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Posted on June 8th, 2012, by

The health care plays an extremely important role and often people need to receive healthcare services at the earliest stages of the development of their body. In this respect, it is necessary to underline that the medical assistance to preterm children should be particularly effective because their survival and their future life is highly dependent on the quality of health care services they receive at the early stages of their development. In fact, often health care professionals, their qualification and ability to assist to preterm children in the first days of their life, define the development of these children in the future. It is not a secret that such children are particularly vulnerable to the negative effects of the environment this is why healthcare professionals should pay a particular attention to their little patients.

On the other hand, health care services concerning preterm children should be viewed in broader sense because often these services are viewed as the effective work of doctors in the assistance to children to recover from the preterm birth and continue their normal development. In fact, it is all the medical personnel that should be responsible for the survival and normal development of such children and the role of nurses can hardly be underestimated in this regard because they are practically permanently in contact with their patients and, therefore, they should be able to provide the patients with the essential medical help in case of some problems that need an immediate medical help. At the same time, they also play an important role as health care services provider since they should not only do their routine job but they should also perfectly understand all the nuances of the treatment and the actions undertaken by doctors, especially in relation to preterm children who need special attention and whose health is in a great danger. Obviously, nurses should possess a profound knowledge of basic methods of treatment of such patients as well as they should know what kind of medical services they should provide to these patients.

In this regard, it should be pointed out that one of the major challenges that preterm children face in the first days of their life is the lack of forces and under-development of the main systems of their body that could maintain the normal functioning of the body and, therefore, the survival of these children. In such a situation the problem of the normal thermoregulation and the stable work of the cardiovascular system are of a paramount importance.

Obviously, traditional approaches, which are traditionally applied to adult patients in case of some problems with thermoregulation and work of cardiovascular systems, cannot always be applied in relation to preterm children, because they cannot be applied in the result of the under-development of body of preterm children and major systems or in the result of the ineffectiveness or, to put it more precisely, the potential threat of traditional approaches to the health and even life of little patients.

Consequently, it is extremely important to develop really effective approaches that could help preterm children to recover in a possibly shorter period of time and stabilize the work of their cardiovascular system and thermoregulation. As the matter of fact, it is the question of life and death of these patients. In such a situation, among the specific approaches, which could be applied to preterm children in order to stabilize the normal work of their cardiovascular system and provide normal thermoregulation of their body, it is possible to single out the kangaroo care which is supposed to contribute to the solution of the problems that can provoke the normal thermoregulation and work of cardiovascular system. To put it more precisely, the kangaroo care can improve consistently thermoregulation of the body of preterm children and contribute to more stable functioning of their cardiovascular system. In such a situation, it is extremely important to research in depth the kangaroo care, its practical application and its major effects that will help better understand perspectives of the use of this approach in the future in the health care assistance to preterm children.

The researches discussed in terms of this paper and their analysis will help reveal possible advantages of the kangaroo care but it is extremely to assess and evaluate the findings of the researchers very carefully in order to reveal possible drawbacks or gaps in the studies and define the future perspectives of further researches in this field.

Literature search

In fact, it should be pointed out that the modern medicine views the problem of medical assistance to preterm children one of the major challenges because the current level of the development of technologies provides health care professionals with opportunities to save lives of preterm children even at the early stages of their development, when they have a low weight and where the vitally important systems and functions of the body remain underdeveloped. In this respect, some specialists (Ludington-Hoe et al, 1993) lays emphasis on the fact that one of the major trends in the modern medicine in the treatment of preterm children is the provision these patients with an environment which could resemble their natural environment and use natural means in order to make their treatment more effective.

At the same time, to find a more definite and reliable information on this problem, it is necessary search literature, in addition to interviews of health care professionals. In this respect, it is basically necessary to focus the search on reliable sources only. This means that it is necessary exclude from the literature search all non-academic sources and, instead, focus on scientific works and researches, preferably published in respectable medical journals. Also, it should be pointed out that the timeline of the research should be limited since the probability that the valuable information may be found in a scientific work that dates back to thirty or forty years in the past is very low.

