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  • 1.
    Angelhoff, Charlotte
    et al.
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Helmer, Charlotte Sahlen
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Linkoping Univ, Dept Paediat, Linkoping, Sweden.
    Olsson, Emma
    Orebro Univ, Dept Pediat, Orebro, Sweden;Orebro Univ, Ctr Hlth Care Sci, Orebro, Sweden.
    Shorey, Shefaly
    Natl Univ Singapore, Natl Univ Hlth Syst, Yong Loo Lin Sch Med, Alice Lee Ctr Nursing Studies, Singapore, Singapore.
    Frostell, Anneli
    Linkoping Univ, Div Psychol, Dept Behav Sci & Learning, Linkoping, Sweden.
    Mörelius, Evalotte
    Linkoping Univ, Div Nursing Sci, Dept Social & Welf Studies, Norrkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.
    Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 7, article id e021606Article in journal (Refereed)
    Abstract [en]

    Introduction: Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.

    Methods and analysis: A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender.

    Ethics and dissemination: The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings.

  • 2.
    Baylis, Rebecca
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Ewald, Uwe
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gradin, Maria
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 10, p. 1045-1052Article in journal (Refereed)
    Abstract [en]

    AIM:

    Early parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU).

    METHODS:

    The study was part of a longitudinal project on Kangaroo Mother Care at two Swedish university hospitals. The parents of 81 infants completed questionnaires during their infants' hospital stay.

    RESULTS:

    Most parents saw and touched their infants immediately after birth, but only a few could hold them skin to skin or swaddle them. Other important events identified by parents included the first time they performed care giving activities and did so independently, interaction and closeness with the infant, signs of the infant's recovery and integration into the family. The timing of the events depended on the physical design of the NICU, whether parents' could stay with their infant round-the-clock and when they were allowed to provide care under supervision and on their own.

    CONCLUSION:

    The design and routines of the NICU dictated when parents first interacted with their infants. Clinical guidelines that facilitate early contact with preterm babies can help parents to make the transition to their parental role.

  • 3.
    Biskop, Emilia
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Paulsdotter, Therese
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Hellström-Westas, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Ågren, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Parental participation during therapeutic hypothermia for neonatal hypoxicischemic encephalopathy2019In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, p. 77-80Article in journal (Refereed)
    Abstract [en]

    Objectives: To examine parental participation in the care of newborn infants receiving therapeutic hypothermia, and to explore the possible impact of in-born vs out-born status, and location of hospital accommodation. Study design: Retrospective, quantitative and descriptive design. Main outcome measures: Infants medical charts were reviewed for defined aspects of parental participation (infant holding, tube feeding, and diaper change), and related to their in-born vs out-born status, and whether the parents were accommodated in the NICU or elsewhere. All infants have been cared for at the University Hospital Neonatal Intensive Care Unit, serving as a regional referral center for hypothermia treatment. This study is a part of a population-based regional cohort of asphyxiated newborn infants (n = 112) that received therapeutic hypothermia in 2007-2015. Results: Parents engaged in holding (60/112, 54%) or tube feeding (59/112, 53%) their infant. Parents of inborn infants (24/112, 21%) were more likely to check the placement of the feeding tube (11/24, 46% vs 15/88, 17%; p < 0.01) and change diapers (9/24, 38% vs 14/88, 16%; p < 0.05) than parents of out-born infants (88/112, 79%). A similar pattern of more extensive involvement was observed for both mothers and fathers who stayed at the neonatal intensive care compared to those accommodated elsewhere (p < 0.05). Conclusions: Active parental participation is feasible at the NICU even during therapeutic hypothermia. Timely postnatal transfer of parents of out-born/transported infants, and the provision of on-site accommodation may influence the quality of parental involvement.

  • 4.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Ewald, Uwe
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gradin, Maria
    Örebro Medical Centre Hospital, Örebro, Sweden.
    Nyqvist, Kerstin Hedberg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Initiation and extent of skin-to-skin care at two Swedish neonatal intensive care units2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 1, p. 22-28Article in journal (Refereed)
    Abstract [en]

    AIM:

    To describe initiation and extent of parents' application of skin-to-skin care (SSC) with their preterm infants at two Swedish neonatal intensive care units.

