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Background: Kangaroo mother care including skin-to-skin care aims to overcome the negative effects of separating parents and infants and to increase the quality of care for infants and parents in need of neonatal care. In most cases where inter-hospital transport is needed, the infant is placed in a transport incubator, which increases the risk of separation due to ambulance service restrictions that imply that parents are not allowed to accompany these transport trips. Aim: To illuminate parents' experiences of holding their infant in a kangaroo position during neonatal ground ambulance transport. Study design: A qualitative design with an inductive approach. Methods: A total of 11 open interviews with Swedish parents were conducted two to seven days after their infant had been transferred in a kangaroo position between hospitals. The transcribed interviews were analysed using qualitative content analysis. Results: The emerged overarching category was “an uninterrupted closeness chain.” The parents experienced that holding their infant during the transport extended the time they were close to their infant. Using the kangaroo position during ground ambulance transport also created a feeling of being important as a parent, as their participation during transport was appreciated. Parents' experiences were allocated into three categories: “Strengthen the feeling of being important as a parent,” “promote security and create a positive environment for the baby” and “the professionals' attitude promotes security.”. Conclusion and relevance for clinical practice: This knowledge about parents' experiences is important in the continued work to develop interventions that focus on promoting zero separation in neonatal care. Using kangaroo position in a safety harness during ambulance transport enhances zero separation and closeness. To encourage the implementation of kangaroo position during ambulance transport, further research is needed to address parents' experiences of zer

Background: The positive effects of Kangaroo mother care in NICU’s are well documented but, to a lesser extent, explored during inter-hospital neonatal transport. Inter-hospital transport, with the infant placed in a transport incubator, increases the risk of separation while infants in Kangaroo mother care position implies that the parents accompany the transport. There exists limited knowledge if physiological stability differs when transported in Kangaroo mother care position compared to transport in a transport incubator. Aims: The aim of this study was to compare physiological stability of infants transported via ground ambulance in either Kangaroo mother care position or positioned in a transport incubator. Method: In total, 24 infants were recruited to be transported between hospitals in either a Kangaroo mother care position (n = 16) or in a transport incubator (n = 8). Inclusion criteria were; current weight >1500 g; current gestational age above 31 +0 weeks; no central catheter; no respiratory support and no planed painful or distressing interventions during the 48-h follow-up period post-transport. Exclusion criteria were; infants whose parents did not speak or understand Swedish or English and infants with a current weight above 4500 g for the KMC group. Physiological stability was obtained during transport and for a 48-h follow-up period by measuring body temperature, respiratory and heart rate, oxygen saturation, pain score, transport risk assessment and number of interventions during transport and 48-h post-transport. Cost-effectiveness and adverse events were also evaluated. Results: Both groups had comparable background characteristics and physiological stability during transport and for the 48-h follow-up period after transport. Transporting in Kangaroo mother care position was more cost-effective. Study limitation: A small sample size in both groups. Conclusion: Transporting an infant in Kangaroo mother care position can be regarded as a choice

Bakgrund: En förälders död är en av de mest dramatiska händelser som kan drabba barn och ungdomar och det kan påverka dem på många olika sätt. Syfte: Att undersöka hur ungdomar som förlorat en förälder inkluderades i ett stödprogram för sörjande familjer och hur deras deltagande tog sig uttryck. Metod: En etnografisk fältstudie där data samlades in med hjälp av observationer, semi-strukturerade intervjuer och fokusgruppsintervjuer. Sex ungdomar i ålder 10–14 år, sex föräldrar och åtta gruppledare deltog. Tematisk analys enligt Braun och Clark utfördes, inspirerad av Bourdieus begrepp fält, kapital, doxa och makt som teoretiskt ramverk. Resultat: Professionella i skolan, inom vården och socialarbete introducerade ofta stödprogrammet för föräldrar och ungdomar och övertygande initialt föräldrarna att delta i programmet. Några vuxna kände redan till att det fanns ett stödprogram. Utgångspunkten för ungdomars deltagande i stödprogrammet var att vuxna erkände att ungdomarna behövde stöd. Med eller utan förhandlingar följde ungdomarna föräldrarnas önskemål att delta i programmet. Stödprogrammet liknade skolans logik både i kontexten, innehållet och tillvägagångsättet. Strukturen och innehållet i programmet var grundat i medicinsk – psykologisk förståelse av sorg och sorgebearbetning. Gruppledarna skapade en atmosfär som liknande skolatmosfären och ungdomarna agerade som elever och utförde det om förväntades av dem. Ungdomarna interagerade endast med varandra under pauserna i stödprogrammet. Betydelse: Studien visar på betydelsen av att vuxna är lyhörda för ungdomars individuella behov av stöd då det kan variera och inte alltid sammanfaller med vuxnas föreställningar om ett bra stöd. Det är lämpligt att involvera ungdomar som förlorat en förälder vid utveckling av framtida stödinsatser riktat mot dem.