Exploring the Relationship Between Mother and Baby Essay

Exploring the relationship between start out and mollycoddle in the neonatal intensive c atomic account 18 building block in relation to c ar for deliver.AbstractAim -To explore the effect of interaction related to c atomic number 18-giving and culture exchange between nurses and bewilders in relation to maternal stress and maternal-infant relationship in the newborn intensive deal unit (neonatal intensive care unit) passim the hospital stay.Background Mothers in the NICU grow depression, worry, stress, and loss of control, and they fluctuate between recoverings of inclusion and ejection related to the provision of wellness care to their neonate. This books review helps to identify nursing interventions that promote collateral outcomes between drive and treat by reducing maternal whole tones of stress and anxiety.Search method acting A literature take care c every last(predicate) overing the period 2008-2012 was conducted. Five articles composinging two nume rical and qualitative studies recounting to the subject were retrieved.Findings Findings reveal that positive(p) and trustful relationships between nurses and mothers contract when nurses communicate and interact with mothers. This alleviated mothers anxiety and enhanced their confidence when interacting with their bumble.Discussion Critical analytic thinking as well as strengths and weaknesses of the relative journals reviewed is given to set forthher with useful recommendations that emerge from the evidence.Conclusion The literature reviewed shows that nurse-mother interaction improves mother-infant relationship. In turn, this pass on eventually assist in decreasing maternal stress and improve the maternal well-being.INTRODUCTIONMothers develop attachment to their baby during pregnancy, which continues and develops to a greater extent fully after the child is born (Cleveland 2009). However, the pathway to becoming a mother is threatened with the admission of the baby to t he NICU. This occurs due to the unfamiliar and intimidating surround of the NICU (Obeidat et al 2009). During the initial admission parents can believe that the healthcare team is much able to care for their baby and this can instill feelings of inadequacy (Cockfort 2011). As a result, maternal attachment whitethorn be hold up by the lack of socialisation between mother and baby as most of the care is do by nurses (Cleveland 2009).DeRouck and Leys (2009), found that the parents of an infant admitted to the NICU face challenges including admission price to information, disclosure active the diagnosis, treatment and scene of their newborn, as well as a lack of control over the care of their newborn.Adding to this distress is the irresolution of survival or the eventual impact of the infants condition on later health and well-being. In agreeition, feeling guilty to mother an unhealthy infant urinates fear of social prejudice. Further, the structure of the NICU places signific ant barriers on mothers abilities to enact the agnate role since decision-making and the daily care of the infant is taken over by medical and nursing staff restricting interactions with the babies stripping onward their maternal authority (Cleveland 2009). In fact, when babies are in the NICU, traditional conceptualizations of the parental role are altered. The situation demands heightened parental break aparticipation time simultaneously placing severe restrictions on parental involvement. In response, parents deficiency to negotiate this tension and traditional definitions of the parental role, which must be continually redefined doneout their experienceWhat emerges is that the predominant source of distress is inability of the mother to protect the infant from pain and add appropriate pain management. (Fenwick et al 2008). A heap of procedures shit pain in the neonate creating concerns for the mother, starting from peripheral cannulas,indwelling catheters and intubation to mention a few. In intubated babies, even though morphine infusions are portioned, the baby still shows signs of distress during nursing times. In this consequence, we administer a exquisite bolus of pain relief prior to nursing so that the baby would be more comfortable.Conversely, Fenwick et al (2008) describes factors that contribute to parents joy in the NICU. These include assurance and psychological back down, the provision of consistent information, education, environmental follow-up care, appropriate pain management, and parental participation and proximity, as well as physical and uncanny embody. therefore, it is imperative that nurses should do their shell to improve the mothers sense of confidence, competence and corporation with her infant through maneuver participation (Domanico et al 2011).Johnson (2008) nones that pare down-to-skin holding or kangaroo care promotes maternal-infant feelings of closeness, builds maternal confidence, and whitethorn be a stress-reducing experience for some(prenominal) the mother and infant. Hence the splendor of providing the opportunity for kangaroo care to occur. Hunt (2008), notes that KMC is in addition crucial to modify parameters, such as cardio-respiratory parameters whilst being beneficial for maintaining body temperature. They add that even the incidence of nosocomial sepsis and the succession of hospital stay decreased with practicing KMC. In addition, Ali et al., (2009), found that Kangaroo mother care also showed positive outcomes towards practicing scoopful breastfeeding.Cockfort (2011) notes that, continuity of care removes to be ensured hence the importance