    METHODS:

    The duration of SSC was recorded in 104 infants' medical charts during their hospital stay, and the parents answered a questionnaire.

    RESULTS:

    Both parents were involved in the practice of SSC. Three infants experienced SSC directly after birth, 34 within 1 h, 85 within 24 h and the remaining 19 at 24-78 h postbirth. SSC commenced earlier (median age of 50 min) in infants whose first SSC was with their father instead of with their mother (median age of 649 min: p < 0.001). The earlier the SSC was initiated, the longer the infant was cared for skin-to-skin per day during his/her hospital stay (p < 0.001). The median daily duration of SSC was 403 min.

    CONCLUSION:

    Early initiation of SSC had positive impact on the extent of parents' application of SSC. Even though the infants in this study were cared for skin-to-skin to a high extent, there is a potential for extended use of SSC in this type of hospital setting for reducing separation between infants and parents.

  • 5.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Funkquist, Eva-Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 2, p. 223-228Article in journal (Refereed)
    Abstract [en]

    AIM: This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home.

    METHODS: The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index.

    RESULTS: Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months.

    CONCLUSION: Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.

  • 6.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Nyqvist, Kerstin Hedberg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Swedish mothers' experience of continuous Kangaroo Mother Care2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 9-10, p. 1472-1480Article in journal (Refereed)
    Abstract [en]

    Aims. To characterise the first infants receiving continuous Kangaroo Mother Care from birth to discharge in a Swedish neonatal intensive care unit and to investigate their mothers' experiences of this model of care. Background.  Admission of a newborn infant to a neonatal intensive care unit commonly implies separation of the new mother from her infant. Kangaroo Mother Care is a model of neonatal care which supports the parental role as primary care-giver and contributes to minimising the separation between the infant and parents. Design. A retrospective survey design. Method. A purposive sample consisting of 23 mother-infant pairs. Relevant infant data were obtained from their medical records. A questionnaire with questions about the infant's care and regarding Kangaroo Mother Care was designed for this study. Results.  The infants were born at a gestational age of 31-41 weeks, birth weight ranging from 1715-3700 g. The mothers of these moderately preterm and ill newborn infants showed good acceptance of the idea of providing their infants with continuous Kangaroo Mother Care during their stay at the neonatal intensive care unit. The mothers' evaluations of this method were predominantly positive. Negative comments concerned lack of information about practical application of the method, and some mothers perceived their infants' care during the night as exhausting. No mother would have preferred not to perform continuous Kangaroo Mother Care or to terminate Kangaroo Mother Care earlier than they did. Conclusions. These mothers accepted this model of care very well, provided that they received the help and support they required. Relevance to clinical practice.  Mothers whose infants are admitted to an neonatal intensive care units in settings similar to the study setting should be offered opportunities to be present and provide Kangaroo Mother Care for their infants, to the extent that they are able and willing to do so and as permitted by the infant's medical condition and care.

  • 7.
    Blomqvist, Ylva Thernström
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Nyqvist, Kerstin Hedberg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Parent-infant skin-to-skin contact: how do parent records compare to nurse records?2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 5, p. 773-775Article in journal (Refereed)
  • 8.
    Blomqvist, YlvaThernström
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Kylberg, Elisabeth
    Jöreskog, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Disability Research.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 9, p. 1988-1996Article in journal (Refereed)
    Abstract [en]

    Aim. 

    This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care.

    Background. 

    During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother Care makes them feel an important participant in their infants’ care.

    Method. 

    Individual interviews conducted in 2009 with seven fathers who performed Kangaroo Mother Care were analysed using qualitative content analysis.

    Results. 

