Intervention and implementation
’s head and chest rested
One of the researchers and a trained research assistant first introduced themselves to the mother/maternal grandmother and briefed them on the study objectives. Then, they received individual training on KC using posters, images, and videos. The participants were also trained on personal hygiene, wearing special clothing, and not using fragrances, cigarettes, hookahs, or cellphones when providing KC. Then, prior to beginning the study, KC was performed twice separately by the caregivers under the supervision of the researcher. The diapered newborn was removed from the bed or incubator with the help of the researcher and placed upright on the caregiver’s chest so that the newborn’s head and chest rested on the caregiver’s chest and skin-to-skin contact was established. The newborn was covered with a sheet, and their head was covered with a hat to prevent a drop in their body temperature. The caregiver performed KC at a 30–60° angle while resting on a chair and leaning back slightly as they supported the newborn’s body and neck with their hands. To minimize measurement errors due to possible fluctuations in ambient temperature and physiological parameters throughout the day, the KC and the measurement and recording of these indicators were carried out for all newborns within the same time period from 15:00 to 17:00 on the fourth or fifth day of birth. KC was performed in a separate room (given the conditions at the neonatal unit of the study setting, including the small space and crowded ward) at temperatures of 26–29 °C. During the intervention, a warmer, oxygen, oxygen hood, and an incubator were available for newborns who might experience significant changes in vital signs during the study. In the case of instability of the newborn’s vital signs during the study (SpOThe study flowchart