of keep. Therefore, it is suggested that handover should not be rushed, whilst a more comprehensive handover can ensure the smooth transition of care for staff and the family. When parents ask questions relating to their baby they feel assured in the competency of staff when information has been passed on correctly. When in formation is not shared in effect parents can lose trust and the federation breaks down.In Malta, even though handover of 2 consecutive geezerhood is given, conflicting advice is still given at times due to the nurses different view-points. Consequently, this requires ward meetings in social club to clarify authorised issues so that advice given and practice is consistent.In Malta, about 373 babies are admitted y early(a) (Grech et al 2012). In view of the benefits discussed, nurses should do their utmost to improve the overall experience of the mothers of such babies.Search MethodA review of published search consisted of the following steps broad reading to determine areas of focus, ac intimacyment of inclusion and exclusion criteria, literature search (appendix 1) and retrieval, critical appraisal and analysis of the research evidence and tax deduction of evidence. Evidence was reviewed with the aims of identifying barriers that affect the motherinfant interaction within t he neonatal intensive care unit and how nurses can actively support attachment. Articles were include if the setting was primarily in a neonatal intensive care unit (neonatal unit or neonatal intensive care unit) and the participants were mothers of infants admitted to neonatal intensive care units or nurses works within that setting. In addition, All articles were critically analyzed with two primary questions in mind (a) What are the needs of parents in the NICU? (b) What nursing behaviors support parents in meeting these needs? Articles were also included if they were primary research studies published between 2008 and 2012 and written in the English language.Primary and secondary literature searches were conducted through the EBSCO, ERIC, Sciencedirect and Medline informationbases. The primary search terms included NICU, neonatal Intensive bring off Unit, family support, communication, nurse and early intervention. The secondary literature search terms included nursing support , efficacy, family, communication, support, neonatal and Kangaroo Mother Care. These terms were apply and utilised in all possible combinations to perform an extensive literature search of the above mentioned electronic entropybases. Thirdly, a review of references was conducted of the identified articles for each yet studies. Eighteen articles were found through the search. Six studies met the inclusion criteria of which, 3 were qualitative and 3 quantitative (appendix 2). The subject was limited to the last 5 years. This time frame helps in the getting the most recent experiences since NICU is a changing environment especially as regards to technology which effects the mothers as well as the nurses.Both quantitative and qualitative studies were found. Both qualitative and quantitative research was conducted to identify what is cognize about the needs of NICU parents and what behaviours support these parents. Both methods of research were included because of the potential for each to contribute to a more complete discretion of this topic.In selecting a research figure, researchers should be guided by one overarching consideration whether the design does the best possible job of providing trustworthy answers to the research questions. One needs to note that both studies have limitations (Cottrell & McKenzie, 2011).In quantitative research, the researchers aim is to determine the relationship between one variable (an mugwump variable) and another (a dependent or outcome variable) in a existence (Morrow 2009).In contrast to quantitative designs, qualitative designs do not result in numerical information for statistical analysis (Schira, 2009). In qualitative methods, researchers are interested in interpreting social phenomena and exploring the meanings that people attach to their experiences (Polit and Beck 2010). Moreover, views, attitudes and behaviours may be explored (Wood & Kerr, 2011), through grounded possible action as it develops theories tha t are grounded in the groups observable experiences, but researchers add their own insight into why those experiences exist.FindingsTable 1 includes information about the 5 studies that met the inclusion criteria . erst an infant is admitted into an NICU, many factors account for parental stress. Admission of the infant to the NICU places mothers in a stressful situation where they must cope with the NICU environment and its associated demands.In the lead conducted by Parker (2011), a grounded surmise approach was used to understand feeling and stressors of 11 mothers whose new-borns were in the NICU. It was found that the early days stroke and numbness accompanied feelings of none or little control over their lives. Moreover, all mothers described feeling unprepared for the previous(p) delivery and the sight of their baby in the NICU. Comparative results were found by lee(prenominal) et al (2009), with regards to the shock experienced with the initial sight of the baby.Everyda y unpredictable changes occur leaving no time for adjustment or preparation. Constant fears about the life and death of the baby do not subside and several mothers spoke about their experience of always anticipating the death of the baby. These findings are also reflected in my clinical setting when mothers would be recounting their experience once