    The fathers’ opportunity for being close to their infants facilitated attainment of their paternal role in the neonatal intensive care unit. Kangaroo Mother Care allowed them to feel in control and that they were doing something good for their infant, although the infant’s care could be demanding and stressful. As active agents in their infant’s care, some fathers stayed with the infant during the whole hospital stay, others were at the neonatal intensive care unit all day long. Despite the un-wished-for situation, they adapted to their predicament and spent as much time as possible with their infants.

    Conclusion. 

    Fathers’ opportunities for Kangaroo Mother Care helped them to attain their paternal role and to cope with the unexpected situation. The physical environment and conflicting staff statements influenced their opportunity for, and experience of, caring for their preterm infants.

  • 9.
    Larsson, Christina
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Karlsson, Victoria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Nurse Decision Making and Attitudes About Circuit Disconnection During Ventilator Therapy at a Swedish Neonatal Intensive Care Unit2018In: Advances in Neonatal Care, ISSN 1536-0903, E-ISSN 1536-0911, Vol. 18, no 6, p. E13-E20Article in journal (Refereed)
    Abstract [en]

    Background: There are many challenges to providing care to infants in need of ventilator therapy. Yet, few studies describe the practical handling of the ventilator circuit during nursing care.

    Purpose: To describe neonatal intensive care unit (NICU) nurses' decision making regarding whether or not to disconnect the ventilator circuit when changing the infant's position and to investigate the grounds for their decisions.

    Methods: A descriptive questionnaire study with both quantitative and qualitative elements was conducted. In 2015, a convenience sample of nurses working in an NICU completed a questionnaire including both closed-ended and open-ended, free-text questions. Answers to the closed-ended questions were analyzed with descriptive statistics, whereas answers to the free-text questions were analyzed using qualitative content analysis.

    Results: Nurses' decisions on whether to disconnect or keep the ventilator circuit closed were based on the infant's needs for ventilator support. The nurses gave several reasons and motivations both for why they disconnected the circuit and for why they did not. The handling of the circuit and the reasons and motivations given were inconsistent among the nurses.

    Implications for Practice: This study highlights the need for continuous, repetitive education and training for NICU nurses, as well as demonstrating the importance of clear and distinct guidelines and working methods regarding the care of infants on ventilator support.

    Implications for Research: Future research should continue to find ways of working and handling an infant on ventilator support that are least harmful to the infant.

  • 10.
    Larsson, Christina
    et al.
    Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Wågstrom, Ulrika
    Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Normann, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Univ Hosp, Neonatal Intens Care Unit, S-75185 Uppsala, Sweden..
    Parents experiences of discharge readiness from a Swedish neonatal intensive care unit2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 2, p. 90-95Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe how parents experienced the support at, and preparation for discharge from, the NICU and how they experienced the first time at home. Design: A qualitative design with quantitative elements was applied. Methods: A questionnaire study. Data were analysed using qualitative content analysis with quantitative elements. Results: The majority of included parents felt adequately prepared for going home and sufficiently supported during the first period home. Negative experiences were related to lack of time for preparation, lack of support and information, especially about the infant's food intake, breastfeeding, and tube feeding, and lack of follow-up counselling post discharge. This study supports that parents who are closely involved in their infant's care at the NICU, and who stay with the infant at the NICU around the clock, are well prepared for the transition to home.

  • 11. Mode, R. Ignell
    et al.
    Mard, E.
    Nyqvist, Kerstin Hedberg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Blomqvist, Ylva Thernström
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Fathers' perception of information received during their infants' stay at a neonatal intensive care unit2014In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, no 3, p. 131-136Article in journal (Refereed)
    Abstract [en]

    Objective: To explore fathers' perception of information received during their infants' care at a neonatal intensive care unit (NICU). Methods: An inductive, qualitative and descriptive study. Eight fathers in two units were interviewed. The infants' gestational age at birth ranged between 23 and 36 weeks. Data were collected through semi-structured, individual interviews and were analyzed by qualitative content analysis. Results: Three categories were identified: perception of information, perception of the source of information, and circumstances influencing the perception of information. Information had an important impact; comprehensible and adequate information increased the fathers' knowledge, which generated a sense of control. Early information about the infant's care was particularly important and positively affected father and infant bonding. Conclusion and practical implications: Ensuring a high quality of information is an important task for NICU staff. Fathers' perception of the quality of information depended on the contents of the information and how it was conveyed. Comprehensible information at the onset of the infant's hospital stay increased the fathers' sense of security, and made them feel in control. It is important that the staff strive to identify what information the father requires, and prevent situations when fathers feel uncertainty about what the staff expect from them.

