Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University, Stanford, CA.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.
J Dev Behav Pediatr. 2022;43(5):e304-e311. doi: 10.1097/DBP.0000000000001029. Epub 2021 Oct 28.
The aim of this study was to investigate whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the rate, frequency, and duration of kangaroo care (KC) in the neonatal intensive care unit (NICU) compared with preterm infants of higher SES or primarily English-speaking families.
Participants were infants born <32 weeks' gestational age (GA), N = 116. We defined SES by the infants' health insurance (private/higher vs public/lower) and language by the language mothers used to communicate with clinical staff (English vs Other language). SES or language groups were compared on (1) rate of KC infants experienced during hospitalization per visitation days, (2) frequency of KC per visitation days, and (3) duration of KC events per day.
Infants in the lower SES and Other language groups experienced KC in reduced amounts, lower frequencies, and shorter durations than infants in either the higher SES or English language groups. SES and language group differences remained significant after controlling for family visitation and GA at birth. After controlling for SES, language group differences in KC duration remained significant.
Our findings revealed disparities in the rate, frequency, and duration of KC experienced in the NICU as a function of both SES and language. Such disparities reduced infants' access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize these disparities.
本研究旨在调查家庭社会经济地位（SES）较低或与临床工作人员交流语言非英语的早产儿与 SES 较高或主要以英语为母语的家庭的早产儿相比，在新生儿重症监护病房（NICU）接受袋鼠式护理（KC）的比率、频率和持续时间是否存在差异。
参与者为胎龄<32 周的婴儿，n=116。我们通过婴儿的医疗保险（私人/较高 vs 公共/较低）来定义 SES，通过母亲与临床工作人员交流时使用的语言（英语 vs 其他语言）来定义语言。SES 或语言组在以下方面进行比较：（1）住院期间每名探视日接受 KC 的婴儿比例；（2）每名探视日 KC 的频率；（3）每天 KC 事件的持续时间。
SES 较低和其他语言组的婴儿接受 KC 的次数、频率和持续时间均少于 SES 较高或英语组的婴儿。在控制家庭探视和出生时 GA 后，SES 和语言组之间的差异仍然显著。在控制 SES 后，KC 持续时间的语言组差异仍然显著。
我们的发现揭示了 NICU 中 KC 的比率、频率和持续时间存在差异，这是 SES 和语言的双重作用。这些差异减少了婴儿获得这种稳定临床状况和促进神经发育的发育性护理实践的机会。我们建议医院托儿所实施政策，最大限度地减少这些差异。
