Why is Kangaroo Mother Care not yet scaled in the UK? A systematic review and realist synthesis of a frugal innovation for newborn care

IF 1.4 Q3 HEALTH CARE SCIENCES & SERVICES
Giulietta Stefani, Mark Skopec, C. Battersby, M. Harris
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引用次数: 8

Abstract

Objective Kangaroo Mother Care (KMC) is a frugal innovation improving newborn health at a reduced cost compared with incubator use. KMC is widely recommended; however, in the UK, poor evidence exists on KMC, and its implementation remains inconsistent. Design This Systematic Review and Realist Synthesis explores the barriers and facilitators in the implementation of KMC in the UK. Data source OVID databases, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and Google Scholar were searched. Eligibility criteria Studies were UK based, in maternity/neonatal units, for full-term/preterm children. First screening included studies on (1) KMC, Kangaroo Care (KC) or skin-to-skin contact (SSC) or (2) Baby Friendly Initiative, Small Wonders Change Program or family-centred care if in relation to KMC/KC/SSC. Full texts were reviewed for evidence regarding KMC/KC/SSC implementation. Results The paucity of KMC research in the UK did not permit a realist review. However, expanded review of available published studies on KC and SSC, used as a proxy to understand KMC implementation, demonstrated that the main barriers are the lack of training, knowledge, confidence and clear guidelines. Conclusion The lack of KMC implementation research in the UK stands in contrast to the already well-proven benefits of KMC for stable babies in low-income contexts and highlights the need for further research, especially in sick and small newborn population. Implementation of, and research into, KC/SSC is inconsistent and of low quality. Improvements are needed to enhance staff training and parental support, and to develop guidelines to properly implement KC/SSC. It should be used as an opportunity to emphasise the focus on KMC as a potential cost-effective alternative to reduce the need for incubator use in the UK.
为什么袋鼠妈妈护理还没有在英国推广?新生儿护理节俭创新的系统回顾与现实综合
目的与使用培养箱相比,袋鼠妈妈护理(KMC)是一种节约创新,以更低的成本提高新生儿的健康水平。KMC被广泛推荐;然而,在英国,关于KMC的证据不足,其实施仍然不一致。设计这个系统的回顾和现实主义的综合探讨障碍和促进在英国实施KMC。检索OVID数据库、护理与相关健康文献累积索引(CINAHL)、Scopus和Google Scholar。研究以英国为基础,在产科/新生儿病房,针对足月/早产儿。第一次筛选包括(1)KMC,袋鼠式护理(KC)或皮肤接触(SSC)或(2)婴儿友好计划,小奇迹改变计划或以家庭为中心的护理(如果与KMC/KC/SSC有关)。全文审阅了有关KMC/KC/SSC实施的证据。结果由于英国对KMC研究的缺乏,无法进行现实的回顾。然而,对现有已发表的关于KC和SSC的研究(用来作为理解KMC实施的代理)的扩展审查表明,主要障碍是缺乏培训、知识、信心和明确的指导方针。结论:英国缺乏KMC实施研究,这与已经得到充分证明的低收入环境下稳定婴儿的KMC益处形成鲜明对比,并强调了进一步研究的必要性,特别是在生病和小新生儿人群中。KC/SSC的实施和研究不一致,质量不高。需要改进以加强员工培训和家长支持,并制定适当实施KC/SSC的指导方针。这应该作为一个机会来强调KMC作为一个潜在的具有成本效益的替代方案,以减少英国对孵化器使用的需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Innovations
BMJ Innovations Medicine-Medicine (all)
CiteScore
4.20
自引率
0.00%
发文量
63
期刊介绍: Healthcare is undergoing a revolution and novel medical technologies are being developed to treat patients in better and faster ways. Mobile revolution has put a handheld computer in pockets of billions and we are ushering in an era of mHealth. In developed and developing world alike healthcare costs are a concern and frugal innovations are being promoted for bringing down the costs of healthcare. BMJ Innovations aims to promote innovative research which creates new, cost-effective medical devices, technologies, processes and systems that improve patient care, with particular focus on the needs of patients, physicians, and the health care industry as a whole and act as a platform to catalyse and seed more innovations. Submissions to BMJ Innovations will be considered from all clinical areas of medicine along with business and process innovations that make healthcare accessible and affordable. Submissions from groups of investigators engaged in international collaborations are especially encouraged. The broad areas of innovations that this journal aims to chronicle include but are not limited to: Medical devices, mHealth and wearable health technologies, Assistive technologies, Diagnostics, Health IT, systems and process innovation.
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