  • 12.
    Noren, Josefine
    et al.
    Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation Research.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Blomqvist, Ylva Thernström
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden.
    Becoming a mother: Mothers' experience of Kangaroo Mother Care2018In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 181-185Article in journal (Refereed)
    Abstract [en]

    Objective: To describe mothers' experiences of providing their preterm infants with Kangaroo Mother Care (KMC).

    Study design: A qualitative descriptive design.

    Setting: Two level III neonatal intensive care units (NICUs) in Sweden.

    Participants: Thirteen mothers of preterm infants.

    Methods: The mothers were interviewed when their infant had reached a corrected age of 4 months +/- 2 weeks. The interviews were recorded and transcribed and data were analyzed using qualitative content analysis.

    Results: The mothers described the skin-to-skin contact with, and closeness to, the preterm infant as something they valued, and involuntary physical separation as something they had to accept and adapt to. Providing the infant with breast milk by expressing and tube feeding was experienced as time-consuming and as impinging on the skin-to-skin contact.

    Conclusion: Mothers want to stay close to their preterm infant. The NICU environment and staff can facilitate KMC by providing a private space for parents and infants, and enable mothers to breastfeed and express breast milk by giving them support based on science and proven experience.

  • 13.
    Norman, Mikael
    et al.
    Karolinska Inst, Div Pediat, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Neonatal Med, Stockholm, Sweden;Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden.
    Källén, Karin
    Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden;Lund Univ, Ctr Reprod Epidemiol, Lund, Sweden.
    Wahlström, Erik
    Natl Board Hlth & Welf, Stockholm, Sweden.
    Håkansson, Stellan
    Vasterbotten Cty Council, Swedish Neonatal Qual Register SNQ, Umea, Sweden;Umea Univ, Dept Clin Sci, Div Pediat, Umea, Sweden.
    Skiöld, Beatrice
    Swedish Neonatal Soc, Stockholm, Sweden;Karolinska Inst, Stockholm, Sweden.
    Navér, Lars
    Karolinska Inst, Stockholm, Sweden.
    Domellöf, Magnus
    Umea Univ, Umea, Sweden.
    Abrahamsson, Thomas
    Linkoping Univ, Linkoping, Sweden.
    Stigson, Lennart
    Gothenburg Univ, Gothenburg, Sweden.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Nyholm, Annika
    Umea Univ, Umea, Sweden.
    Ingemansson, Fredrik
    Jonkoping Acad, Jonkoping, Sweden.
    Holmström, Gerd
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Söderberg: Ophthalmic Biophysics.
    Björklund, Lars
    Lund Univ, Lund, Sweden.
    Wikström, Anna-Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Obstetrics.
    Wallin-Gyökeres, Annica
    Parent Representat, Stockholm, Sweden.
    The Swedish Neonatal Quality Register - contents, completeness and validity2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 8, p. 1411-1418Article in journal (Refereed)
    Abstract [en]

    Aim: To describe the Swedish Neonatal Quality Register (SNQ) and to determine its completeness and agreement with other registers.

    Methods: SNQ collects data for infants admitted to neonatal units during the first four postnatal weeks. Completeness and registers' agreement were determined cross-linking SNQ data with Swedish population registers (the Inpatient, Medical Birth and Cause of Death Registers) for a study period of five years.

    Results: In total, 84 712 infants were hospitalised. A total of 52 806 infants occurred in both SNQ and the population registers; 28 692 were only found in the population registers, and 3214 infants were only found in SNQ. Between gestational weeks 24-34, completeness of SNQ was 98-99%. Below and above these gestational ages, completeness was lower. Infants missing in SNQ were term or near-term in 99% of the cases, and their diagnoses indicated conditions managed in maternity units, or re-admissions for acute infections, managed in paediatric units. For most diagnoses, the agreement between SNQ and population registers was high, but some (bronchopulmonary dysplasia and grade of hypoxic-ischaemic encephalopathy) were often missing in the population registers.