Naturally, the probability that old scientific works have some noteworthy information should not be totally rejected but, as a rule, these works can provide only some information for the further research while if the proper and reliable information is needed than it is better to focus the search on scientific works which had been published since 1990s.

It is important to underline the fact that a researcher should not totally rely on one source only. In fact, it is necessary to find some common trend that could be traced in various scientific works and, what is more, all these scientific works and findings should basically support each other. In such a way, speaking about the use of the kangaroo care it is necessary to find sources which are published in medical journals, which are relatively new, and, finally, these literary sources, i.e. scientific researchers should have similar findings and focused on the similar problems.

In terms of the current research, the search of the literature revealed the fact that the problem of the maintenance of the normal functioning of cardiovascular system and thermoregulation of preterm children is very important. In this regard, many researches refer to the kangaroo care as one of the effective means to maintain the normal functioning of cardiovascular system and thermoregulation. It should be said that a variety of researches agree that the kangaroo care may produce a positive impact on both cardiovascular system of preterm children and their thermoregulation (Cattaneo et al, 1998). In such a way, six researches dedicated to this problem were identified. They are as follows:

1. Christine B. Fischer, Dieter Sontheimer, Frank Scheffer, Jacqueline
Bauer, and Otwin Linderkamp (1998) Cardiorespiratory stability of
premature boys and girls during kangaroo care.( Early Human Development
52 (1998) pp 145-153.)

2. Suzan M. Ludington-Hoe, Gene Cranston Anderson, Sharleen Simpson,
Annie Hollingsead, Luz Angela Argote, Humberto Rey. (1999).Birth-Related
Fatigue in 34- 36- Week Preterm Neonates: Rapid Recovery With Very Early
Kangaroo (Skin-to-Skin) Care JOGNN, 28, 94-103.

3. Kathrin Fohe, Siegfried Kropf, Stefan Avenarius. ( 2000) Skin-to-skin
contact improves Gas Exchanges in Premature Infants. Journal of
perinatology 5 (311-315).

4.Suzan M. Ludington- Hoe, Gene Cranston Anderson, Joan Y. Swinth, Carol
Thompson, Anthony J. Hadeed. Randomized Controlled Trial of Kangaroo
Care: Cardiorespiratory and Thermal Effects on Healthy Preterm Infants.
(2004) Neonatal Network Vol.23, No. 3,
(pp 39-47) .

5.N.J. Bergman, L.L Linley and S.R Fawcus (2004) Randomized controlled
trial of skin-to-skin contact from birth versus conventional incubator
for physiological stabilization in 1200- to 2199- gram newborns. Acta
Paediatric 93: pp 779-785.

6. Suzan M. Ludington-Hoe, Tina Lewis, Kathy Morgan, Xiaomei Cong,
Laurie Anderson and Stacey Reese. (2006) Breast and Infant Temperatures
With Twins During Shared Kangaroo Care. JOGNN Vol.35, No. 2 pp. 223-231.

On the basis of the analysis of these researches, it will be possible to assess and evaluate the importance and effectiveness of the kangaroo care and its future perspectives.

Review of physiological effects of kangaroo care

Obviously, the research of the identified literature should be focused on the analysis of the major effects of the kangaroo care, which is considered to be a very effective approach in medical care of preterm children. This is why it is necessary to dwell upon each research and discuss it in details. However, at the beginning it is necessary to point out that the kangaroo care is defined as “skin-to-skin contact for preterm infants and their parents”ť (Fisher et al., 1998)

