***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background . Based on the general bonding hypothesis , it is suggested that kangaroo mother care ( KMC ) creates a climate in the family whereby parents become prone to sensitive caregiving . The general hypothesis is that skin-to-skin contact in the KMC group will build up a positive perception in the mothers and a state of readiness to detect and respond to infant 's cues . Method . The r and omized controlled trial was conducted on a set of 488 infants weighing < 2001 g , with 246 in the KMC group and 242 in the traditional care ( TC ) group . The design allows precise observation of the timing and duration of mother – infant contact , and takes into account the infant 's health status at birth and the socioeconomic status of the parents . Bonding Assessment . Two series of outcomes are assessed as manifestations of a mother 's attachment behavior . The first is the mother 's feelings and perceptions of her premature birth experience , including her sense of competence , feelings of worry and stress , and perception of social support . The second outcome is derived from observations of the mother and child 's responsivity to each other during breastfeeding at 41 weeks of gestational age . Interventions . KMC has three components . The first is the kangaroo position . Once the premature infant has adapted to extrauterine life and is able to breastfeed , he is positioned on the mother 's chest , in a upright position , with direct skin-to-skin contact . The second component is kangaroo nutrition . Although breastfeeding is the prime source of nutrition , infants also may receive preterm formula whenever necessary and vitamin supplements . The third component is the clinical control ; infants are monitored on a regular basis , daily until they are gaining at least 20 g per day . Afterward , weekly clinic visits are scheduled until term , which constitutes the ambulatory minimal neonatal care . In the TC group , infants are kept in incubators until they are able to self-regulate their temperature and are thriving ( ie , have an appropriate weight gain ) . Infants are discharged according to current hospital practice , usually not before their weight is ∼1700 g. Afterward , as with the KMC group , weekly clinic visits are scheduled until term . Results . We observed a change in the mothers ' perception of her child , attributable to the skin-to-skin contact in the kangaroo-carrying position . This effect is related to a subjective “ bonding effect ” that may be understood readily by the empowering nature of the KMC intervention . Moreover , in stressful situations when the infant has to remain in the hospital longer , mothers practicing KMC feel more competent than do mothers in the TC group . This is what we call a resilience effect . In these stressful situations we also found a negative effect on the feelings of received support of mothers practicing KMC . We interpret this as an isolation effect . To thwart this deleterious effect , we would suggest adding social support as an integral component of KMC . The observations of the mothers ' sensitive behavior did not show a definite bonding effect , but rather a resilience effect . This is attributable to the KMC intervention ; mothers practicing KMC were more responsive to an at-risk infant whose development has been threatened by a longer hospital stay . Otherwise , we observed that the mothers ( in both the KMC group and the TC group ) had behavioral patterns that were adapted to the child 's at-risk health status and to the precarious condition of some premature infants requiring intensive care . We conclude that the infant 's health status may be a more prominent factor in explaining a mother 's more sensitive behavior , which overshadows the kangaroo-carrying effect . Conclusion . These results suggest that KMC should be promoted actively and that mothers should be encouraged to use it as soon as possible during the intensive care period up to the 40 weeks of gestational age . Thus , KMC should be viewed as a means of humanizing the process of giving birth in a context of prematurity . This finding confirms the conclusions of the 1996 Trieste workshop suggesting that KMC should be promoted both in hospitals and after early discharge Thirty mothers of preterm infants requiring neonatal intensive care unit ( NICU ) hospitalization were assigned r and omly to one of three groups to assess differences in treatment effectiveness of facilitating parental adaptation to the NICU stresses . Groups consisted of : ( a ) a treatment group receiving videotape training in active problem-focused coping strategies ; ( b ) a treatment group receiving videotape training in emotion-focused strategies to help manage anxiety ; and ( c ) a control group receiving promotional information about the hospital and the NICU . On pretreatment measures most of the mothers exhibited little distress , a finding unlike those for the majority of NICU studies . On posttreatment follow-up both the problem-focused and emotion-focused treatment groups were significantly less anxious than the controls and lower levels of depression were observed for the emotion-focused group . Findings suggest that the coping interventions examined were cost efficient and appear promising in facilitating mothers ' coping with NICU stresses The purpose of this r and omized controlled trial was to investigate the influences of music during kangaroo care ( KC ) on  maternal anxiety and preterm infants ' responses .  