    Conclusion: SNQ completeness and agreement against other registers, especially for preterm infants, is excellent. SNQ is a valid tool for benchmarking, quality improvement and research.

  • 14.
    Oras, Paola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gradin, Maria
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Hellström-Westas, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Funkquist, Eva-Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks2015In: Journal of Human Lactation, ISSN 0890-3344, E-ISSN 1552-5732, Vol. 31, no 3, p. 377-385Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support.

    OBJECTIVE:

    This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age.

    METHODS:

    As part of a larger study on kangaroo mother care in Sweden, a 24-hour breastfeeding diary was sent home after discharge from hospital, and at 2, 6, and 12 months of the infant's corrected age. Eighty-three mothers responded to the follow-up questionnaires, and the number of respondents to the breastfeeding diary was 48 at discharge, 43 at 2 months, 22 at 6 months, and 8 at 12 months. Infants were born at a median (range) gestational age of 32 (28-33) weeks. Breastfeeding patterns were analyzed according to durations, frequencies per 24 hours, and intervals between sessions.

    RESULTS:

    In exclusively breastfed infants, the median (range) breastfeeding session frequency was 14 (8-26) times per 24 hours including 4 (1-9) times per night after discharge (n = 24) and 10 (6-25) times per 24 hours including 2 (0-5) times per night at 2 months (n = 23). In partially breastfed infants, the median (range) frequency was 5 (1-14) times per 24 hours including 2 (0-4) times per night at 6 months (n = 20) and 5.5 (1-12) times per 24 hours including 2 (0-3) times per night at 12 months (n = 8).

    CONCLUSION:

    Mothers reported large variations in breastfeeding patterns, with higher median breastfeeding session frequencies than previously described in term infants in affluent settings.

  • 15.
    Oras, Paola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gradin, Maria
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Hellström-Westas, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Funkquist, Eva-Lotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 7, p. 783-789Article in journal (Refereed)
    Abstract [en]

    AIM:

    This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored.

    METHODS:

    A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28+0 to 33+6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records and follow-up questionnaires were filled in by parents.

    RESULTS:

    The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35+0 (32+1 to 37+5) weeks of postmenstrual age and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p<0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding.

    CONCLUSION:

    A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.

  • 16. Strand, H
    et al.
    Blomqvist, Ylva Thernström
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Gradin, M
    Nyqvist, Kerstin Hedberg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kangaroo mother care in the neonatal intensive care unit: staff attitudes and beliefs and opportunities for parents2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 4, p. 373-378Article in journal (Refereed)
    Abstract [en]

    AIM: To compare attitudes towards Kangaroo mother care (KMC) among staff in two high-tech neonatal intensive care units, which provided parents with different opportunities to get involved in their infants' care.

    METHOD: Questionnaires were completed by healthcare staff in Unit A, which provided parents with unrestricted access so that they could provide continuous KMC, and Unit B, where parents could only practice KMC intermittently.

    RESULTS: Unit A staff were more positive about the benefits and use of KMC, including its use in unstable infants, and rated their knowledge and practical skills more highly than staff in the other unit. Unit B staff also appreciated the method, but expressed more hesitation in using it with unstable infants. In particular, they stressed the need to adapt the physical environment of the NICU to enable parents to stay with their infants and practice the method.

    CONCLUSION: Staff working in the NICU that gave parents unrestricted access were more positive about KMC than staff in the NICU that offered limited opportunities for parents to stay with their children. This finding suggests that it is important to eliminate unjustifiable obstacles to the presence of parents in the NICU, so that they can provide KMC.