First of all, it should be said that the researches dedicated to the use of the kangaroo care basically reveal similar trends and effects of the application of this method. In this respect, it should be said that the research conducted by Christine B. Fischer, Dieter Sontheimer, Frank Scheffer, Jacqueline Bauer, and Otwin Linderkamp, in 1998, was dedicated to the problem of the analysis of the effect of the kangaroo care on the functioning of cardiovascular system and cardiorespiratory function of preterm children. In their research, “Cardiorespiratory stability of
premature boys and girls during kangaroo care”ť, the scientists attempted to trace the impact of the kangaroo care on preterm children. They defied the major goal of their study and attempted to study the stability of the cardiorespiratory system of preterm children. It is worthy of mention that the study involved 20 children which were born preterm (Fisher et al. 1998). The researchers involved the subjects representing both genders and the amount of boys and girls involved in the study was equal. The 20 premature boys and girls had undergone the kangaroo care, but it is necessary to point out that the researchers studied the stability of the cardiorespiratory system of the boys and girls during maternal kangaroo care and in the incubator (Fisher et al, 1998). In such a way, the researchers have got an opportunity to compare and contrast the effect of both the maternal kangaroo care and the effect of the incubator.

Furthermore, it should be said that the measurement and assessment of the functioning of cardiorespiratory system of the children involved three stages: pre-test, test, and post-test (Fisher et al, 1998). In such a way the researchers attempted to provide the high precision of the measurement and the results of the research. Obviously, such an approach contributes to the high reliability of the entire research because due to such measurement, it is possible to trace the changes that occurred to the children involved into the study before the test, during the test, and, finally after the test. Consequently, it was possible to trace the general effects of the research and the impact of the kangaroo care on the children. The researchers used the stability score to assess the stability of the cardiorespiratory function of the children. In the result, of the research, the authors found out that the three stability items and the total stability did not change substantially during the three conditions, i.e. pre-test, test, and post-test. This fact is very important because the major measurements should be made at the key stages of the experiment (Burns and Grove, 2004).

However, the researchers revealed the fact that some individuals proved to be susceptible to the decrease or increase of the stability markedly during the kangaroo care (Fisher et al, 1998). In such a way, it is possible to speak about the possible difference in the effect of the kangaroo care on the preterm children, at least those that were involved in the current study. Moreover, the difference in the effect of the kangaroo care on the stability of the cardiorespiratory function of the children involved in the study differed consistently depending on the gender of the children. To put it more precisely, the researchers arrived to the conclusion that the boys showed significantly less cardiorespiratory stability during both kangaroo care and in the incubator, while girls caridorespiratory function was more stable (Fisher et al, 1998).

In such a way, it is possible to speak about the existing difference between the effect of the kangaroo care on children which is probably defined by their gender and respective physiological peculiarities. This finding is very important and should be taken into consideration by specialists who apply this approach in their medical practice.

Another significant research that is worthy of attention is the research conducted by N.J. Bergman, L.L. Linley and S.R. Fawcus. In their article “Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199- gram newborns”ť the researchers attempted to study the impact of the kangaroo care on preterm newborns. Similarly to the previously discussed research, the scientists attempted to compare the effectiveness and the effects of the kangaroo care to a conventional incubator. The major goal of this research was also similar to the previous one since the researchers targeted at the stabilization of the newborn, preterm children (Bergman et al, 2004). However, it should be said that the distinguishable feature of this research is the fact that the researchers were conscious of the fact that an extended maternal-infant separation which targeted at the revealing the effect of such a separation when children were placed in the incubator and did not have skin-to-skin contact with their mothers. The researchers also pointed out that the recent studies had already revealed the adverse effects of the separation of children, especially preterm children, from their mothers. This is why in their research, the scientists attempted to assess the effectiveness of the kangaroo care which they viewed as an alternative to a conventional incubator, where children were traditionally placed when they were separated from mothers (Dodd, 2005). The researchers emphasize that the kangaroo care, which actually implies the maternal-infant skin-to-skin contact, provides an alternative habitat to the incubator (Bergman et al, 2004). Also the researcher estimate that, in general, the kangaroo care produces a positive impact on stable premature children, though the scientists indicated to the fact that in the previous studies the effect of the kangaroo care on unstable preterm newborn was under-researched.

