766 - A novel approach to quantification of parental attention during kangaroo care: A real-world study

Publication Number: 766.3883

Syed Taha, Centre for Perinatal Research, University of Nottingham, Nottingham, England, United Kingdom; Aarti K. Mistry, Centre for Perinatal Research, University of Nottingham, Nottingham, England, United Kingdom; Don Sharkey, University of Nottingham, Nottingham, England, United Kingdom

Background: Kangaroo care (KC) improves physiological stability, clinical outcomes, neurodevelopmental scores and parental bonding. No studies have explored parental attention during KC.

Objective: To quantify the visual attention patterns of parents providing KC in a real-world setting.

Design/Methods: This observational study was conducted at two Level 3 NICUs. Infants undergoing KC and requiring vital sign monitoring were eligible. Eye tracking glasses (Neon, Pupil Labs) were placed on the parent during KC to capture video and eye gaze. Parents and the attending clinical team decided on suitability and length of KC session. Ethical approval was given.

Gaze fixation data from each recording was mapped to preset areas of interest (AOIs) based on a reference image. The AOIs were: 1) Infant, 2) Vital sign monitor, 3) Other medical equipment e.g. ventilator, 4) Mobile devices e.g. smartphones, 5) Other individuals in the surrounding area e.g. staff. Unmapped areas were labelled as “general surroundings”. Numerical data and heatmaps for duration of fixation (DoF) for each AOI were generated (Figure 1 example). Total DoF across all recordings was calculated for each AOI and expressed as a percentage of the total recording duration. DoF was also compared between infants on respiratory support against those who were not.

Results: The first ten (of 25) recordings were obtained with a combined capture time of approximately 9 hours 49 minutes. Median gestation was 38+3 weeks, seven infants were on respiratory support. One recording was stopped early (16 minutes) due to infant clinical concerns.

Parental gaze predominantly focused on their general surroundings, accounting for 47.6% of the time (Table). DoF on their baby was 31.1% of total fixation time, followed by other individuals at 8.4% and vital sign monitors at 5.8%. Figure 2 shows fixation percentages for individual recordings; parental gaze upon the infant varied from 10.4% to 48.7%. Parents of infants requiring respiratory support spent less time looking at their child (36.1% vs 45.9%), and more time looking at vital sign monitors (6.2% vs 0.4%) and other medical equipment (7.0% vs 2.4%), although the sample sizes were small and the differences did not reach statistical significance.

Conclusion(s): This novel approach to quantifying parental visual attention during KC demonstrates it is highly susceptible to environmental distractions, potentially impacting on the quality of parent-infant bonding. Parents of infants on respiratory support appear to focus more on monitoring and medical equipment. Recruitment for this study continues.

Figure 1
Heatmap demonstrating total duration of fixation upon each preset area of interest

Table
Total duration of fixation upon the preset AOIs and general surroundings, expressed as raw time values and percentage of the total recording time, and median values for duration of fixation % upon each AOI by respiratory status

Figure 2
A stacked column graph demonstrating the % of time each parent’s gaze was upon the preset AOIs or general surroundings (LFO2 = Low-flow oxygen, HFO2 = High-flow oxygen, CPAP = Continuous positive airway pressure)