  • 17.
    Thernström Blomqvist, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Kangaroo Mother Care: Parents’ experiences and patterns of application in two Swedish neonatal intensive care units2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Kangaroo Mother Care (KMC) is an alternative model of care that prevents parent-infant separation when preterm infants need neonatal intensive care by skin-to-skin contact between infants and their parents. KMC is also a strategy that involves parents in their infants’ care and enables them to assume the responsibility for the care. Furthermore, KMC promotes parent-infant bonding and attachment.

    The overall aim of this thesis was to gain a deeper understanding and knowledge about parents’ capacity, willingness, and experiences of KMC and to which extent parents choose to use KMC throughout their infants' hospital stay. These studies were conducted in the NICUs at two Swedish university hospitals (NICU A and NICU B).

    Mothers of infants cared for at NICU A (n=17) answered a questionnaire about their experiences of KMC (Paper I). Twenty parents of infants cared for at NICU A recorded the duration of each KMC session during a period of 24 hours and the identity the KMC provider (Paper II). Seven fathers were interviewed about their experiences of KMC (Paper III) and 76 mothers and 74 fathers completed a questionnaire about what facilitated or rendered it difficult to perform KMC (Paper IV). The time of initiation of KMC and duration in minutes, and the identity of the KMC providers was recorded continuously during the infants’ (n=104) hospital stay: 83 mothers and 80 fathers also completed a questionnaire during their infants’ hospital stay (Paper V).

    This thesis provides new knowledge about parents’ practice of KMC, also continuously day and night, in a high tech NICU in an affluent society, with good resources for infant care in an incubator by trained staff. The accuracy of parents’ records of KMC were comparable to nurses’ records. The results indicate that parents want to be together with their infant in the NICU and be actively involved in the infants’ care. Although parents may experience KMC as exhausting and uncomfortable, they still prefer KMC to conventional neonatal intensive care as it supports their parental role. Early initiation of KMC after birth appears to result in a longer total duration of KMC during the infants’ hospital stay.

    List of papers
    1. Swedish mothers' experience of continuous Kangaroo Mother Care
    Open this publication in new window or tab >>Swedish mothers' experience of continuous Kangaroo Mother Care
    2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 9-10, p. 1472-1480Article in journal (Refereed) Published
    Abstract [en]

    Aims. To characterise the first infants receiving continuous Kangaroo Mother Care from birth to discharge in a Swedish neonatal intensive care unit and to investigate their mothers' experiences of this model of care. Background.  Admission of a newborn infant to a neonatal intensive care unit commonly implies separation of the new mother from her infant. Kangaroo Mother Care is a model of neonatal care which supports the parental role as primary care-giver and contributes to minimising the separation between the infant and parents. Design. A retrospective survey design. Method. A purposive sample consisting of 23 mother-infant pairs. Relevant infant data were obtained from their medical records. A questionnaire with questions about the infant's care and regarding Kangaroo Mother Care was designed for this study. Results.  The infants were born at a gestational age of 31-41 weeks, birth weight ranging from 1715-3700 g. The mothers of these moderately preterm and ill newborn infants showed good acceptance of the idea of providing their infants with continuous Kangaroo Mother Care during their stay at the neonatal intensive care unit. The mothers' evaluations of this method were predominantly positive. Negative comments concerned lack of information about practical application of the method, and some mothers perceived their infants' care during the night as exhausting. No mother would have preferred not to perform continuous Kangaroo Mother Care or to terminate Kangaroo Mother Care earlier than they did. Conclusions. These mothers accepted this model of care very well, provided that they received the help and support they required. Relevance to clinical practice.  Mothers whose infants are admitted to an neonatal intensive care units in settings similar to the study setting should be offered opportunities to be present and provide Kangaroo Mother Care for their infants, to the extent that they are able and willing to do so and as permitted by the infant's medical condition and care.

