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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Psychiatry. Jul 19, 2026; 16(7): 119676
Published online Jul 19, 2026. doi: 10.5498/wjp.119676
Nurses’ experiences of managing maternal anxiety during kangaroo mother care: A qualitative study in the neonatal intensive care units
Zeynep Aközlü, İrem Cafrı, Merve Azak, Seda Çağlar
Zeynep Aközlü, Department of Nursing, Faculty of Health Sciences, Bahçeşehir University, Istanbul 34353, Türkiye
İrem Cafrı, Merve Azak, Seda Çağlar, Department of Pediatric Nursing, Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, Istanbul 34320, Türkiye
Author contributions: Aközlü Z, Cafrı İ, and Azak M contributed to data analysis and manuscript writing; Aközlü Z, Cafrı İ, Azak M, and Çağlar S contributed to design study and critical revisions for important intellectual content; Cafrı İ contributed to data collection; Çağlar S contributed to study supervision. All authors read and approved the final manuscript.
AI contribution statement: DeepL was used for grammar checking and assist in translating some technical terms from Turkish to English. AI tools were used solely for language polishing and translation assistance to ensure the manuscript meets academic English standards. No writing assistance in terms of content creation was received.
Institutional review board statement: The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of Bahçeşehir University (Approval No. E-85646034-604.01-119913).
Informed consent statement: Prior to the interviews, all participants were provided with a detailed explanation of the study’s aim and procedures. Informed consent was obtained electronically from all nurses. The principles of autonomy and confidentiality were strictly maintained; participants were informed of their right to withdraw from the study at any time without any negative consequences. To ensure anonymity, all personal identifiers were removed from the transcripts, and participants were assigned code numbers (e.g., participant 1, participant 2). Data were stored on a password-protected platform accessible only to the research team.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Merve Azak, PhD, Assistant Professor, Department of Pediatric Nursing, Istanbul University-Cerrahpaşa, Florence Nightingale Faculty of Nursing, University Street, Avcılar, Istanbul 34320, Türkiye. merve.azak@iuc.edu.tr
Received: February 3, 2026
Revised: February 19, 2026
Accepted: March 24, 2026
Published online: July 19, 2026
Processing time: 143 Days and 9.6 Hours
Abstract
BACKGROUND

The technologically intensive neonatal intensive care unit (NICU) environment often triggers substantial maternal anxiety. While kangaroo mother care (KMC) is a gold-standard intervention, its success depends heavily on the nurse’s role in managing the mother’s emotional burden and facilitating adaptation.

AIM

To explore neonatal nurses’ experiences, perceptions, and strategies related to managing maternal anxiety during KMC.

METHODS

A qualitative descriptive design was employed. Data were collected through semi-structured, in-depth interviews with 15 nurses selected using criterion sampling. The data were analyzed using thematic analysis.

RESULTS

Five overarching themes emerged: Manifestations of maternal anxiety, its effects on the care process, nurses’ anxiety management strategies, the emotional and professional impact on nurses, and clinical requirements for effective care. Nurses reported that anxiety most commonly stemmed from fear of harming the infant and concerns related to medical devices, often accompanied by observable emotional and physical distress. Anxiety occasionally limited participation in KMC and reduced the duration or quality of sessions. Effective management strategies included transparent information-sharing, therapeutic communication, involvement of fathers, and peer modeling. While successful anxiety regulation enhanced nurses’ professional satisfaction, environmental limitations and insufficient training that undermined professional confidence were identified as key systemic barriers.

CONCLUSION

Nurses function as critical external co-regulators who transform maternal fear into self-efficacy. Effective management requires a holistic integration of therapeutic communication, professional competence, and supportive NICU environments. Future initiatives should prioritize simulation-based training focused on the emotional dimensions of care and the ergonomic redesign of NICUs to support maternal mental health.

Keywords: Kangaroo mother care; Maternal anxiety; Neonatal nursing; Neonate; Newborn

Core Tip: This qualitative descriptive study examines how nurses in the neonatal intensive care unit address maternal anxiety during kangaroo mother care. The findings reveal that nurses are not only clinical practitioners but also emotional regulators who transform maternal fear into self-efficacy through therapeutic communication and modeling. In contrast to the predominant focus on burnout in the field, effectively managing anxiety leads to substantial professional fulfillment for nurses. The study emphasizes the importance of addressing ergonomic inadequacies in the neonatal intensive care unit and strengthening nurses’ professional confidence through anxiety management training tailored to their needs.

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