There are no experimental studies that explore the influences of combination of music and KC on psychophysiological responses in mother-infant dyads . Purposive sampling was used to recruit 30 hospitalized preterm infants body weight 1500 gm and over , gestational age 37 weeks and lower from two NICUs . Mother-infant dyads were r and omly assigned to the treatment and the control group using permuted block r and omization stratified on gender . There were 15 mother-infant dyads in each group . Subjects in the treatment dyads listened to their choice of a lullaby music during KC for 60 min/section/day for three consecutive days . Control dyads received routine incubator care . Using a repeated measures design with a pretest and three posttests , the responses of treatment dyads including maternal anxiety and infants ' physiologic responses ( heart rate , respiratory rate , and O2 saturation ) as well as behavioural state were measured . The results revealed that there were no significant differences between the two groups on infants ' physiologic responses and the values were all in the normal range . However , infants in the treatment group had more occurrence of quiet sleep states and less crying ( p<0.05 - 0.01 ) . Music during KC also result ed in significantly lower maternal anxiety in the treatment group ( p<0.01 ) . Maternal state anxiety improved daily , indicating a cumulative dose effect . The findings provide evidence for the use of music during KC as an empirically-based intervention for bahavioural state stability and maternal anxiety in mother-infant dyads Objective This study tested the effect of an intervention to strengthen parent-professional collaboration by increasing the accuracy of parents ' underst and ing of medically relevant information and providing parent-professional meetings to plan infants ' care . Methods A tri-ethnic sample of mothers of 154 very-low-birth-weight infants participated , with parents of 77 infants in a control group and parents of 77 infants in an intervention group .  Comprehension of infant medical condition and satisfaction with collaboration in treatment decisions in the 2 groups were measured 3 times during the first 28 days after admission using 9 collaboration scales . Intervention effects were analyzed with ANOVA and ANCOVA . Results and Conclusions Statistically significant change was found in 6 of 9 scales used to measure collaboration and accuracy of parents ' underst and ing . The intervention group had fewer unrealistic concerns ( P = .018 ) , and less uncertainty about infant medical conditions ( P = .003 ) ; less decision conflict ( P ≤ .001 ) , more satisfaction with the process by which medical decisions were made ( P = .012 ) and with the amount of decision input they had ( P = .058 ) , and reported more shared decision making with professionals ( P = .010 ) . There were no statistically significant differences between the groups in satisfaction with infants ' care , satisfaction with relationships with physicians and nurses , and satisfaction with the decisions made for their infants ' treatment . Infant birth weight and gestational age and maternal demographic characteristics were found to influence collaboration results . The intervention was especially effective in improving underst and ing and collaboration in low-income , young , minority mothers Controversy characterizes the reported effects of home monitoring on parental well-being . However , past studies were largely retrospective and uncontrolled . The present prospect i ve study compared the psychological effects of a home-monitoring program on 40 parents of first-born premature infants with its effect on 30 parents of similar prematures and 32 parents of normal full-term infants .  Home interviews conducted within 2 weeks after discharge were complemented with st and ardized instruments measuring psychological symptoms , life events , and family satisfaction . All of the parents of monitored infants participated in an educational and support program and did not report increased depression , anxiety , or other psychological symptoms , compared with parents of nonmonitored premature of full-term infants . These monitoring parents reported significantly more support than did other parent groups ( p = 0.005 ) . Surprisingly , parents of non-monitored prematures reported higher psychological symptoms than those in either of the other study groups . Results suggest that a professional educational and support program protects the psychological well-being of parents of premature infants Objective : To evaluate the influence of parenting intervention on maternal responsiveness and infant neurobehavioural development  following a very premature birth . Design : Cluster-r and omised controlled trial , with a crossover design and three-month washout period . Setting : Six neonatal intensive care units . Patients : Infants born < 32 weeks ’ gestation . Intervention : The Parent Baby Interaction Programme ( PBIP ) is a supportive , educational intervention delivered by research nurses in the neonatal intensive care unit , with optional home follow-up for up to six weeks after discharge . Main