Perera Madhawa, Nagpal Taniya S, Blankenship Maire M, Tolusso Danilo V, Cox Jordyn M, Prashadika Dilini, Schafer Mark, Tinius Rachel A
Exercise Science, Western Kentucky University, Bowling Green, KY, USA.
Department of Kinesiology, Iowa State University, Ames, IA, USA.
SAGE Open Nurs. 2025 Jan 19;11:23779608251313895. doi: 10.1177/23779608251313895. eCollection 2025 Jan-Dec.
Healthcare professionals are in an optimal position to deliver exercise information to pregnant women, yet previous research suggests this seldom happens. Midwives and nurse practitioners, who may have more time with pregnant women, are particularly well suited for this role.
This qualitative study examined the exercise advice and counseling provided by midwives and nurse practitioners in Kentucky, focusing on the barriers they face.
Twenty-one midwives and nurse practitioners were recruited until the sample size reached saturation. A survey with open-ended questions was distributed to potential participants in regional hospitals, universities, and professional associations. The framework method was employed to identify common themes in the responses from participants.
Five main themes emerged: nature of advice, discussing exercise benefits, safety concerns, barriers to counseling, and suggestions for improvement. Findings revealed that midwives and nurse practitioners recommend moderate exercise, aiming for 150 min weekly, monitoring heart rate for intensity, continuing prepregnancy exercise routines, starting low-intensity exercise during pregnancy such as walking, slowing down as pregnancy advances, and avoiding heavy lifting and vigorous activities. Many midwives and nurse practitioners in our sample took a reactive approach to exercise counseling, providing exercise advice if pregnant women asked questions or if they were at high risk for hypokinetic diseases. It was also observed that midwives and nurse practitioners discussed the maternal benefits of exercise more than the fetal benefits. Only a few nurse practitioners and midwives were content with their counseling, while the majority did not feel their counseling was effective.
Many midwives and nurse practitioners in Kentucky provided comprehensive and accurate physical activity guidelines to pregnant women. However, there is room for them to improve: proactive counseling should include discussions on fetal benefits and using the "talk test" for exercise intensity. Advising patients to slow down as pregnancy progresses should be reconsidered, and evidence-based guidance on specific exercises should be prioritized.
医疗保健专业人员处于向孕妇提供运动信息的最佳位置，但先前的研究表明这种情况很少发生。助产士和执业护士与孕妇相处的时间可能更多，特别适合承担这一角色。
这项定性研究调查了肯塔基州助产士和执业护士提供的运动建议与咨询，重点关注他们面临的障碍。
招募了21名助产士和执业护士，直至样本量达到饱和。向地区医院、大学和专业协会的潜在参与者发放了一份包含开放式问题的调查问卷。采用框架法来确定参与者回答中的共同主题。
出现了五个主要主题：建议的性质、讨论运动益处、安全问题、咨询障碍以及改进建议。研究结果显示，助产士和执业护士建议进行适度运动，目标是每周150分钟，通过监测心率来控制运动强度，延续孕前的运动习惯，在孕期开始低强度运动，如散步，随着孕期进展放慢速度，避免提重物和剧烈活动。我们样本中的许多助产士和执业护士采取被动的运动咨询方式，只有在孕妇提问或有患运动不足疾病的高风险时才提供运动建议。还观察到，助产士和执业护士更多地讨论了运动对母亲的益处，而非对胎儿的益处。只有少数执业护士和助产士对他们的咨询工作感到满意，而大多数人觉得他们的咨询效果不佳。
肯塔基州的许多助产士和执业护士为孕妇提供了全面且准确的身体活动指南。然而，他们仍有改进空间：主动咨询应包括讨论运动对胎儿的益处，并使用“谈话测试”来确定运动强度。对于建议患者随着孕期进展放慢速度这一点应重新考虑，并且应优先提供关于特定运动的循证指导。
