Effect of Kangaroo Mother Care Versus Hammock Positioning
Condition: Behavior, Child
Study type: Interventional

Summary: 
      Aim

      This study aimed to investigate the effect of kangaroo mother care (KMC)versus hammock
      positioning (HP) on physiological indices and behavioral organization among preterm neonates.

      Hypotheses

      Preterm neonates who receive KMC exhibit more stable physiological indices and behavioral
      organization state than those who do not .

      Preterm neonates who receive HP exhibit more stable physiological indices and behavioral
      organization state than those who do not .

      Preterm neonates who receive KMC exhibit more stable physiological indices and behavioral
      organization state than those who receive HP.
    

Detailed description: 
      A quasi-experimental, pre-posttests, research design was carried out at the Neonatal
      Intensive Care Unit (NICU) of Specialized University Hospital . A sample of 90 preterm
      neonates were randomly assigned into three equal groups. The preterm neonates in the control
      group received the routine care of the NICU, which entails; encircling the neonate in a fetal
      position using rolled towel inside the incubator.

      For the KMC group:

      Researchers contacted the mother a day before applying KMC, and advised her to take shower
      and abstain from using perfumes before attending to the NICU. On days of KMC application, the
      researchers asked the mother to remove the upper clothes in a private room and put on an
      open-front gown and mask. The mother was assisted to sit in a comfortable chair with a soft
      backrest and footrest to prevent fatigue. Then, the preterm neonate was carefully put naked
      except for the head and diaper area on the mothers' bare chest with flexed arms and legs as
      in froglike position, and the head was turned sideways. The researchers wrapped and secured
      the mother's gown and put a blanket on the neonates' back to ensure neonatal thermal
      insulation. The mother was instructed to support the neonate's bottom with the right hand
      while supporting the head and neck with the other hand.

      For HP group:

      Researchers made a hammock by using a rectangular cotton cloth with ropes that passed through
      the circular openings of the incubator and tied on the upper part of it. After one hour of
      feeding, the preterm neonate was placed in a supine fetal position in the hammock where the
      head was supported in a neutral midline position by using rolled towel without neck
      hyperflexion or hyperextension. Moreover, the spine of the preterm neonate was supported
      while arms and knees were flexed.

      Kangaroo mother care and HP were performed in the morning shift for one hour from 10 am till
      11 am on three consecutive days. Behavioral states of preterm neonates were assessed in the
      three groups four times during the intervention at fixed intervals in order to minimize the
      measurement errors due to fluctuations in their behavioral states. In case of incidental
      neonatal distress, the intervention was discontinued. After one hour of applying KMC or HP,
      the preterm neonates were placed in the incubator as the routine NICU care. Finally,
      neonates' physiological indices and behavioral states in the three groups were recorded after
      15 min from the intervention using tools I&II. Data were collected over 12 months from March
      2020 till the end of February 2021.
    

Intervention name(s): Kangaroo Mother Care; Hammock Positioning; Routine Care of NICU
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): the preterm neonate was carefully put naked except for the head and diaper area on the mothers' bare chest with flexed arms and legs as in froglike position, and the head was turned sideways. The researchers wrapped and secured the mother's gown and put a blanket on the neonates' back to ensure neonatal thermal insulation; After one hour of feeding, the preterm neonate was placed in a supine fetal position in the hammock where the head was supported in a neutral midline position by using rolled towel without neck hyperflexion or hyperextension. Moreover, the spine of the preterm neonate was supported while arms and knees were flexed; ; encircling the neonate in a fetal position using rolled towel inside the incubator.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Kangaroo-Mother Care Method; Patient Positioning; Infant Behavior; Physiological; Premature; Neonatal Nursing