the babys condition improves. This is in line with the findings of Fenwick et al (2009) and downwind et al (2009). In addition, the findings imply that the positive reassurance of the effects of a positive and caring environment and support network between parents and nurses in the NICU is not always unvarnished among every unit.Nicholas-Sargent (2009) found that assurance is the most important aspect to be fulfilled. Her quantitative study of 46 mothers found that the length of stay in the NICU and mothers information needs were found to be importantly inversely correlated. Therefore, this suggests that the longer an infant remains hos pitalized in the NICU, the less emphasis the mother places on receiving information about the infants condition. This shows that the needs of the mothers in the NICU can change over time. My observations stand for these findings since mothers familiarise themselves and adapt to the situation. Moreover, they would eventually want to be successful with the care of the baby. This is reflected in the grounded surmise analysis conducted by Fenwick et al (2008), using semi-structured interviews.They found that the nurse-mother relationship had the potential to significantly affect how women perceived their connection to the infant and their confidence in caring for their infant which occurred through a three way interaction. existence successful in their desire to care for the baby, engendered feelings associated with being a real mother. However, not all women in this study were able to successfully employ these strategies. In the situation where the mother perceived herself as sedat e and unassertive, and in a position without any power, it was very difficult to gain the confidence inevitable in order to be able to openly question, negotiate and direct the care of her infant. Therefore, it is very important to identify these mothers in order to help them by giving them continuous reassurance. This would particularly be take when the situation changes from support needing to encouragement in participation. downwind et al (2009) found that mothers sired support from the healthcare professionals and the social networks that mothers made. These helped to create the connections that developed between the mothers and infants making their journey towards parenthood possible. They discovered that challenges are further compounded in Taiwan, where women are traditionally required to practice the cultural ritual which includes confinement to the reside with a special balanced diet for the get-go month postnatal. downwind et al (2009) used the grounded theory appro ach with in-depth interviews and constant comparison.All interviews were audio-taped and notes were made during and immediately after the interview concerning actions and body language of the mother during the interview. The finding of this study further indicated that the initial sight of the life-support equipment was shocking. The technological environment created a fearsome atmosphere, and the medical equipment attached to their infants caused the mothers further physical separation. The mothers indicated that they were so afraid of the equipment that it took them a long time to be able to participate in their infants care. In turn, this hampered them from expressing positive motherinfant interactions.Chiu and Anderson (2008), found that preterm births very much negatively influence motherinfant interaction due to lack of physical take. In addition, they found that skin-to skin contact post-birth has positive effects on infant development. These researchers conducted a rando mized controlled trial (RCT) using questionnaires for data parade. In addition, mothers were further video-taped during a feeding session. Ali et al., (2009),highlight the importance of kangaroo care in their RCT where the researchers conducted their study with one nose candy and fourteen infants. This study showed that the infants exposed to kangaroo mother care had an increase in rectal temperature compared to received care, thus having a decreased risk of hypothermia. The mean temperature during kangaroo mother care was of 37 degrees Celsius while the mean temperature during conventional care was of 36.7 degrees Celsius. The data collected was through posted questionnaires.DiscussionIn the 3 qualitative studies found, the data was collected through interviews of which 2 were semi-structured while 1 was unstructured. Parker (2011), Fenwick et al (2008) and Lee et al (2008), used the Grounded theory approach. However, while Parker and Fenwick use semi-structured interviews, Lee uses unstructured interviews. In semi-structured interviews there is a topic guide with call of areas or questions to be covered with each respondent. This technique ensures that researchers allow obtain all the information required, and gives respondents the exemption to respond in their own words, provide as much detail as they wish, and offer illustrations and explanations. Lee et al (2009) uses ground theory approach but incorporated with unstructured interviews.Unstructured interviews also known as are flexible but are more time-consuming than semi-structured since the interviewer listens and does not take the lead. The interviewer listens to what the interviewee has to say. The interviewee leads the intercourse (Wood & Ross-Kerr, 2011). However, anonymity for confidentiality which is of utmost importance is not possible. When using unstructured interviews, the researchers have to be able to establish rapport with the participant. The reason is that the interviewers have to be trusted if someone is to