The subjects of the research were preterm newborn whose weight varied from 1200 to 2199 g at birth. In general there were 34 children involved in the research (Bergman et al, 2004). As for the methodology applied by the researchers, it should be said that it was the prospective, unblended, randomized, controlled clinical trial. Potential subjects of the researched were identified before the delivery and randomized by the computerized minimization technique (Bergman et al, 2004). In such a way, the researchers attempted to minimize the effect of the human factor in the process of the selection of the subjects that naturally increases the reliability and objectivity of the research. At any rate, unlike the previously discussed researchers, these specialists used the computerized technique of the selection of the subjects. The experiment involved the observation of children for six hours and the basic physiological parameters were measured. To put it more precisely, the major goal of the researchers at this stage was to measure the stability of the children which was measured in terms of the set of pre-determined physiological parameters and a composite cardiorespiratory stabilization score (Bergman et al, 2004). Basically, the use of such tools provided researchers with relatively high level of reliability though the validity of the results of the research was not properly assessed. At the same time, the randomized selection also may be viewed as a factor that could decrease validity and reliability of the research because the authors did not work out take into consideration such a factor as the gender of subjects but mainly focused on their age and weight.

In the result of the research, the authors compared the stabilization scores for the children placed in the conventional incubator to those children to which the kangaroo care was applied. The effectiveness of the kangaroo care proved to be higher compared to the conventional incubator. To put it more precisely, the stabilization scores were 77.11 to the children that had undergone the kangaroo care, and 74.23 for incubator (Bergman et al, 2004). In order to understand the extent, to which the effectiveness of the kangaroo care was higher compared to the conventional incubator, it should be said that the maximum score was 78 and the stabilization scores of the children to which the kangaroo care was applied practically reached this maximum score. Moreover, the researchers also found out that a part of the children placed in the incubator suffered from hypothermia.

As a result, the researchers arrived to the conclusion that the kangaroo care contributes consistently to the stabilization of the physiological functions of preterm children and it is particularly effective in the stabilization of the cardiorespiratory and thermoregulation functions. In such a way, this research also proved the effectiveness of the kangaroo care and, what was even more important, it indicated to the advantages of the kangaroo care compared to the conventional incubator. In such a situation, the researchers arrived to the main conclusion of their study that newborn should not be separated from their mothers.

However, it is also necessary to take into consideration the clinical practice (Dodd, 2005) since it is not always possible to apply the kangaroo care and mother cannot physically be with their children, for instance. This is why such findings, being quite important, still should not be viewed as an absolute recommendation.

Furthermore, the research conducted by Suzan M. Ludington- Hoe, Gene Cranston Anderson, Joan Y. Swinth, Carol Thompson, Anthony J. Hadeed was another important study of the effect of the Kangaroo care on children. In their article “Randomized Controlled Trial of Kangaroo Care: Cardiorespiratory and Thermal Effects on Healthy Preterm Infants”ť the authors described in details their research and made their conclusions concerning the effects of the application of the kangaroo care. It should be pointed out that the major goal of the study was to define the safety and effects of the kangaroo care on preterm children and similarly to the previous research, the scientists compared their observation of effects of the kangaroo care to the conventional NICU care (Ludington- Hoe et al, 2004). At the same time, it is worthy of mention, that the researchers selected healthy preterm children for their study that means that the state of the children, i.e. the subjects of the study, was relatively stable because their general state was assessed as healthy. Unlike the previous study, the researchers placed the preterm children for three hours instead of six as it was in the study that has been just discussed above.

Basically, the researchers focused their attention on the measurement of cardiorespiratory and thermal responses.

To make the results of the research more precise and in order to trace the possible changes in the state of the children, all the measurements were taken at three stages: pre-test, test, and post-test. There were twenty-four children selected for the study, eleven of which received the kangaroo care, while the rest thirteen were placed in the conventional NICU care (Ludington- Hoe et al, 2004). In such a way, the researchers could compare the effects of both approaches assessing the state of approximately equal number of children.

The researchers used the major variables such as heart rate, respiratory rate, oxygen saturation, abdominal skin temperature. Naturally, the use of a wide range of variables makes the results of the research more reliable and increases their validity. In this respect, the division of the subjects into two groups was also quite effective for the reliability and validity of the results because the subjects could be compared to a control group and the differences defined proved the difference between the kangaroo care and NICU.