outcome measures : Parenting stress at 3 months adjusted age , as measured by the Parenting Stress Index ( PSI ) . Other outcomes included the Neurobehavioural Assessment of the Preterm Infant ( NAPI ) and maternal interaction as assessed by the Nursing Child Assessment Teaching Scale ( NCATS ) and the responsivity subscale for Home Observation for Measurement of the Environment ( HOME ) . Results : 112 infants were recruited in the intervention phases and 121 in the control phases . Mean st and ardised NAPI scores at 35 weeks did not differ between the PBIP and control groups . Both groups had low but similar NCATS caregiver scores before discharge ( 36.6 in the PBIP group and 37.4 in control , adjusted mean difference −0.7 , 95 % CI −2.7 to 1.4 ) . At three months , adjusted age mean PSI scores for the PBIP group were 71.9 compared with 67.1 for controls ( adjusted mean difference 3.8 , 95 % CI −4.7 to 12.4 ) . NCATS scores and HOME responsivity scores were similarly distributed between the groups . Conclusion : This early , nurse-delivered , parent-focused interaction programme intervention had no measurable effects on short-term infant neurobehavioural function , mother – child interaction or parenting stresses OBJECTIVE To determine whether providing mothers of babies in neonatal intensive care units with audiotapes of their conversations with a neonatologist improves recall of information and psychological wellbeing . DESIGN R and omised , single blinded trial . SETTING Neonatal intensive care unit , North Queensl and , Australia . PARTICIPANTS 200 mothers of babies in a neonatal intensive care unit . INTERVENTIONS Mothers given ( n=102 ) or not given ( n=98 ) audiotapes of their conversations with a neonatologist . MAIN OUTCOME MEASURES Recall of information , attitudes to and use of the tape , satisfaction with conversations , postnatal depression , anxiety , general health , and stress about parenting , at 10 days and four and 12 months . RESULTS 91 % ( n=93 ) of mothers in the tape group listened to the tape ( once by day 10 , twice by four months , and three times by 12 months ; range 1 - 10 ) . At 10 days and four months , mothers in the tape group recalled significantly more information about diagnosis , treatment , and outcome than mothers in the control group . At four months mothers in the tape group were 75 % more likely to recall all of the information about treatment than mothers in the control group ( 59 % v 34 % ; risk ratio 1.75 , 95 % confidence interval 1.27 to 2.4 ) . Six mothers , all in the control group , could not recall their conversations . No statistically significant differences were found between the groups in satisfaction with conversations ( 10 days ) , postnatal depression and anxiety scores ( 10 days , four and 12 months ) , and stress about parenting ( 12 months ) . CONCLUSION Providing the mothers of babies in neonatal intensive care units with audiotapes of conversations with a neonatologist enhanced their recall of information ( up to four months ) . The taped conversations did not affect the mothers ' wellbeing or satisfaction with the neonatologist . TRIAL REGISTRATION Australian Clinical Trials Registry 12606000478516 OBJECTIVE To examine how family-based interventions in the neonatal intensive care unit ( NICU ) may change  parental knowledge and behaviors and decrease stress . METHODS Eighty-four high-risk mother-infant dyads were r and omly assigned to two intervention and one control groups . Group 1 ( n = 28 ) participated in a demonstration of infant reflexes , attention , motor skills , and sleep-wake states . Group 2 ( n = 31 ) viewed educational material s. Group 3 ( n = 25 ) , controls , participated in an informal discussion . Parent-infant interactions ( Nursing Child Assessment Feeding Scale ) were videotaped . Mothers completed measures of stress ( Parenting 
    Output:
    
Results Interventions for supporting , communicating with , and providing information to parents that have had a premature infant are reported .
Parents report feeling supported through individualised developmental and behavioural care programmes , through being taught behavioural assessment scales , and through breastfeeding , kangaroo-care and baby-massage programmes .
Parents also felt supported through organised support groups and through provision of an environment where parents can meet and support each other .
Parental stress may be reduced through individual developmental care programmes , psychotherapy , interventions that teach emotional coping skills and active problem-solving , and journal writing .
Evidence reports the importance of preparing parents for the neonatal unit through the neonatal tour , and the importance of good communication throughout the infant admission phase and after discharge home .
Providing individual web-based information about the infant , recording doctor – patient consultations and provision of an information binder may also improve communication with parents .
The importance of thorough discharge planning throughout the infant 's admission phase and the importance of home-support programmes are also reported .
Conclusion The paper reports evidence of interventions that help support , communicate with and inform parents who have had a premature infant throughout the admission phase of the infant , discharge and return home .