reveal intimate life information. This may lead to interviewee preconceived idea. Also, it is important to realise that unstructured interviewing can produce a great deal of data which can be difficult to analyse. Lee et al (2008) and Fenwick et al (2008) conducted the interviews themselves while Parker (2011) did not, thus reducing the bias. However, interviewer bias occurs even if someone else is conducting the interview.The number of mothers in the study of Lee et al (2008) was adequate since with in-depth interviews 20 participants are enough. However, to account for the small sample, more interviews and observations were done with the same participants in order to reach theoretical saturation. normally informants are selected for in-depth interviews in a purposive manner questioning the generalizability of the results (Wood & Kerr, 2011).A major controversy among grounded theory researchers relates to whether to follow the original Glaser and Strau ss procedures or to use the adapted procedures of Strauss and Corbin (Polit & Beck 2010). Grounded theory method according to Glaser emphasizes induction or emergence, and the individual researchers creativity within a clear frame of stages, while Strauss is more interested in validation criteria and a systematic approach. Parker (2011) uses the original Glaser and Strauss (1967) paradigm while Lee et al (2008) and Fenwick et al (2008) use Strauss and Corbin (1998) procedures.One of the fundamental features of the grounded theory approach is that data collection, data analysis, and sampling of study participants occur simultaneously. A procedure referred to as constant comparison is used to develop and refine theoretically relevant categories. Categories elicited from the data are constantly compared with data obtained earlier in the data collection process so that commonalities and variations can be determined. As data collection proceeds, the inquiry becomes increasingly centre o n emerging theoretical concerns. All 3 studies use constant comparison.All the above 3 studies use audio-taping for data collection except for Fenwick et al (2008) who used field note documentation as well. Audio-taping enables eye contact to be maintained and to have a complete record for analyses, however, some interviewees may be nervous of tape-recorders. On the contrary, in note taking on the other hand, a lot of eye contact is lost unless a type of short-hand is learnt. However, the interviewer will have plenty of useful quotations for report when transcribing the interview.Randomized controlled trials consist of a complete experimental test of a new intervention, involving the random grant of a large and varied sample to different groups (Polit & Beck, 2010). The target of an RCT is to arrive to a judgment as to whether the novelty of an intervention is more effective than the traditional intervention (Polit & Beck, 2010). This intention was well noticed end-to-end the RCT s chosen by Ali etal., (2009). Wood & Kerr, (2011) sustain that RCTs are the most rigorous method to determine a cause-effect relationship between the treatment and the outcome. Furthermore, RCTs were also described as the gold standard trial for evaluating the potential of a clinical intervention ((Muijs 2010). One of the primary aims of RCTs is to prevent selection bias by distributing the patient, at random between the two groups, so that the difference in the outcome and results can be justified and attributed lonesome(prenominal) to the intervention under study.Thus, through random selection there is a better balancing of any confounding factors, therefore creating similarity between the groups (Cottrell & McKenzie, 2010). In effect in this literature review, RCTs were found to be useful and beneficial to compare the effect of KMC and conventional care on the physiological aspects of the infant. Ali et al., (2009) chose to add city block to randomisation so as to ensure a b etter balance in the number of infants allocated in the groups. These groups were randomized through simple randomization and the disruption of groups was achieved by delivering a concealed envelope technique. with random sampling, Polit & Beck (2010) explain that each element in the population has an equivalent, autonomous chance of being chosen. However, this design is not used frequently as it is lengthy and may be expensive (Wood & Kerr, 2011).Chiu and Anderson (2008), use tangled methods of data collection by using both questionnaires and video-taped interviews. The use of multiple sources or referents to draw conclusions about what constitutes the truth is called triangulation. This is one approach in establishing credibility as it enables the researcher to counteract the weaknesses in both designs. The use of video-taping provides the most comprehensive recording of an interview since it captures body language, facial expressions and interaction (Gerrish and Lacey 2010). Ho wever the interviewee may become uncomfortable and act differently than in normal dower questioning the reliability of the data collected. In addition, questionnaires are the main research tools used in quantitative research. They are very plus as they can be constructed in such a way as to meet the objectives of close any research project.In the Family Needs Inventory used by Nicholas-Sargent (2009), the not applicable part was removed from the Likert scale in order to report definite opinions. Questionnaires can measure the participants factual knowledge about a certain subject or an idea or else they can be used to explore opinions, attitudes or behaviours (McNabb, 2008). Moreover, questionnaires