Qualitative study on public health nurses’ experience and assessment of nutritional and physical activity counseling of women with gestational diabetes

Abstract

INTRODUCTION The number of pregnant women with gestational diabetes mellitus (GDM) has increased worldwide. GDM is a known risk factor for pregnant mothers and their fetuses that may increase various complications and health concerns. Nutrition and physical activity (PA) counseling during pregnancy can be crucial in supporting pregnant women to adopt healthier lifestyle practices and reducing these risks. This study describes public health nurses' (PHNs) experiences of nutrition and PA counseling and their assessments on how to develop the counseling for pregnant women with GDM. METHODS This is a descriptive qualitative study containing theme-interviews of 11 PHNs working in an antenatal maternity care setting. The data were analyzed using inductive content analysis. RESULTS Five main themes were identified related to PHNs' experiences and assessment of nutrition and PA counseling for pregnant women with GDM: competency of nutrition and PA counseling, challenges of counseling, positive experiences of counseling, printed material, and counseling practices. PHNs considered nutrition and PA counseling both challenging and rewarding. There was lack of knowledge and skills to provide proper counseling and adequate material to support versatile counseling. CONCLUSIONS Material related to nutrition and PA counseling should be updated and standardized. PHNs need further training to improve knowledge in the area of diet and exercise.

Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review

“…Table 1 presents the characteristics of the 13 included studies. Most of the studies were conducted in the USA [ 23 , 34 , 35 , 36 , 37 ], three studies were conducted in the United Kingdom [ 38 , 39 , 40 ], and one each in South Africa [ 41 ], Brazil [ 42 ], Norway [ 43 ], Sweden [ 44 ], and Finland [ 45 ] respectively. Seven were quantitative studies [ 34 , 35 , 36 , 39 , 40 , 41 , 43 ], four qualitative [ 23 , 37 , 45 ], one a mixed methods study [ 38 ] and one a controlled, non-randomised study [ 42 ].…”

“…Most of the studies were conducted in the USA [ 23 , 34 , 35 , 36 , 37 ], three studies were conducted in the United Kingdom [ 38 , 39 , 40 ], and one each in South Africa [ 41 ], Brazil [ 42 ], Norway [ 43 ], Sweden [ 44 ], and Finland [ 45 ] respectively. Seven were quantitative studies [ 34 , 35 , 36 , 39 , 40 , 41 , 43 ], four qualitative [ 23 , 37 , 45 ], one a mixed methods study [ 38 ] and one a controlled, non-randomised study [ 42 ]. Most of the prenatal healthcare providers were midwives [ 37 , 38 , 39 , 40 , 43 , 44 ], obstetrician/gynaecologists [ 34 , 36 , 37 , 41 ] and nurses [ 34 , 37 , 45 ].…”

“…Seven were quantitative studies [ 34 , 35 , 36 , 39 , 40 , 41 , 43 ], four qualitative [ 23 , 37 , 45 ], one a mixed methods study [ 38 ] and one a controlled, non-randomised study [ 42 ]. Most of the prenatal healthcare providers were midwives [ 37 , 38 , 39 , 40 , 43 , 44 ], obstetrician/gynaecologists [ 34 , 36 , 37 , 41 ] and nurses [ 34 , 37 , 45 ].…”

“…Several barriers to prenatal physical activity and exercise are synthesised in this review ( Table 1 ). Studies cited insufficient time [ 23 , 35 , 38 , 40 , 44 , 47 ], lack of knowledge and skills [ 35 , 38 , 40 ] inadequate or insufficient training [ 23 , 37 , 38 , 44 , 45 ], lack of resources [ 35 , 38 , 40 , 44 ], lack of patient interest [ 23 ], and difficulty in counselling women with low levels of education or income or those from varying socio-cultural backgrounds [ 23 , 44 ] as barriers.…”

“…However, this scoping review indicated that prenatal care providers rarely provide physical activity education and counselling to pregnant women during their antenatal visit. Even when the information is provided, it is inadequate or lacking in scientific content, because they have no scientific knowledge [ 23 , 34 , 39 , 41 , 43 ] nor training [ 23 , 24 , 37 , 38 , 45 ] regarding physical activity during pregnancy. This is concerning as inactive pregnant women are therefore limited information, and are likely not to be motivated to engage in physical activity.…”