Foong Wai Cheng, Foong Siew Cheng, Ho Jacqueline J, Tan Pek Yong, Leong Jen Jen, Baskaran Mehala
Department of Paediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia.
Department of Paediatrics, Island Hospital, George Town, Penang, Malaysia.
BMC Pregnancy Childbirth. 2025 Jul 24;25(1):790. doi: 10.1186/s12884-025-07660-7.
Kangaroo mother care (KMC), besides reducing mortality, offers significant benefits for preterm and low birth weight infants, prompting the World Health Organization to reaffirm a strong recommendation for KMC as essential care. However, uptake remains unsatisfactory due to challenges in implementation and sustainment.
To explore factors influencing KMC implementation by healthcare workers (HCWs) and identify interventions for improvement.
Using purposive sampling, we conducted key informant interviews with HCWs from neonatal wards and neonatal intensive care units (NICU) of two hospitals. Data were transcribed and categorised based on the Triandis framework.
KMC was not regarded as an essential component of early management for preterm infants. The challenge was not a lack of awareness but the difficulty integrating KMC into existing workflows while balancing other clinical responsibilities. Heavy workloads resulted in KMC sidelined in favor of routine ward tasks. Junior HCWs lacked the autonomy to initiate KMC without senior approval. Even HCWs eager to advocate for KMC faced significant frustrations. Overcrowded wards, limited resources, and staff shortages made KMC feel like an added burden. Additionally, they struggled to persuade reluctant parents and feared repercussions if unexpected complications arose when parents performed KMC. The lack of KMC in key performance indicators further compounded these challenges, hindering its widespread implementation.
For KMC implementation to improve, it must be recognized as an essential part of neonatal care, with incentives for promoting KMC. Support for staff and adequate space in the wards, ideally by having mother-infant wards and NICUs are also necessary.
This study was registered with the National Medical Research Registry (NMRR-17-2984-39191).
袋鼠式护理（KMC）除了能降低死亡率外，还为早产儿和低体重儿带来显著益处，促使世界卫生组织再次强烈推荐将KMC作为基本护理措施。然而，由于实施和维持方面的挑战，其采用率仍不尽人意。
探讨影响医护人员实施KMC的因素，并确定改进措施。
采用目的抽样法，我们对两家医院新生儿病房和新生儿重症监护病房（NICU）的医护人员进行了关键 informant 访谈。数据根据 Triandis 框架进行转录和分类。
KMC 未被视为早产儿早期管理的重要组成部分。挑战并非缺乏认识，而是在平衡其他临床职责的同时，难以将 KMC 融入现有工作流程。繁重的工作量导致 KMC 被搁置，优先处理常规病房任务。初级医护人员未经上级批准缺乏启动 KMC 的自主权。即使渴望倡导 KMC 的医护人员也面临重大挫折。病房拥挤、资源有限和人员短缺使 KMC 感觉像是额外负担。此外，他们难以说服不情愿的父母，并担心父母进行 KMC 时出现意外并发症会带来后果。关键绩效指标中缺乏 KMC 进一步加剧了这些挑战，阻碍了其广泛实施。
为了提高 KMC 的实施效果，必须将其视为新生儿护理的重要组成部分，并提供促进 KMC 的激励措施。为工作人员提供支持以及病房有足够空间，理想情况下设有母婴病房和 NICU 也是必要的。
本研究已在国家医学研究注册处（NMRR - 17 - 2984 - 39191）注册。
