Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses

Abstract

Aims and objectives: To explore factors that impact nurses' knowledge, perceptions and practice related to kangaroo care in neonatal intensive care units in China.

Background: It is recognised extensively that kangaroo care is an effective intervention for improving the outcomes of preterm infants and has been recommended as a routine practice for neonatal care. However, this practice is uncommon in China and little is known about neonatal nurses' knowledge and attitude.

Design: A descriptive cross-sectional survey.

Methods: An online questionnaire was completed by 830 neonatal nurses. Data were analysed using measures of central tendency, dispersion, ANOVA, t tests and the general linear model.

Results: A total of 48.2% of the participants reported practicing kangaroo care. Range of score for each scale was knowledge 0-16 (M = 9.62), perceptions 28-103 (M = 79.99), barriers 17-85 (M = 65.40) and practice 11-55 (M = 34.44). Experience in using kangaroo care was a primary factor for the scores of four scales. Particularly, experienced nurses had higher level of knowledge and perceived less barriers. Respondents' role in neonatal intensive care units considerably influenced perceptions and practice level. Nurses' highest education and neonatal intensive care unit level also influenced the knowledge and practice score, separately. A major barrier to practice was the reluctance of physicians, nurses and parents.

Conclusion: Neonatal nurses' knowledge, attitude and practice levels related to kangaroo care were relatively low. Results suggested that leadership and knowledgeable practitioners could initiate education and clinical training to improve nurses' knowledge and awareness on the efficacy of kangaroo care. Moreover, initiatives and behaviours would be enhanced following increased knowledge and perceived value. Such barriers as the reluctance of medical staff may likewise be lowered or removed after experiencing kangaroo care.

Relevance to clinical practice: Neonatal nurses' knowledge and belief need to be improved for optimal practice of kangaroo care. Organisational support and clear guidelines are also in need for successful kangaroo care.

Keywords: kangaroo care; neonatal intensive care units; preterm infants; skin to skin care.