are also less expensive than most other research instruments and are also less time-consuming . Self-administered questionnaires provide the participants with anonymity, and responses are not affected by the interviewers toughness or presence (Wood & Ross-Kerr, 2011). On the other ha nd, the main disadvantage of questionnaires is that there is a high gap of a poor response rate since some questions are ignored, misinterpreted, incorrectly completed or inadequately detailed (Polit and Beck 2010).The RCT of Chiu and Anderson (2009) and Ali etal. (2009),, is one of the most powerful tools of research where people are allocated at random to receive one of several clinical interventions. However RCTs are susceptible to multiple types of bias at all stages of their workspan (Geretsegger et al 2012). Hence the need to establish validity and reliability. In the study done by both Ali etal.,(2009) and Chiu and Anderson (2009),the researchers increase the rigor on the study by using a large number of participants. In addition, Chiu and Anderson (2009) use the treat Child Assessment Satellite Training Program (NCAST) Feeding and dogma scales. Nicholas-Sargent (2009), improved the rigour by using the Critical Care Family Needs Inventory (CCFNI), as a framework for the FNI. CCFNI has been thoroughly reported with results indicating internal consistency and construct validity (Gerrish and Lacey 2010). Despite this, Nicholas-Sargent (2009), use a small scale study and therefore the results cannot be generalized.LimitationsIn the study done by Lee et al (2008), the data were only collected from one hospital in this present study cause generalisability of the results to be low. Moreover, the sample was restricted to those who did not have additional social, cultural or medical circumstances to consider. Moreover, coding was done by researcher itself and this might have caused some bias. Both Nicholas-Sargent (2009) and Parker (2011) use small scale studies but these were qualitative studies.Therefore, to a certain extent the findings cannot be generalized across the population of families involved with the NICU. In addition, Parker (2011) uses a retrospective study, which might have been subject to bias in recalling information. There was absence of pilot study in both Nicholas-Sargent (2009) and Chiu and Anderson (2009). The use of pilot studies helps to assess the design, methodology and feasibleness of the tool and typically includes participants who are similar to those who will be used in the larger research study ( Wood & Kerr 2011). Hence, their importance.Also, the instruments chosen by Chiu and Anderson (2009), being the (NCAST and the feeding and teaching scales) for this study might not be sensitive enough to capture any between-group difference in changes resulting from the intervention.Finally, Ali et al., (2009) fail to mention intention to treat analysis where researchers can introduce reality into research by outlining that not all randomize participants will continue throughout the study. Therefore, this might be a potential weakness in this study. It was also noted the there was no detailed report about the time intervals between the two different groups. Hence, this may also have introduced performance bias. In the grounded theory approach taken by Fenwich et al (2008), limitations lie in the method of data collection itself through semi-structured interviews that were tape-recorded and field note documentation done. The authors did not acknowledge limitations in the study.RecommendationsMaternal contactFenwich et al (2008) suggests prioritising maternal-infant closeness when underpinning policies and protocols and suggests the unrestricted access to their child. Lee et al (2008) found that in Taiwan mothers are allowed to visit for 30 minutes twice a day. In Malta, mothers are allowed to stay with the child 24 hours a day. In addition, skin-to-skin contact is recommended by both Lee et al (2008) and Chiu and Anderson (2009). The latter suggests that all mothers, if they are able and whether or not they ask for it, skin-to-skin contact should be encouraged. My suggestions on interventions for critically ill infants include encouraging the parents presence at the bedside, assisting the p arents in personalizing the bedside, and teaching the parents to gently touch their infant.Another approach is to hang a simple picture board with the first names of nurses and practitioners near the entrance to the unit. This picture board helps anxious families feel welcomed in this healing environment.In our unit, those babies who have central lines such as umbilical arterial catheters (UAC), the mothers are not allowed to hold the baby for fear of bleeding if the UAC gets dislodged. However, if the mother shows signs of needing contact with the baby, we allow her to hold the baby with constant supervision. In the case of babies that are ventilated mothers are only allowed to hold their baby if the prognosis is very poor. Therefore, this shows that, if the baby is on long term ventilation, skin-to-skin is hindered from being introduced.Fenwich et al (2008), recommend the development of tools that can better evaluate the satisfaction of the mother. Hence, the need for longitudinal qualitative research. In my opinion this would yield good results when past experiences would show which improvements were helpful and which were not. NICE standards (2010), specify the use of surveys. We can incorporate these surveys after consideration with the midwifery officer.Mother-nurse-infant interactionBecause of the complexity of illness, parents of