Beyond ratio metrics: Improving quantification of paternal kangaroo care participation to strengthen paternal self-efficacy evidence

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Abi Fa'izzarahman Prabawa, Eni Rindi Antika, Lilik Sriyanti

2026 Journal of Neonatal Nursing Vol. 32 Issue 2 Letter Cited by 0

Abstract

This correspondence comments on recent evidence that fathers' participation in kangaroo care during neonatal intensive care unit hospitalisation is associated with higher paternal self-efficacy at discharge and three months later. We argue that representing “proportional involvement” as a father-to-mother frequency ratio can be difficult to interpret and may introduce statistical artefacts, because the ratio can increase when fathers provide more care or when mothers have fewer opportunities. We propose more interpretable alternatives: modelling paternal and maternal kangaroo care separately, distinguishing total skin-to-skin dose from fathers’ share, and prioritising duration-based measures. We also note that brief father-focused counselling or psychoeducation during admission may complement measurement improvements by supporting stress management and role transition. © 2026 Neonatal Nurses Association.

Affiliations

Islamic Education Guidance and Counseling Study Program, Faculty of Education and Teacher Training, Universitas Islam Negeri (UIN) Salatiga, Indonesia; Guidance and Counseling Study Program, Faculty of Science Education and Psychology, Universitas Negeri Semarang, Indonesia; Islamic Education Guidance and Counseling Study Program, Faculty of Education and Teacher Training, Universitas Islam Negeri (UIN) Salatiga, Indonesia