Cross-sectional Kano survey of premature-infant caregivers’ post-discharge care needs in Hubei

A cross-sectional survey of 201 primary caregivers found that survival-related needs were the most urgent in the home care of premature infants, while infant feeding emerged as a priority category. The study applied the Kano model to 27 care needs among caregivers whose infants had been discharged from a tertiary hospital in Hubei Province, China. Participants were recruited between November 2024 and January 2025 from a Grade A tertiary hospital in Hubei Province.

Eligible participants were primary caregivers of premature infants discharged within the preceding six months, meaning the study focused on the early period of care at home. Researchers used convenience sampling and administered a self-designed questionnaire based on the Kano model. The instrument contained 27 items covering care needs for premature infants after discharge.

Each item was assigned to a Kano attribute category using the Maximum Frequency Method. The researchers then used Better–Worse coefficients and the Average Satisfaction Coefficient to prioritize the care needs. Three needs related to infant feeding were classified as “Must-be attributes.” Six needs associated with the health issues of premature infants were classified as “One-dimensional attributes,” and the remaining 18 needs were categorized as “Attractive attributes.”

The combined results indicated that primary caregivers of premature infants at home generally had high care needs, with survival-related needs identified as the most pressing. Infant feeding stood out in the attribute analysis because all three feeding-related items were placed in the must-be category. The findings provide a structured basis for targeted nursing service plans.

The authors concluded that support should be organized according to the priority and Kano attribute assigned to each care need, with the aim of improving the quality of home care and health outcomes for premature infants. Several limits define the study’s scope. Its cross-sectional design provides a snapshot rather than tracking changes in caregivers’ needs over time, while convenience sampling and recruitment from one hospital may restrict how broadly the results represent other caregivers and settings.

The analysis focused on primary caregivers and their reported care needs; it did not evaluate whether priority-based support services improve infant outcomes. The self-designed, 27-item questionnaire also represents the specific set of needs assessed by the investigators rather than a direct measurement of clinical outcomes in the infants.

Subject of Research: Post-discharge care needs of primary caregivers of premature infants in Hubei Province

Article Title: Analysis of care needs for primary caregivers of premature infants at home based on the Kano model: A cross-sectional study

Article References: Lan, F., Yu, J., Huo, Z., Wang, Y., Shi, Q., Liao, Y., & Liu, J. (2026). Analysis of care needs for primary caregivers of premature infants at home based on the Kano model: A cross-sectional study. PLOS One, 21(10), e0360393. https://doi.org/10.1371/journal.pone.0360393

Image Credits: AI Generated

DOI: 10.1371/journal.pone.0360393

Keywords: premature infants, primary caregivers, post-discharge care, Kano model, infant feeding, cross-sectional survey, nursing services, caregiver needs, Hubei Province, Analysis, care, needs