Running Head: Appraising The Evidence 19 Permission Was Rece

Running Head Apprasing The Evidence19permission Was Received By Stu

Permission was received by student to share this paper on July 15th, 2015 --NG Kangaroo Care vs. Infant Warmers in Reducing Mortality in Low Birth Weight Infants XXXXXXXXXXXX School Class Date Kangaroo Care vs. Infant Warmers in Reducing Mortality in Low Birth Weight Infants Clinical Question The specific clinical question guiding the search for a quantitative article is: In low birth weight babies, does kangaroo mother care improve heart rate, oxygen saturation, respiration, and temperature? The specific clinical question guiding the search for a qualitative article is: In mothers of premature infants in the NICU, what is the experience of kangaroo holding. Problem The problem this paper addresses is whether kangaroo care is an effective measure in increasing thermoregulation among low birth weight infants, thus reducing infant mortality.

The significance of this problem is that low birth weight infants are less likely to achieve thermoregulation on their own and require specific interventions in regulating their body temperature. The World Health Organization (WHO) supported a study in Nepal in which an increased mortality was noted across all grades of hypothermia, and the risk was twelve times higher among preterm babies (Bera, et al., 2014). Interventions that may help reduce infant mortality related to ineffective thermoregulation include kangaroo care or infant warmers. According to Nimbalkar, et al. (2014), early skin to skin contact (SSC) can reduce the incidence of hypothermia in newborns within the first 48 hours of life and can contribute in the reduction of neonatal mortality due to hypothermia.

The major pathophysiology of hypothermia in the newborn is the disturbance of its regulated temperature inside the womb to the sudden exposure to the colder environment outside the mother’s womb. At birth, newborns have limited control over regulating their own body temperature and require assistance through other means to help keep their body temperature up. The first 24 to 48 hours of life, especially in low birth weight infants, is the most crucial in preventing hypothermia, thus reducing the possibility of death. The purpose of this paper is to interpret the quantitative and qualitative articles identified to see whether they are or are not important to our group topic. The paper will compare and contrast the main components of the matrix table.

Paper For Above instruction

Description of Findings Concepts

The independent variable studied between both quantitative and qualitative articles is kangaroo care. The quantitative describes how kangaroo care can impact a low birth weight infant and the 4 physiological parameters: heart rate, oxygen saturation, respiration, and temperature, which is the dependent variable. The variable of interest studied in the qualitative article is the mother’s reactions and/or experiences of kangaroo holing their preterm infant in the NICU. The concept of this study was for the mothers to express any behaviors or interactions while kangaroo holding.

Methods

The methods used between the quantitative and qualitative articles are studied differently from one another. The study design used in the quantitative article is a quasi-experimental with before and after subjects serving as their own control. Before the mothers participated they were counseled on the benefits of kangaroo mother care and then volunteer mothers demonstrated kangaroo mother care (Bera et al., 2014). Once mothers signed the consent to participate, they were asked to wear an open front dress with their babies in nothing but a cap, socks, and nappy. The mothers then placed their infant in a “frog like” position on their bare chest, with the baby in a flexed position. Data were obtained on days 1 with one hour of kangaroo mother care, day 2 with two hours of kangaroo care, and day 3 with three hours of kangaroo mother care. This procedure continued for as long as the mother felt comfortable during kangaroo mother care. Mothers who felt uncomfortable were allowed another demonstration and ones that failed after multiple demonstrations were withdrawn (Johnson, 2007).

The study design collected for the qualitative article was phenomenology. This method was used to describe the lived experiences of mothers and how kangaroo holding impacted their understanding of the advantage and importance it serves to preterm infants. The mothers were interviewed after their third sixty minute session of kangaroo holding in the NICU (Johnson, 2007). Data was collected from the mother’s behavior and interactions that were observed unobtrusively and then analyzed and recorded for content analysis. Participants

The participants studied in the quantitative article included low birth weight babies born at the Institute of Postgraduate Medical Education and Research, Kolkata, and its associated SSKM Hospital, and mothers of these babies (Bera et al., 2014). The sample included 265 mother-baby pairs selected through purposive sampling over 3 years to collect data for the research. In comparison, the qualitative article interviewed eighteen mothers who kangaroo held their premature infants in the NICU over 5 months (Johnson, 2007).

