UK midwives delivering physical activity advice; what are the challenges and possible solutions?

Marina Mitra, Katie Marino, D. Vishnubala, Andy Pringle, Camilla Nykjaer
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Abstract

Despite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions.Ten UK midwives (mean work experience ± SD: 15.5 years ± 10.2) participated in semi-structured interviews between May and July 2023. Data were analysed using a deductive thematic approach following Braun and Clarke's six steps. Demographic data were collected by Microsoft Forms then summarised using Microsoft Excel.Six themes with 25 subthemes were identified as barriers and solutions in delivering PA advice. The role of midwives in providing PA advice during pregnancy; the role of midwives in providing PA advice postpartum; intrinsic barriers that limit PA advice provision (confidence, safety concerns, knowledge, and midwife's personal body habitus); extrinsic barriers that limit PA advice provision (lack of time, education, PA not a priority in care); solutions to allow midwives to promote PA (including formal PA education, and dissemination of resources); and optimising delivery of PA advice (personalized approach, interprofessional collaboration, and linking to mental health benefits).Midwives consider themselves ideally placed to provide PA advice to pregnant women, with many aware of the benefits PA provides. Despite this, there is a lack of PA advice provision and knowledge of PA guidelines. Postpartum PA advice appeared to be considered outside the remit of midwives, due to limited contact. Further research is needed to determine the current level of PA advice provision for pregnant and postpartum women and explore the role of other healthcare professionals involved in maternity care.
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英国助产士提供体育锻炼建议;有哪些挑战和可能的解决方案?
尽管体育锻炼(PA)在孕期和产后对健康有特殊的益处,但许多妇女表示在此期间体育锻炼减少了。由于存在一系列障碍,助产士缺乏提供 PA 建议的能力。本研究旨在评估英国助产士目前在向孕妇和产后妇女提供 PA 建议方面的角色和知识,并找出障碍和潜在的解决方案。10 名英国助产士(平均工作经验± SD:15.5 年± 10.2)在 2023 年 5 月至 7 月期间参加了半结构化访谈。按照布劳恩和克拉克的六个步骤,采用演绎式主题方法对数据进行了分析。通过 Microsoft Forms 收集了人口统计学数据,然后使用 Microsoft Excel 进行了汇总。助产士在孕期提供 PA 建议的角色;助产士在产后提供 PA 建议的角色;限制提供 PA 建议的内在障碍(信心、安全顾虑、知识和助产士的个人身体习惯);限制提供 PA 建议的外在障碍(缺乏时间、教育、PA 不是护理中的优先事项);让助产士促进 PA 的解决方案(包括正规 PA 教育和资源传播);以及优化 PA 建议的提供(个性化方法、跨专业合作以及与心理健康益处挂钩)。助产士认为自己是向孕妇提供 PA 建议的理想人选,许多助产士都了解 PA 的益处。尽管如此,在提供 PA 建议和了解 PA 指南方面仍存在不足。由于接触有限,产后 PA 建议似乎被认为不属于助产士的职责范围。需要开展进一步的研究,以确定目前为孕妇和产后妇女提供 PA 建议的水平,并探讨参与产妇护理的其他医疗保健专业人员的作用。
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