To our knowledge, this study was the first to use an individualized exercise counselling model to guide health counsellors in advising healthy pregnant women about exercising and to examine the effec-tiveness of exercise in relieving pregnancy-related distress symptoms.
The findings strongly suggest that exercise counselling provides an effective means of alleviating women's symptoms of distress. Many
different intervention techniques, strategies and theories have been proposed in the literature for promoting physical exercise in pregnant women (Pearce, Evenson, Downs, & Steckler, 2013). Nevertheless, health care providers still face many documented barriers to the use of counselling theory. Therefore, specific training in exercise counsel-ling and behaviour-changing techniques may be necessary (Downs, Dinallo, Birch, Paul, & Ulbrecht, 2017).
Several limitations of this study should be acknowledged. Data were collected from the control group before the intervention and data collection from the experimental group. Due to the withholding of the exercise counselling intervention from the control group, there were ethical considerations (Harris et al., 2006). We did not apply a randomized control trial (RCT) design to increase the internal validity of this study. In addition, the sample loss of the present study may limit the conclusions because it is possible that a larger sample size may alter some of the results. Moreover, a daily exercise diary was collected from the experimental group to prevent an increase in exer-cise behaviour and to prevent affecting the symptom scores of the control group. Therefore, we could not clearly understand the changes within and the differences between the two groups.
5 | C O N C L U S I O N S
The present study shows that individual face-to-face exercise counselling may increase the performance of a sufficient amount of exercise and significantly relieve pregnancy-related symptom distress.
Women's distress symptoms were relieved via exercise counselling, although the pretest scores were more significantly related to the total, physical and psychological distress symptom scores. Individual-ized exercise counselling not only assesses women's beliefs regarding exercise during pregnancy but also helps to develop personal goals and allows health care providers to show women how to perform exercise prescriptions with appropriate FITTP principles. Individual-ized exercise counselling allows women to clearly understand the ben-efits of exercise during pregnancy and how to perform detailed exercises according to their personal FITTP principles to relieve pregnancy-related symptom distress and provides clear personal guidelines for exercising. Consequently, it seems likely that pregnant women who receive more detailed advice regarding the benefits of exercising during pregnancy would be more likely to perform a suffi-cient amount of exercise according to the ACOG guidelines. Overall, the present results suggest that exercise counselling for healthy preg-nant women should form a regular part of prenatal care visits. In par-ticular, health care providers should consider the particular health status and history of the patient and provide exercise counselling and routines to maximize the overall health and well-being of both the pregnant woman and her fetus.
A C K N O W L E D G E M E N T S
This study was supported by a research grant from Mackay Hospital in Taiwan (MMH-MM-10506). The authors are grateful to all of the research project participants.
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F U N D I N G I N F O R MA T I O N
This study was supported by a research grant from Mackay Hospital in Taiwan (MMH-MM-10506).
C O N F L I C T O F I N T E R E S T
None declared. This research did not receive any specific grants from funding agencies in the public, commercial or not-for-profit sectors.
E T H I C A L A P P R O V A L
This study was approved by the Institutional Review Board of Mackay Medical Hospital (16MMHISO21e).
A U T H O R S H I P S T A T E M E N T
CFL, CJL and LKC were responsible for the study design; CFL, CJL and YCH were responsible for data collection and analysis; and CFL, CJL, FHW and CWC were responsible for the manuscript writing. The authors confirm that all listed authors meet the authorship criteria and that all authors are in agreement with the content of the manuscript.
O R C I D
Ching-Fang Lee https://orcid.org/0000-0002-1965-1909
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How to cite this article: Lee C-F, Huang Y-C, Wen F-H, Lin C-J, Chi L-K, Chang C-W. Effectiveness of individual face-to-face exercise counselling in changing exercise behaviours to relieve symptom distress in pregnant women. Int J Nurs Pract. 2020;e12837.https://doi.org/10.1111/ijn.12837
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