no good in 12% of respondents.
As the results of the survey indicated, the home-delivered, cook-chilled foods were generally, favorably accepted by users (rate of satisfaction, 58% [very good and good], duration of usage, 54.3% [6 months or longer]), for them to continue their dietary therapy at their homes. It is suggested that the service of delivering cook-chilled meals can be used as one of the choices enabling continued dietary therapy for patients with chronic renal failure who have difficulty in self-management of the diet at home for diverse reasons.
许多研究表明，医学营养疗法对处于各个阶段的肾脏疾病均有效。然而，对于独居患者、老年患者和残疾患者而言，长期坚持饮食疗法并非易事，这也增加了医疗机构注册营养师的担忧。我们的活动以社会服务的形式展开，为肾病患者开发冷藏即食食品食谱，并与一家提供送餐服务的公司合作。
我们的研究对象为处于保守治疗阶段的肾衰竭门诊患者、透析阶段的患者以及糖尿病肾病患者。为了制定食谱，根据日本肾脏病学会的指南确定了饮食中能量、蛋白质、钾、磷、盐和水分的营养含量。2000年，对140名冷藏即食和送餐食品的经常使用者进行了一项调查。调查项目包括：年龄、性别、使用该服务的时长、对餐食的满意度、菜品的可口性、意见和要求以及使用该服务的原因。
在1996年2月至2000年8月期间，逐步开发出了针对处于保守治疗阶段的肾病患者、透析阶段的患者以及糖尿病肾病患者的冷藏即食食品食谱。截至2003年7月，食谱总数达到946种。在接受调查的140名使用者中，我们收到了91份有效回复（65.0%）。关于该服务的使用时长（n = 91）：使用1年或更长时间的占38.6%，6至12个月的占15.7%，3至6个月的占22.9%，1至3个月的占12.3%，1个月或更短时间的占10.8%。关于对餐食的满意度（n = 91），58%的受访者表示非常满意或满意，30%表示一般，12%表示不满意。
正如调查结果所示，用户普遍对家庭配送的冷藏即食食品表示满意（满意度为58%[非常满意和满意]，使用时长为54.3%[6个月或更长时间]），这使得他们能够在家中继续进行饮食治疗。建议送餐服务可作为一种选择，使因各种原因在家中难以自行管理饮食的慢性肾衰竭患者能够继续接受饮食治疗。
