Effects of kangaroo nursing after cesarean section on paternal role adjustment and subjective well-being for first-time fathers / 中华健康管理学杂志

ABSTRACT

Objective:To explore the effects of kangaroo nursing after cesarean section on the paternal role adaptation and subjective well-being of first-time fathers.Methods:In this randomized controlled trial, a total of 160 first-time fathers of newborns delivered by cesarean section from May 2021 to May 2022 in the First Affiliated Hospital of Wenzhou Medical University were continuously selected as research objects and randomly divided into experimental group (80 cases) and control group (80 cases) by random number table method. In the control group, the nursing staff carried out routine obstetric care after the birth of the newborns, the newborns were swaddled to keep warm and transferred to the ward, the fathers took care of them by the side; and the fathers were given postnatal routine education and guidance once a day, including newborn bathing, touching and umbilical buttock care, maternal breast care, breastfeeding, diet, medication and discharge precautions etc. The experimental group were given kangaroo nursing on care basis of control group the father took a comfortable position that half leaned on the recliner with his shirt unbuttoned, the naked newborn was placed on the father′s chest at an angle of approximately 60 degree on the head up and feet down for maximum skin to skin contact with the help of researchers. The newborn′s back was covered with a blanket and wrapped in the father′s clothes, soft music was playing throughout the whole process, meanwhile, researchers encouraged interactions through verbal communications and touching between the father and the newborn. After newborns returned to the ward, they were given kangaroo nursing immediately by the fathers for the first time, and then twice a day in the same way, lasting for 30-40 min every time, and a total of 6 times of kangaroo nursing were completed during in first 3 days after birth. The average hospitalization period of both groups was 5 days. The father-role adjustment scale and subjective well-being scale were asseessed in the fathers, the independent sample t test was used to compare differences of father-role adjustment level and subjective well-being at the time of discharge between the two groups, the Pearson correlation analysis was used to evaluate the correlation between the two variables. Results:The total score of paternal role adaptation, and the three dimensions scores including role identity, parent-child attachment establishment and nursing behavior implementation in the experimental group were all significantly higher than those in the control group (83.91±7.90 vs 78.79±9.44, 28.94±2.64 vs 27.85±3.36, 28.39±3.15 vs 26.46±3.52, 26.59±4.26 vs 24.48±3.81) ( t=3.725, 2.276, 3.647, 3.309, all P<0.05). The total score of subjective well-being, and the three dimensions scores including health worry, energy, melancholy or pleasant mood in the experimental were all significantly higher than those in the control group (88.34±6.38 vs 83.43±7.26, 7.70±1.77 vs 6.95±1.46, 20.03±3.15 vs 18.76±2.94, 19.41±2.01 vs 17.99±2.68) ( t=4.546, 2.928, 2.625, 3.805, all P<0.05), and were all significantly higher than those before the intervention (74.83±5.84, 6.11±2.22, 16.98±2.68, 15.18±2.13) ( t=13.069, 5.207, 6.261, 13.332, all P<0.05). There was a positive correlation between fathers′ subjective well-being and paternal role adaptation ( r=0.614, P<0.001). Conclusions:The father-centered kangaroo nursing after cesarean section can improve postpartum paternal role adaptation and subjective well-being of first-time fathers. There is a positive correlation between the subjective well-being and the paternal role adaptation level.