critically ill infants are anxious and fear the worst with every visit to the NICU. Strategies need to be adapted to decrease maternal anxiety while supporting the needs of these infants. (Nicholas-Sargent 2009). Nurses play a resilient role in helping parents throughout the stressful and challenging experience of the NICU by underdeveloped therapeutic relationships and providing emotional support. These approaches enable parents to feel more supported, more involved, confident, and more effective as parents of their vulnerable newborn. The experience of parents in the NICU occurs during an emotionally intense period fraugh t with anxiety, stress, depression, and feelings of hopelessness. Therefore, Nicholas-Sargent (2009) suggests that, it would be vital to do an NICU orientation for expectant parents with a high risk of giving birth to a premature infant or a compromised newborn.Supporting and facilitating their parenting role will help decrease their stress, strain, anxiety, and depression. Lee et al (2008), nurses need to respect the cultural preferences of mothers as this would promote desired health outcomes. This would aid in meaningful, holistic and individualized care. According to Nicholas-Sargent (2009), personalized one-to-one as opposed as opposed to group support would be helpful. In addition Nicholas-Sargent (2009), suggests that nurse education is needed to improve the awareness of the impact of the talk over service. However, the service needs to be more flexible due to fluctuations in the health condition of the baby. In fact, what we notice is that mothers would require steering at different stages of the hospitalization.Therefore, if the service was refused once, it may still mean that mothers would need it at some other point in time. Nicholas-Sargent (2009), further suggests that the counselling service would be increase to the whole family from the hospital as well as in the community., Both the DH (2009), and NICE (2010) highlight the importance of Family-Centered Care (FCC) views the family as the childs primary source of strength and support and allows for collaboration, respect, and support with the parents and family during all levels of the service delivery.To foster participation in care for the infant, unrestricted visiting hours should be encouraged for the atomic family of the neonate. In Malta, visiting hours are restricted to parents only due to increase in cross contagious disease when family members were allowed to visit for 1 hour everyday during the day. However, timing of care may still be lay to facilitate parents participation. In a ddition, special moments such as babys first time off CPAP (continuous positive airway pressure) needs to take place during parents presence. Cockfort (2011), highlights that missed opportunities to involve parents in care, heighten anxiety and can create a sense of sadness and loneliness .Information for mothersMothers vary in the make sense of information they can assimilate under stress. Therefore identifying parents feelings through active listening and observing will help us to pick up on parents cues and respond appropriately in order to provide parents with accurate and clear information (Fenwick et al 2008). Nicholas-Sargent (2009), adds that, information regarding the health status of the baby needs to be give in a timely provision.Parker (2011), recommends the access to certified interpreters for non-English speaking parents to enable them to ask questions and get the information they need as well as information regarding the counselling services.Likewise, an updated info rmation board at the infants bedside helps mothers retain information while feeling welcome at the bedside. In my opinion, these interventions create an environment that facilitates maternal- infant attachment by promoting maternal competence with meaningful positive parenting skills and fostering partnership in care..ConclusionIn summary, the findings showed that parents of infants admitted to the NICU experience stress, depression, anxiety, and feelings of powerlessness, hopelessness, and alienation within the environment of the NICU. These situations are often overwhelming and catastrophic for the mothers keeping in mind that the process of motherhood is a protecting and amiable phenomenon. Therefore mothers should participate in the care of their sick, fragile infant in the NICU through mother-infant interaction.Nurses need to be supportive and informative in dealing with parents in the NICU. Therefore, the need for parents to be given the access of interpretation by certified i nterpreters in order to overcome language barriers has been identified. Further, information and emotional support is required throughout the stay in the NICU, However, it was further found that information in preparation for finish planning is vital. This enhances parental knowledge and decreases stress, which promotes more effective parenting.Further, as understanding of the parents experience of having an infant admitted to the NICU increases, nurses will be better prepared to meet parental needs and alleviate parental suffering. Providing holistic, developmentally supportive care and open communication with parents in this stressful experience is essential. Moreover, the need for family-centered care has been identified. character reference LISTAli, M.S., Sharma. J., Sharma. R., & Alam. S. (2009). Kangaroo mother care as compare to conventional care for low birth system of weights babies. Dicle Tip Dergisi. 36(3), 155-160.Chiu S. & Anderson G.C., (2009). 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