Transforming neonatal nursing: a randomized controlled trial comparing kangaroo care and standard protocols for survival in preterm infants with respiratory distress syndrome

Table 5 Mother-infant bonding tool scores and psychosocial outcomes across study period

MIBT component	KMC group (n = 120)	Standard care group (n = 120)	Mean difference (95% CI)	Effect size (Cohen’s d)	p-value¹
Technical competency²
- Baseline (Day 1)	2.1 (0.8) [1]	2.0 (0.7) [2]	0.1 (−0.1, 0.3)	0.13	0.324
- Day 3	3.4 (0.7) [2]	2.4 (0.8) [1]	1.0 (0.8, 1.2)**	1.33	<0.001
- Day 7	4.2 (0.6) [1]	2.8 (0.7) [2]	1.4 (1.2, 1.6)**	2.14	<0.001
- Pre-discharge	4.8 (0.5) [1]	3.1 (0.6) [1]	1.7 (1.5, 1.9)**	3.12	<0.001
Maternal responsiveness⁴
- Baseline (Day 1)	2.3 (0.9) [2]	2.2 (0.8) [1]	0.1 (−0.1, 0.3)	0.12	0.342
- Day 3	3.6 (0.8) [1]	2.6 (0.7) [2]	1.0 (0.8, 1.2)**	1.34	<0.001
- Day 7	4.3 (0.7) [1]	3.0 (0.8) [1]	1.3 (1.1, 1.5)**	1.75	<0.001
- Pre-discharge	4.7 (0.6) [2]	3.3 (0.7) [1]	1.4 (1.2, 1.6)**	2.17	<0.001
Emotional bonding⁵
- Baseline (Day 1)	2.4 (0.8) [1]	2.3 (0.9) [1]	0.1 (−0.1, 0.3)	0.12	0.336
- Day 3	3.8 (0.7) [2]	2.8 (0.8) [2]	1.0 (0.8, 1.2)**	1.34	<0.001
- Day 7	4.4 (0.6) [1]	3.2 (0.7) [1]	1.2 (1.0, 1.4)**	1.85	<0.001
- Pre-discharge	4.8 (0.5) [1]	3.5 (0.6) [2]	1.3 (1.1, 1.5)**	2.37	<0.001
Confidence in caregiving⁶
Baseline (Day 1)	2.0 (0.7) [1]	1.9 (0.8) [1]	0.1 (−0.1, 0.3)	0.13	0.318
Day 3	3.5 (0.6) [2]	2.4 (0.7) [2]	1.1 (0.9, 1.3)**	1.69	<0.001
Day 7	4.3 (0.5) [1]	2.9 (0.6) [1]	1.4 (1.2, 1.6)**	2.55	<0.001
Pre-discharge	4.7 (0.4) [1]	3.2 (0.5) [2]	1.5 (1.3, 1.7)**	3.33	<0.001

MIBT Mother-Infant bonding tool; KMC Kangaroo Mother Care; CI confidence interval; SD standard deviation; η² = partial eta squared
¹Statistical significance determined using mixed-effects ANOVA with Bonferroni correction
²Technical Competency subscale range: 0–5; assesses practical KMC skills
³Values presented as mean (SD); numbers in square brackets [n] indicate missing data
⁴Maternal Responsiveness subscale range: 0–5; measures recognition and response to infant cues
⁵Emotional Bonding subscale range: 0–5; evaluates affective connection
⁶Confidence in caregiving subscale range: 0–5; assesses perceived self-efficacy
** p < 0.001
Abbreviations: MIBT = Mother-Infant Bonding Tool; KMC = Kangaroo Mother Care; CI = Confidence Interval; SD = Standard Deviation; %² = Partial eta squared

ISSN: 1472-6955