Experiences of parents providing kangaroo care to a premature infant: A qualitative systematic review

Abstract

Parents who give birth to an unexpected preterm infant not only suffer a psychological impact, but, in addition, their roles as parent are full of uncertainty. As part of family‐centered care, kangaroo care is an important way to support premature infants and their family. This review synthesizes qualitative studies on the experiences of parents who have used kangaroo care for preterm infants in neonatal intensive care units. English and Chinese databases were searched for relevant studies from 1970 to July 2018. The findings of qualitative studies were extracted and pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A total of 731 studies were screened, and 9 were included. Five synthesized findings were identified: sense of emptiness of the parent's role, barriers in the translation of parental roles in kangaroo care, preparation enhances parental role expectations, kangaroo care enhances parental competency, and encouragement and support from family and friends. Through the implementation of kangaroo care, nurses are able to help prepare and guide parents, fit parents’ needs, and help improve their ability and self‐confidence in their parental roles.

Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit

“…KC is reported to improve many clinical [1][2][3] and neurocognitive developmental 4,5 outcomes. The optimum dose and timing of KC needed to confer these advantages is unknown.…”

“…Despite the many apparent benefits of KC, however, several barriers may reduce opportunities for such practice, including parental factors (e.g., rates of visitation, family comfort with the practice) and health system factors (e.g., unit design, adequate staff support, parent educational programs, access to translators) 3,[20][21][22][23][24][25][26][27][28] . Parents and health care providers are also susceptible to cultural norms and personal beliefs that affect the frequency and amount of KC 20,21,25 .…”

“…This practice has been shown to reduce medical complications of preterm birth, such as hypothermia, sepsis, and rehospitalization 1,2 . It has also been shown to promote infant growth, breastfeeding, and mother-infant attachment 3 . Moreover, KC has been associated with improved neurocognitive developmental outcomes, including better hearing, speech, social, and executive function skills, in preterm infants and children 4,5 .…”

“…Developmental care practices have been adopted as a part of the standard of medical care in many neonatal intensive care units (NICU) 15–19 to reduce preterm-birth-related morbidities, support parent-infant bonding, and to possibly improve long-term developmental outcomes. Despite the many apparent benefits of KC, however, several barriers may reduce opportunities for such practice, including parental factors (e.g., rates of visitation, family comfort with the practice) and health system factors (e.g., unit design, adequate staff support, parent educational programs, access to translators) 3,20–28 . Parents and health care providers are also susceptible to cultural norms and personal beliefs that affect the frequency and amount of KC 20,21,25 .…”

“…Moreover, in the United States, non-English-speaking families in the NICU have been shown to be more susceptible to misunderstanding their child’s diagnosis and treatments because clinical staff and families do not share a common language 33 . To date, there is limited information about whether and how parents’ opportunities to provide KC for their prematurely born infant in the NICU are influenced by their socioeconomic and linguistic background 3 , despite the beneficial role of this developmental care practice. In the present study, we investigated whether the family’s SES and their preferred language to communicate with clinical staff influenced the total amount, frequency, and duration of KC with their preterm infants in the NICU.…”