The results of the study basically revealed the similar trends that have been found out in previously discussed researches. To put it more precisely, the researchers arrived to the conclusion that the kangaroo care produces a positive impact on the physiological state of the preterm children because it contributes to the stabilization of the cardiorespiratory function and thermoregulation of children and this stabilization proved to be more effective compared to the children that had undergone the standard NICU care (Ludington- Hoe et al, 2004).

Another study, conducted by Kathrin Fohe, Siegfried Kropf, Stefan Avenarius, is also noteworthy from the point of view of the impact of the kangaroo care on the cardiorepsiratory and thermoregulation of preterm children. In their article, “Skin-to-skin contact improves Gas Exchanges in Premature Infants”ť, the researchers describe their study that targets at the analysis of the effectiveness of the kangaroo care in the intensive care that is applied in preterm children. The researchers selected 53 subjects for the study and the study was conducted into three stages. At the beginning the subjects were placed into a conventional incubator for 60 minutes. After that they received the kangaroo care for 90 minutes and then they were returned to the incubator again but this time for 90 minutes (Fohe et al, 2004). During the experiment, the measurements of heart and respiratory rate were made as well as other measurements which basically targeted at the assessment of the physiological state of the children, especially in regard to the cardiorespiratory function and thermoregulation.

It should be said that to conduct their research, the authors used heart rate, respiratory rate, transcutaneous pO2 and pCO2 and rectal temperature measurements. They used Kontron instruments in order to achieve the higher level of accuracy since these instruments provide high rate and respiratory rate accuracy +/- 1%, SaO2 accuracy +/- 2%, temperature accuracy +/- 0.1 degree by Celsius. Basically, the use of such tools is quite effective and provides reliable results, but the placement of children to incubator, followed by skin-to-skin-contact, and then incubator again at different periods of time decreases the reliability of results because the impact of the change of the environment could not be properly analyzed. For instance, some effects observed during skin-to-skin contact could be actually the result of incubator impact, where children had been placed for 60 minutes before skin-to-skin contact. The generalizability of the research is sufficient because the number of subject was selected quite large, though weight limitations naturally cannot make the results of this research applicable to other weight groups.

In the result of their research, the authors arrived to the conclusion that the kangaroo care did not only maintained the stable state of the children but it also produced a positive impact on the cardiorespiratory function and thermoregulation of the children (Fohe et al, 2004). Also, it should be pointed out that the researchers did not find any negative effects of the removal of the children to the incubator. The latter conclusion contradicts a bit to the findings of the previously discussed researchers but it is necessary to point out that this study involved stable preterm children. Consequently, it is quite natural that, being placed in the incubator, they did not suffer from the separation from mothers, while in the case if they were unstable the effects of the placement of the children into the incubator could be different.

Another research “Birth-Related Fatigue in 34- 36- Week Preterm Neonates: Rapid Recovery With Very Early Kangaroo (Skin-to-Skin)”ť conducted by Suzan M. Ludington-Hoe, Gene Cranston Anderson, Sharleen Simpson, Annie Hollingsead, Luz Angela Argote, Humberto Rey was also focused on the assessment of the effectiveness of the use of the kangaroo care in the preterm children. The researchers assessed the impact of the kangaroo care on the state of the children (Ludington-Hoe et al, 1999). Basically, their findings are similar to the findings of the researches discussed above. To put it more precisely, the researchers revealed the fact that the kangaroo care may be very effective, especially when it is applied at the early stages after the birth of children (Ludington-Hoe et al, 1999). The major outcome of the use of the kangaroo care was the stabilization of the cardiorespiratory function and thermoregulation of children. In fact, the subjects of the research were preterm children. The researchers applied the kangaroo care to research its impact on their recovery and they also had a control group that was placed in a conventional incubator. The researchers made basic measurements, in including heart rate, temperature, respiratory rate. The measurements were made at three major stages pre-test, test and post-test. In the result, of the research the authors arrived to the conclusion that the kangaroo care could contribute to the faster recovery of preterm children compared to the test group that was placed in a conventional incubator.

