Barriers to Kangaroo Care in the NICU: A Qualitative Study Analyzing Parent Survey Responses : Advances in Neonatal Care

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Barriers to Kangaroo Care in the NICU

A Qualitative Study Analyzing Parent Survey Responses

Saltzmann, April M. RN, MSN, NNP-BC; Sigurdson, Krista PhD; Scala, Melissa MD

Editor(s): Dowling, Donna PhD, RN, Section Editors; Newberry, Desi M. DNP, NNP-BC, Section Editors; Parker, Leslie PhD, APRN, FAAN, Section Editors

Author Information
Advances in Neonatal Care 22(3):p 261-269, June 2022. | DOI: 10.1097/ANC.0000000000000907



Despite its benefits, parents in the neonatal intensive care unit (NICU) face significant barriers to kangaroo care (KC). Clinician-reported barriers to KC include staff education, environment, and equipment among others; however, parent-perceived barriers are underexplored.


To examine parental understanding of KC, parental perception of experiences with KC, and parental views on the key factors that help or hinder KC.


This is an observational, mixed-methods study that used an author-developed survey to assess parental feelings, perceived importance, and barriers to KC. Likert scale responses were analyzed using descriptive statistics. Free-text responses were analyzed using thematic analysis. A comparison of results was made between parents receiving and not receiving infant mental health services.


Fifty (N = 50) parents completed surveys. Eighty percent of parents stated they wanted more information on KC. Common barriers to KC were reported by parents, such as issues with space/environment. The most frequently reported barrier when asked openly was fear of hurting their infant. Ninety-six percent of parents believed that KC helped their emotional well-being. Parents receiving mental health services reported more fear but results did not reach significance.

Implications for Practice and Research: 

The frequency with which factors are reported as important to parents may allow a prioritization of barriers to KC, which may help focus quality improvement initiatives. The results of this study underscore the vital role nurses play in supporting KC. Additional attention needs to be given to the mental health of NICU parents and its impact on care practices.

© 2021 by The National Association of Neonatal Nurses.

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