Using the principles of practice development to address challenges in recruitment and data collection when face-to-face methods are unavailable.

BACKGROUND: Researchers conducting studies involving pregnant women often find recruitment challenging. The COVID-19 pandemic added further complexity to studies requiring face-to-face participation. AIM: To demonstrate how to maintain the principles of practice development (PD) when a study must switch from face-to-face to remote methods of collecting data. DISCUSSION: The number of participants in the authors' study increased when they moved from face-to-face to telephone engagement during the COVID-19 pandemic. They continued using PD principles when they changed method and the quality of the data they collected remained constant, even once lockdown restrictions were in place. CONCLUSION: PD principles can offer ways for nurse researchers to engage, collaborate with and reflect with people for research projects, including when constraints compete with participation. They can also assist researchers in optimising and maintaining recruitment and data collection when face-to-face research methods are impossible. IMPLICATIONS FOR PRACTICE: The telephone can be a valuable alternative medium for recruiting participants and collecting data when face-to-face methods are impossible to use. PD principles can be maintained and response rates and participation may even be greater when using it.

Factors that positively influence in-hospital exclusive breastfeeding among women with gestational diabetes: An integrative review.

PROBLEM: Women with gestational diabetes have higher rates of introducing infant formula before leaving hospital. BACKGROUND: Despite health professional support, less women with gestational diabetes exclusively breastfeed in hospital. AIM: To find factors that positively influence in-hospital exclusive breastfeeding practices among women with gestational diabetes. METHODS: An online search was performed in Medline, Scopus, Pubmed, CINAHL and Cochrane databases. Studies containing the keywords gestational diabetes and breastfeeding were retrieved. FINDINGS: Authors identified 1935 papers from search criteria. Twenty-six papers with no restrictions on research design met inclusion criteria and were included in the review. Factors were divided into personal, antenatal, intrapartum and postnatal factors. The main modifiable factors that were associated with improved in-hospital exclusive breastfeeding rates were having a strong intention to breastfeed, being confident, feeling supported and having continuity of education and support. Women's main reasons to introduce formula were related to baby's hypoglycaemia, delayed lactogenesis II and perceived low milk supply. Skin-to-skin contact after birth combined with frequent breastfeeds were effective ways to improve in-hospital exclusive breastfeeding rates. CONCLUSION: Influencing factors such as women's breastfeeding intention, confidence and ongoing support are no different to the general population of women. However, promoting skin-to-skin contact after birth combined with frequent feeds are crucial for women with gestational diabetes who are more likely to introduce formula due to delayed lactogenesis II and fear of neonatal hypoglycaemia. There is a need for developing educational and supportive interventions that are tailored specifically for women who have gestational diabetes.

Feasibility of face-to-face and online learning methods to provide nutrition education to midwives, general practice nurses and student nurses.

Midwives and general practice nurses are ideally positioned to provide nutrition education to pregnant women. However, it appears that they do not receive sufficient nutrition training to enable them to fulfil this role. This study aimed to develop, implement and evaluate a suite of learning resources developed specifically for midwives, general practice nurses and student nurses. A four-module suite of learning resources was developed based on recommendations in the Australian Antenatal Care Clinical Guidelines as well as formative evaluation with stakeholders. The feasibility of these modules was tested using a pre-test and post-test quasi-experimental design with three arms using convenient sampling (face-to-face with midwives; online with student nurses; and online with midwives, nurses and practice nurses). Completion rates across the three study arms were poor (n=40 participants in total). For the combined data, there was a significant increase in knowledge scores across all modules from the pretest score (median (IQR): 3.46 (2.09-4.13)) to the post-test score (5.66 (4.66-6.00)) (p<0.001). Studies of high quality are required to determine if changing the nutrition knowledge and confidence in delivering nutrition care of health professionals results in sustainable changes to their clinical practice.

Review of patient satisfaction with services provided by general practitioners in an antenatal shared care program.

BACKGROUND: Antenatal shared care (ANSC) is a model of care in Australia whereby pregnant women are managed by their general practitioner (GP) and an obstetrician at a public antenatal clinic throughout the pregnancy. The aim of this study was to assess pregnant women's satisfaction with the ANSC program and the adequacy of advice provided to pregnant women. METHODS: Women participating in ANSC in the Illawarra region of NSW were invited to complete a satisfaction survey, which included questions on relevant topics discussed with their GP. RESULTS: Most women reported being highly satisfied with the ANSC service. Over half of the women had not received any information about breastfeeding and nutritional supplementation of iodine.

Antenatal shared care: are pregnant women being adequately informed about iodine and nutritional supplementation?

OBJECTIVES: To assess nutrition-related knowledge and practices, including supplement use, of both pregnant women and healthcare providers that participate in antenatal shared care (ANSC). METHODS: Pregnant women enrolled in ANSC (n = 142) completed a knowledge and practices survey and a validated iodine-specific Food Frequency Questionnaire. General practitioners (GP) and nurses (N = 61) participating in the ANSC program completed a short survey which assessed their knowledge about nutrition for pregnancy, focussing on iodine. RESULTS: Both groups had poor knowledge about the importance and roles of iodine during pregnancy. Most women (82%) reported taking a supplement during their current pregnancy, and 70% were taking a supplement containing iodine. Only 26% of GPs discussed iodine supplementation with pregnant patients. The median (IQR) iodine intake of pregnant women was 189 (129-260) µg/day which meets the estimated average requirement (160 µg/day). Half (52%) of women's dietary iodine was provided by dairy foods, and only 7% came from fish and seafood. Most healthcare providers (74%) expressed interest in receiving ongoing professional education about iodine in pregnancy. CONCLUSION AND IMPLICATIONS: Ongoing nutrition education for ANSC health practitioners is required to ensure that women receive sufficient dietary advice for optimal pregnancy outcomes. Further research is required to address reasons behind dietary choices of Australian pregnant women.