    Keywords
    babies, midwifery, mothers, nurses, nursing, Sweden
    National Category
    Nursing
    Identifiers
    urn:nbn:se:uu:diva-140796 (URN)10.1111/j.1365-2702.2010.03369.x (DOI)000289630400029 ()21118321 (PubMedID)
    Available from: 2011-01-10 Created: 2011-01-10 Last updated: 2019-06-28Bibliographically approved
    2. Parent-infant skin-to-skin contact: how do parent records compare to nurse records?
    Open this publication in new window or tab >>Parent-infant skin-to-skin contact: how do parent records compare to nurse records?
    2011 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 5, p. 773-775Article in journal (Refereed) Published
    National Category
    Nursing
    Identifiers
    urn:nbn:se:uu:diva-152867 (URN)10.1111/j.1651-2227.2011.02160.x (DOI)000289250200030 ()21375581 (PubMedID)
    Available from: 2011-05-02 Created: 2011-05-02 Last updated: 2019-06-28Bibliographically approved
    3. Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role
    Open this publication in new window or tab >>Kangaroo Mother Care helps fathers of preterm infants gain confidence in the paternal role
    Show others...
    2012 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 9, p. 1988-1996Article in journal (Refereed) Published
    Abstract [en]

    Aim. 

    This article is a report on a descriptive study of fathers’ experiences of providing their preterm infants with Kangaroo Mother Care.

    Background. 

    During neonatal intensive care, fathers describe the incubator as a barrier and the separation from their infant as stressful. Fathers consider it important to be close to the infant, and performing Kangaroo Mother Care makes them feel an important participant in their infants’ care.

    Method. 

    Individual interviews conducted in 2009 with seven fathers who performed Kangaroo Mother Care were analysed using qualitative content analysis.

    Results. 

    The fathers’ opportunity for being close to their infants facilitated attainment of their paternal role in the neonatal intensive care unit. Kangaroo Mother Care allowed them to feel in control and that they were doing something good for their infant, although the infant’s care could be demanding and stressful. As active agents in their infant’s care, some fathers stayed with the infant during the whole hospital stay, others were at the neonatal intensive care unit all day long. Despite the un-wished-for situation, they adapted to their predicament and spent as much time as possible with their infants.

    Conclusion. 

    Fathers’ opportunities for Kangaroo Mother Care helped them to attain their paternal role and to cope with the unexpected situation. The physical environment and conflicting staff statements influenced their opportunity for, and experience of, caring for their preterm infants.

    Keywords
    father, infant, Kangaroo Mother Care, neonatal intensive care unit, nursing
    National Category
    Nursing
    Identifiers
    urn:nbn:se:uu:diva-164073 (URN)10.1111/j.1365-2648.2011.05886.x (DOI)000306806000009 ()22111919 (PubMedID)
    Available from: 2011-12-15 Created: 2011-12-15 Last updated: 2019-06-28
    4. Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents
    Open this publication in new window or tab >>Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents
    2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 345-353Article in journal (Refereed) Published
    Abstract [en]

    Background:

    Kangaroo Mother Care supports parents’ role at the neonatal intensive care unit. To enhance parents’ provision of Kangaroo Mother Care, it is essential to obtain knowledge of what parents perceive as supportive factors and barriers regarding their opportunities to perform Kangaroo Mother Care.

    Aim:

    To identify factors that parents of preterm infants perceived as supportive factors or barriers for their performance of Kangaroo Mother Care and to explore the timing of and reasons for parents’ discontinuation of Kangaroo Mother Care.

    Methods:

    A descriptive study performed at two neonatal intensive care units in Sweden with 76 mothers and 74 fathers of preterm infants born at gestational ages ranging from 28 to 33 weeks. Data on infant characteristics were obtained from the infants’ medical records. A questionnaire, based on scientific literature and the researchers’ clinical experience, was completed by the mothers and the fathers separately, shortly after the infant’s discharge from the hospital. The data was analyzed with qualitative content analysis and descriptive statistic.

    Results:

    Four categories were identified in parents’ responses regarding support and barriers for their performance of KMC: Parent related factors, Time, Infants related factors and The NICU and home environment. The hospital staff and environment were described by the parents as both supportive and barriers for their application of Kangaroo Mother Care. Some mothers described the infants’ feeding process as an obstacle to Kangaroo Mother Care. Sleeping with the infant skin-to-skin in the same position throughout the night could be difficult, as an uncomfortable sleeping position caused insufficient sleep. A majority of both mothers and fathers continued providing their infant with Kangaroo Mother Care to some extent after discharge.