The difference between the quantitative study and the qualitative study is the quantitative studies focus on both the mother and the baby and the effect kangaroo care has on physiological parameters, whereas the qualitative article only focuses on the mother’s interactions and thoughts on kangaroo holding their preterm infants.

Instruments

The instruments used in the quantitative study are the 4 physiological parameters: heart rate, oxygen saturation, respiration, and temperature. These were assessed immediately before and after kangaroo mother care was implemented over 3 consecutive days. Axillary temperature was measured with a digital thermometer, respirations by chest rise and fall for one minute, and heart rate and oxygen saturation through pulse oximetry (Bera et al., 2014). The instrument used in the qualitative study was open-ended, transcribed audiotaped, face-to-face interviews. The interviews were transcribed verbatim, with audiotapes played again to verify accuracy. Transcriptions were coded by descriptive phrases for content analysis, and themes were derived from participant responses (Johnson, 2007).

Evidence

The quantitative article by Bera et al. assessed the physiological parameters of low birth weight babies; mean temperature increased from 36.5°C to 36.9°C after kangaroo care on day 1, with statistical significance (p

Both studies support the hypothesis that kangaroo care benefits low birth weight infants physiologically and enhance maternal perceptions. The quantitative data demonstrated significant physiological improvements, while the qualitative findings revealed positive maternal experiences, emphasizing the importance of support and education for mothers in the NICU.

In terms of clinical practice, these findings advocate for integrating kangaroo care into neonatal health protocols, especially in resource-limited settings where traditional incubator care may be less accessible. For example, the WHO encourages kangaroo mother care for vulnerable infants, citing reductions in hypothermia and neonatal mortality (WHO, 2013). The combined evidence suggests that health practitioners should promote early skin-to-skin contact, educate mothers on its benefits, and create supportive environments that facilitate kangaroo care (Charpak et al., 2005; Conde-Agudelo et al., 2016).

Limitations acknowledged across studies include small sample sizes and observational designs, which restrict causality assertions. Despite these limitations, the consistency of outcomes across physiological measures and maternal reports indicates the potential for kangaroo care to improve neonatal health outcomes broadly. Future research should employ randomized controlled trials with larger, diverse populations and longitudinal follow-ups to ascertain long-term benefits (Feldman et al., 2016).

In conclusion, the evidence strongly supports kangaroo mother care as a safe, effective, and beneficial intervention to improve thermoregulation, vital signs, and maternal experiences with preterm infants. Healthcare providers should facilitate and encourage this practice to optimize survival and development outcomes for low birth weight infants, especially in settings with limited resources.

References

• Charpak, N., Ruiz, P., & Zupan, J. (2005). Kangaroo mother care. Seminars in Neonatology, 10(2), 129-137.
• Conde-Agudelo, A., Díaz-Rosselló, P., & Gutiérrez, L. (2016). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants: A systematic review. Cochrane Database of Systematic Reviews, (8), CD002405.
• Feldman, R., Weller, A., Sirota, L., & Eidelman, A. I. (2016). Skin-to-skin contact (kangaroo care) promotes physiologic and developmental regulation in preterm infants. Journal of Child Psychology and Psychiatry, 57(3), 414-423.
• Nimbalkar, S., Patel, V., Patel, D., Nimbalkar, A., Sethi, A., & Phatak, A. (2014). Effect of early skin-to-skin contact following normal delivery on incidence of hypothermia in neonates more than 1800 g: Randomized control trial. Journal of Perinatology, 34(2), 88-93. https://doi.org/10.1038/jp.2014.15
• World Health Organization (WHO). (2013). Recommendations for Obstetric Care in Low-Resource Settings. WHO Publications.
• Bera, A., Ghosh, J., Singh, A. K., Hazra, A., Som, T., & Munian, D. (2014). Effect of kangaroo mother care on vital physiological parameters of the low birth weight newborn. Indian Journal of Community Medicine, 39(4), 238-244. https://doi.org/10.4103/0970-0218.143030
• Johnson, A. (2007). The maternal experience of kangaroo holding. Journal of Obstetric, Gynecologic & Neonatal Nursing, 36(6), 548-557. https://doi.org/10.1111/j.1552-6909.2007.00187.x
• Nimbalkar, S., et al. (2014). Same as above.
• Additional references should include recent studies on kangaroo care and neonatal outcomes to complement this evidence.