Antenatal education - Putting research into practice: A guideline review.

PROBLEM: Antenatal care guidelines used in Australia are inconsistent in their recommendations for childbirth and parenting education (CBPE) classes for preparation of women and parents for pregnancy, childbirth, and early parenting. BACKGROUND: Clinical practice guidelines in maternity care are developed to assist healthcare practitioners and consumers to make decisions about appropriate care. The benefit of such guidelines relies on the translation and quality of the evidence contained within them. In the context of antenatal care guidelines, there is a potential evidence-practice gap with regard to CBPE. AIMS: This review aims to appraise the quality of Australian antenatal care guidelines in their recommendations for CBPE for women and partners. METHODS: Publicly available Australian antenatal care guidelines were identified including local health district websites and professional organisations pertaining to maternity care. Guidelines were reviewed independently, and the quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. FINDINGS: Five guidelines were included in the review and appraised using AGREE II. With the exception of the Department of Health Pregnancy Care Guidelines, guidelines scored poorly across all six domains. When appraised according to specific CBPE recommendations for rigour of development, presentation, and applicability; all guidelines received low scores. DISCUSSION: Prenatal services remain largely unregulated across the board, with no systematic approach to make recommendations for CBPE and guidelines lacking in rigour with regard to CBPE. CONCLUSION: Within the guidelines reviewed there was a lack of evidence-based recommendations provided for educators or consumers regarding childbirth and parenting education.

Experiences of people with cancer who have participated in a hospital-based exercise program: a qualitative study.

PURPOSE: Exercise interventions for people with cancer and cancer survivors improve physical health, fatigue, and quality of life. Despite these benefits, poor adherence to exercise is an ongoing challenge among this population. In order to improve adherence in clinical services, this study aims to explore the benefits, challenges, barriers, and facilitators experienced by people with cancer and cancer survivors who participated in a hospital-based exercise program, specifically those who completed or did not complete the full program. METHODS: This study involved a qualitative approach. People with a cancer diagnosis who did complete (completers, n = 11) and did not complete (non-completers, n = 4) a 12-session exercise program at a tertiary hospital were recruited. Semi-structured interviews were conducted and thematic analysis was employed to identify emergent themes. RESULTS: Perceived benefits of exercise was the most prominent theme to emerge, with most participants recognizing improvements in physical, mental, and/or social well-being. Non-completers focused on treatment-related side effects, whereas completers saw an opportunity to return to a healthy lifestyle. The transition from a supervised environment to everyday life presented as the most significant barrier to exercise beyond the program among both program completers and non-completers. CONCLUSIONS: Most people with cancer identified physical, mental, and social benefits from exercising. However, people with cancer and cancer survivors had difficulty maintaining exercise participation beyond completion of a supervised hospital-based program. IMPLICATIONS: Improving exercise participation in people with cancer and cancer survivors may require supervised exercise interventions plus the implementation of strategies to manage side effects and to facilitate the transition of exercise into everyday life to enhance long-term adherence.