In this regard, it should be said that to assess the reliability of the research it is necessary to take into consideration the extent to which the care was intensive and specialists (Fraser, 2004) point out that often researchers do not take into consideration the natural potential of children, i.e. physiological abilities and the strength of children that increases their chances for recovery, and, instead, researchers view the positive result of the experiment solely as a positive effect of the method applied, in this case, the kangaroo care.

Nevertheless, this research basically supports findings of other researchers discussed above about a positive effect of the kangaroo care. On the other hand, it is necessary to point out that the researchers did not attempted to distinguish between children of different genders and basically, the physical state of children were not absolutely equal and this fact was not taken into consideration either, but the initial conditions, before the beginning of the research are of a paramount importance (Parahoo, 2006)

Also it is possible to refer to the research conducted by Suzan M. Ludington-Hoe, Tina Lewis, Kathy Morgan, Xiaomei Cong, Laurie Anderson and Stacey Reese, which the authors described in details in their article “Breast and Infant Temperatures With Twins During Shared Kangaroo Care”ť. The purpose of the research was to reveal the effect of the kangaroo care in the treatment of preterm twin patients. To put it more, precisely the researchers attempted to understand the extent to which this approach could be effective been applied to twins (Ludington-Hoe et al, 2006).

It should be pointed out that this research was quite innovative because previous researches conducted in this field did not take into consideration the possibility of the use of kangaroo care to twins simultaneously. This is exactly what researchers attempted to realize and investigate in their study. The subjects of the research were two sets of premature twins and their mothers. The researchers conducted two case studies to determine the temperature of twins that were simultaneously kangarooed (Ludington-Hoe et al, 2006). It was really important to find out the effects of kangarooing on both twins and their mother or, to put it more precisely, it was necessary to find out the effect of the presence of twins on the breast of the mother and, what was probably even more important, it was necessary to define whether the warmth of the breast was sufficient to warm both twins.

In fact the methods the researchers applied in their study is called the shared kangaroo care because kangarooing care was actually shared between the twins. They were held in the shared kangaroo care for one and half hour. The temperature of both twins was recorded from incubators, while breast temperatures were recorded from thermistors (Ludington-Hoe et al, 2006). It should be said that the previous researches of the kangaroo care had already revealed the positive impact of this approach on the thermoregulation of preterm children because the kangaroo care provided the possibility to keep preterm children warm by body heat generated by the mother and from the maternal breasts the warmth was conducted to the child. At the same time, previous researchers have never used the shared kangaroo care involving twins simultaneously.

In the result of this research, the authors found out that the temperatures of twins remained warm and, what was more, the temperatures even increased during the shared kangaroo care. Also the researchers found that each breast responded to the thermal needs of the child on that breast (Ludington-Hoe et al, 2006). In such a situation, the authors of the research attempted to find the physiological explanation of this phenomenon and after the analysis of the data collected they arrived to the conclusion that the shared kangaroo care may be really effective and applied to premature twins since it helps to maintain their warmth and assist to the thermoregulation of the body with the help of the maternal breasts. Moreover, the researchers explained such a simultaneous effect of the kangaroo care on both twins by the fact that each breast of the mother responded individually to the thermal needs of each of the twins.

Basically, this research seems to be quite reliable, though it is worthy of mention the fact that the research involved only two sets of the premature twins. This means that potentially the conclusions made by the researchers on the basis of their study of these twins may be typical and applied to all twins. On the other hand, the fact that the research involved only two sets of twins is a bit disturbing because potentially, physiological peculiarities of twins and their mothers may vary consistently that means that the research should have involved a larger number of subjects in order to retrieve more reliable results. Specialists (Polit and Beck, 2002) point out that the reliability of the research is, to a significant extent, defined by the quantitative characteristics that in this case means the number of children involved into the experiment, because to get more reliable results, the researchers needed to use more subjects to reveal the extent to which their findings may be observed in other subjects.