    Keywords
    Kangaroo Mother Care, Neonatal, Preterm Infants, Parents
    National Category
    Pediatrics
    Research subject
    Pediatrics
    Identifiers
    urn:nbn:se:uu:diva-179516 (URN)10.1111/j.1471-6712.2012.01040.x (DOI)000318815700018 ()22816503 (PubMedID)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2019-06-28Bibliographically approved
    5. Kangaroo Mother Care in two Swedish NICUs
    Open this publication in new window or tab >>Kangaroo Mother Care in two Swedish NICUs
    Show others...
    2012 (English)Article in journal (Other academic) Submitted
    Abstract [en]

    Aim:

    To describe initiation and the extent of parents’ application of Kangaroo Mother Care (KMC).

    Methods:

    The exact duration of which 104 preterm infants were cared for skin-to-skin was recorded in the infants’ medical charts during their hospital stay: the parents answered a questionnaire.

    Results:

    Both parents were involved in the practice of KMC. Three infants experienced KMC directly after birth, 34 within one hour, 85 within 24 hours, and the remaining 19 infants at 24 – 78 h post birth. KMC commenced earlier (median age of 50 minutes) in infants whose first KMC contact was with their father than with their mother (median age of 649 minutes: p < 0.000). The earlier KMC was initiated, the more the infant was cared for with KMC per day during his/her hospital stay (p < 0.000). The median daily duration of KMC was 403 minutes.

    Conclusion:

    Early initiation of KMC had a positive impact on the extent of parents’ application of the method. Even though the infants in this study were cared for with KMC to a high extent there is a potential for extended use of KMC in this type of hospital setting for reducing separation between infants and parents.

    Keywords
    Kangaro Mother Care, Parenting, Neonatal Intensive Care Unit
    National Category
    Pediatrics
    Research subject
    Pediatrics
    Identifiers
    urn:nbn:se:uu:diva-179517 (URN)
    Available from: 2012-08-17 Created: 2012-08-17 Last updated: 2012-09-20Bibliographically approved
  • 18.
    Thernström Blomqvist, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Frölund, Lovisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Hedberg Nyqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Provision of Kangaroo Mother Care: supportive factors and barriers perceived by parents2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 345-353Article in journal (Refereed)
    Abstract [en]

    Background:

    Kangaroo Mother Care supports parents’ role at the neonatal intensive care unit. To enhance parents’ provision of Kangaroo Mother Care, it is essential to obtain knowledge of what parents perceive as supportive factors and barriers regarding their opportunities to perform Kangaroo Mother Care.

    Aim:

    To identify factors that parents of preterm infants perceived as supportive factors or barriers for their performance of Kangaroo Mother Care and to explore the timing of and reasons for parents’ discontinuation of Kangaroo Mother Care.

    Methods:

    A descriptive study performed at two neonatal intensive care units in Sweden with 76 mothers and 74 fathers of preterm infants born at gestational ages ranging from 28 to 33 weeks. Data on infant characteristics were obtained from the infants’ medical records. A questionnaire, based on scientific literature and the researchers’ clinical experience, was completed by the mothers and the fathers separately, shortly after the infant’s discharge from the hospital. The data was analyzed with qualitative content analysis and descriptive statistic.

    Results:

    Four categories were identified in parents’ responses regarding support and barriers for their performance of KMC: Parent related factors, Time, Infants related factors and The NICU and home environment. The hospital staff and environment were described by the parents as both supportive and barriers for their application of Kangaroo Mother Care. Some mothers described the infants’ feeding process as an obstacle to Kangaroo Mother Care. Sleeping with the infant skin-to-skin in the same position throughout the night could be difficult, as an uncomfortable sleeping position caused insufficient sleep. A majority of both mothers and fathers continued providing their infant with Kangaroo Mother Care to some extent after discharge.

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