Parent‐infant skin‐to‐skin contact: parents’ views versus nurses’ views

Abstract

In the past two decades, there have been advances in the promotion and advocacy of skin-to-skin contact (skin care) or kangaroo care in NICUs including WHO guidelines (1), a recent position statement from an international conference on skin care (2), and meta-analysis studies of morbidity, mortality and psychosocial outcome following skin care in the NICU (3-5). As the promotion and consideration of skin care has developed in countries with advanced neonatal medicine and technological resources, there have been at least two viewpoints on skin care (seen as a recommended practice): one is on the safety and efficacy of skin care (6) and the other is on how to involve and support parents in skin care of their infant as part of the broad context of family-centred care in the NICU (7).This study addresses an important issue, measuring the daily amount of time infants spend being held in skin care, and also who, nurses or parents, can best document the amount of time infants spend in skin care (8). The article indicates that parents who participated in the study were willing to document the time and duration of skin care over a 24-h period and note which parent provided skin care (mother or father). The authors assume that parents were reliable in recording the frequency and duration of their care on simple charts. One assumption of reliability is that the average duration of care recorded by parents was quite similar to the duration charted by the infant's nurses. As indicated in the study, parents and nurses differed in the documentation of the actual number of times infants were on their parents' bodies. The exact agreement between parents' and nurses' documentation regarding both the skin care duration and starting ⁄ termination times was forty per cent. Parents also noted more people who provide skin care than did nurses. A tacit assumption might be that because parents were actually there (holding their babies) and often behind screens that could obstruct the nurses' view, the parents' frequency count and count of number of skin care providers might be more accurate. The authors said that without independent verification such as video recording, it is not possible to determine the accuracy of the parents' (or nurses') count. With the issue of independent verification, the authors ruled out videotaping because of privacy concerns. It is possible to think of other methods that might indicate the amount of time the infant was on the mother's, father's (or any family member's) body. Research on physiological parameters associated with skin care indicates changes in infant temperature and heart rate (9-12). There are sensors that could indicate the infant's position in space -i.e. outside the isolette and movement sensors that might indicate an infant's rhythmic movement on a parent's chest. After studying the reliability of such measures, it might be feasible to use increase and decrease in one or more of these parameters (such as temperature, heart rate or rhythmic physical movement on a parent's chest) as a reliabl...

Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

“…In regards to practice, nurses can now be assured that KC can be used to minimize bedside procedural pain [20] [50] and can practice in a way consistent with current best practice recommendations [9] [51]. Also, the mother we studied eagerly participated, suggesting a positive attitude toward holding her infant during the clustered painful procedures; some, but not all, mothers want to hold their infants during painful procedures [52] [53]. Determining and encouraging maternal willingness to do so are recommended.…”

Meanings, beliefs and attitudes of the neonatal unit staff in México about the parents' participation in a neonatal unit: A qualitative approach

“…According with Boukydis, is a challenged for educational necessities of the parents, thus, some UNs provide supporting parents with supervision of nurses and physicians, while, in other NUs the health team feel that they have a lack of preparation and that does not have administrative recognition to support the participation of parents [8] .…”