Counselling on physical activity in Danish antenatal care: A qualitative study of experiences from both the pregnant woman's and the care provider's perspective.

OBJECTIVES: Physical activity during pregnancy is beneficial to maternal and fetal health, but most pregnant women do not achieve the recommended level of physical activity. To investigate how antenatal care can promote physical activity during pregnancy, this study explores experiences of physical activity counselling from the perspectives of pregnant women and antenatal care providers. METHODS: In a qualitative design with an inductive approach individual semi-structured interviews with 19 pregnant women and seven antenatal care providers were performed and analyzed using thematic analysis. RESULTS: The themes "Experiencing inadequate counselling", "Benefiting from individualized guidance", and "Voicing a need for enhanced support" cover the perspectives from the participating pregnant women. They often experienced insufficient physical activity counselling that left them insecure about proper physical activity during pregnancy. The pregnant women desired individualized and concrete advice and early and continuous support. From antenatal care providers the themes "Providers' perceived barriers in counselling", "Balancing the act of counselling", and "Acknowledging potential for enhanced counselling" were identified. They perceived barriers towards counselling including time restraints, lack of interest, and doubts about certain physical activity during pregnancy but expressed trying to adjust the counselling to meet the woman's individual situation. They acknowledged that continuous support during pregnancy and updated knowledge and increased focus among providers might improve physical activity counselling. CONCLUSIONS: Pregnant women received scarce counselling on physical activity in antenatal care, while care providers described several barriers towards counselling on physical activity. Both pregnant women and antenatal care providers recognized opportunities for enhanced physical activity counselling.

Cross-cultural adaption, translation and reliability tests of the Danish version of the Pregnancy Exercise Self-Efficacy Scale.

OBJECTIVE: Self-efficacy has been shown to influence initiating and maintaining physical activity. Pregnancy often leads to a decline in physical activity and exercise self-efficacy assessments could be a tool to help women stay active during pregnancy. The Pregnancy Exercise Self-Efficacy Scale (P-ESES) is an English questionnaire assessing the self-efficacy in pregnant women to perform physical activity. The aim of this study was to translate the P-ESES questionnaire into a valid and reliable Danish version, P-ESES-DK. STUDY DESIGN: The study included a qualitative design for the validation of the questionnaire and a prospective longitudinal observational study for the reliability testing. MAIN OUTCOME MEASURES: The questionnaire was translated into Danish in a four-stage process with translation, back-translation and synthesis. The pre-final version was tested by eight women and changes were made to complete the final version of P-ESES-DK. The reliability testing was performed using a test-retest analysis of P-ESES-DK with 75 Danish pregnant women. Reliability was assessed using Intraclass Correlation Coefficient (ICC), Cronbach's alpha and agreement was visualized using a Bland-Altman plot. RESULTS: The questionnaire was found to have a good content validity. The assessment of the test re-test reliability showed an ICC of 0.809 and a Cronbach's alpha of the test and re-test were 0.839 and 0.869, respectively. The Bland-Altman plot showed that 93.9% of the answers were within the 95% limits of agreement. CONCLUSIONS: The Danish version of P-ESES was found to be both reliable and valid. Thus, it can be used as a helpful tool to measure self-efficacy related to physical activity during pregnancy.