Nevertheless, the basic trends defined by the researchers basically prove the fact that the kangaroo care could produce a positive impact on the thermoregulation of preterm children. Moreover, the researcher even attempted to go further in their research and analyzed the potential of the shared kangaroo care, instead of the traditional kangaroo care (Ludington-Hoe et al, 2006). The fact that the shared kangaroo care, when twins were simultaneously kangarooed produced a positive impact on their state and maintain their warmth in accordance with the needs of each child, is very effective that may be viewed as evidence of the general effectiveness of kangarooed care because it is obvious that, according to basic physical laws, the twins should consume more warmth than a single child.

Nevertheless, even in such a case, both twins were kept warm.

At the same time, taking into consideration that the researchers applied quantitative methods of the analysis, it should be said that the research of only two sets of twins is not sufficient since it does not provide ample opportunities to reveal common trends and, therefore, define the extent of generalizability of findings as the conclusion of the authors is based on a small group of subjects. In addition, it also undermines reliability and validity of the research because the researchers did not receive evidences that prove the presuppositions at large scale. To put it more precisely, they used the two set of twins, though the use of larger number of subjects would provide more precise and reliable results. Furthermore, they used temperature measurements to trace the changes and responds of twins and mother on decrease or increase of twins’ temperature, but the measurements of temperature could show that effects but not the cause of the change of temperature and researches did not practically use other tools that could help better assess the general physiological state of the mother and children.

Future perspectives

Obviously, the researches discussed above prove the fact that the kangaroo care may be very effective, especially in the care in preterm children. At any rate, practically all the findings revealed the fact that the use of the kangaroo care contributes to the stabilization of the cardiorespiratory function and thermoregulation of children. At the same time, there were practically no negative effects found in the result of the use of the kangaroo care, though, it is worthy of mention that the effect of the kangaroo care on different children may vary. For instance, the stabilization of the cardiorespiratory the and thermoregulation of boys may be less signifincant that the stabilization of these functions of girls. In fact, these findings are very important because they show that the kangaroo care is very perspective and can be widely applied in the future.

Basically, these findings reveal the fact that it is possible to use the potential of the kangaroo care in preterm children, who need the particular attention and medical assistant from the part of healthcare professionals. In perspective, the kangaroo care may be applied more effectively due to its positive impact on the cardiorespiratory function and thermoregulation. It should be pointed out that potentially the kangaroo care may be used to increase the stability of the cardiorespiratory function and thermoregulation and, in all probability, this care may be applied not only to preterm children but also to other children who suffer from the problem with thermoregulation or some cardiorespiratory disorders (Anderson, 1999).

At the same time, it is necessary to underline that some researches need to be continued or improved because Lidington-Hoe et al, 2006, for instance, does not involve a large number of subjects. Consequently, the conclusions of the researchers should be verified in the following researches focused on the same problem, i.e. impact and effects of the kangaroo care on twins. Also, it should be said that often such factors as gender of subjects were not taken into consideration and the selection of subjects was not very effective since it did not provide a really wide range of subjects that is necessary for the generalizability of the study, and its high reliability and validity. Naturally, all these drawbacks of the researches discussed above should be taken into consideration in future researches.

Conclusion

Thus, taking into account all above mentioned, it is possible to conclude that the modern medicine has reached great results in different field but the problem of medical care that should be provided to preterm children still remains one of the major challenges to healthcare professionals on all levels, including nurses. In such a situation, it is extremely important to development effective methods and techniques which could be used to improve the state of preterm children. In this respect, it should be said that one of the major problems health care professionals face in the treatment of these little patients is the problem of the instability of their state. It is not a secret that preterm children may have serious problems and, in such a situation, the kangaroo care could be applied effectively. A number of the researchers, which have been discussed in terms of this paper, show that the kangaroo care may be an effective tool that can contribute to the stabilization and even improvement of the cardiorespiratory function and thermoregulation of children. At the same time, the kangaroo care may be also used as a supplementary treatment.

Finally, it should be said that it is obvious that the kangaroo care has great perspectives in the future but its further researches are needed in order to fully discover the potential of this technique and better understand its effects.

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