Mixed Methods Systematic Review: Parents’ and Healthcare Providers’ Perceptions, Experiences, Knowledge of, and Attitudes to Kangaroo Care of Preterm Babies in Hospital Settings

Background:
Kangaroo care (KC) is universally known as an effective intervention to improve the development of preterm infants. However, despite the evidence, the global implementation of KC remains low.

Aims:
The review aimed to answer the following questions: :1) What are parents’ and healthcare providers’ perceptions, experiences, knowledge of, and attitudes to KC of preterm babies in hospital settings? 2) To what extent are parents satisfied with kangaroo care?

Methods:
A systematic search was conducted to identify relevant quantitative and qualitative studies. Studies were synthesized using parallel-results convergent integrated design.The MMAT 2018 was used for quality assessment.
Results:
Thirty-five studies were included. This review identified that HCPs were generally knowledgeable about KC. In contrast parents had limited information about KC. Furthermore, it seems both HCPs’ and parents' had positive perceptions and attitudes toward KC globally. However, there was a lack of evidence on parental satisfaction that are associated with KC.

Conclusions:
While HCPs' know about KC, parents' knowledge was limited. Disseminating knowledge about KC amongst parents could be initiated in prenatal clinic services. Besides, organisational support is required for continuing education to develop practice guidelines and protocols, to ensure the standardisation of information for HCPs for some preterm infants. Additionally, this review supports the need for future research on father’s role and involvement in KC. Further studies are needed to explore parents’ satisfaction. Finally, there is a need for more research in relation to the practice and implementation of KC in some infants.