The Effectiveness of the Kangaroo Care Method in Neonates and Its Relationship With Parental Stress and Satisfaction in the Neonatal Intensive Care Unit

Introduction Kangaroo care (KC), defined as the first, sustained skin-to-skin contact between parents and their neonates, is widely recognized as a key family-centered intervention in the Neonatal Intensive Care Unit (NICU). Beyond its physiological characteristics, including improved thermoregulation, cardiorespiratory stability, and breastfeeding, KC has demonstrated significant psychosocial benefits, particularly in reducing parental stress and enhancing parent-neonate bonding. Despite strong international evidence, there is limited data from the Greek NICU setting on the association of KC with parental stress and satisfaction. This study aimed to evaluate the effect of KC in reducing parental stress and increasing parental satisfaction with neonatal care. Methods A quasi-experimental two-group design (intervention versus control) was implemented in a Greek NICU. A total of 80 parents of preterm or full-term neonates (gestational age 24-40 weeks) participated. Parents in the intervention group (n=40) applied KC for 1 hour daily throughout the hospitalization, while the control group (n=40) received regular care with limited physical contact. Parental stress was assessed using the Parental Stress Scale: NICU (PSS: NICU) at baseline and at the end of hospitalization, and parental satisfaction using the NICU Parent Satisfaction Form (NICU-PSF). The clinical status of the neonate was assessed using the ALPS-Neo scale. Independent t-tests and Chi-square tests were used for comparisons between groups, and Spearman’s rho correlations examined associations between demographic/clinical variables and parental outcomes. Results Parents in the KC group showed significantly lower total scores compared to controls (107.69 ± 9.45 vs. 121.40 ± 14.68, p = 0.015). Stress related to the change in parental role was also significantly reduced (32.92 ± 2.89 vs. 38.60 ± 6.08, p = 0.002). No significant differences were observed in stress related to NICU sounds (p = 0.46) or the appearance of the newborn (p = 0.11). Overall parenting satisfaction was high in both groups (KC group: 4.14 ± 0.44 vs control group: 4.18 ± 0.02, p=0.572). Maternal age was negatively associated with anxiety across all domains (rho = -0.337 to -0.389, p < 0.01). Perceived family support showed a strong positive association with anxiety related to the NICU environment and neonate appearance (rho = 0.61-0.73, p < 0.001). Neonatal clinical status (ALPS-Neo) was positively associated with both parenting satisfaction (rho = 0.473, p < 0.001) and stress related to neonate appearance (rho = 0.383, p = 0.001). Conclusion KC was associated with significantly lower parental stress, particularly regarding parental role disruption, reinforcing its value in enhancing parental involvement and emotional well-being in the NICU. Parental satisfaction remained high in all groups, further influenced by the clinical status of the neonates. The findings support the extensive, systematic integration of KC in Greek NICUs, aligned with international recommendations, to improve both parental psychological outcomes and overall quality of neonatal care.