Elia Firda Mufidah, Adi Atmoko, Muslihati, M. Ramli, Jessica Ong Hai Liaw
This letter responds to the work of Varela Pulido et al. (2026), who demonstrate that proportional paternal involvement in Kangaroo Care (KC) significantly strengthens paternal self-efficacy among fathers of preterm infants. While self-efficacy is often conceptualized as a cognitive belief in one's capability, a growing body of evidence highlights the essential role of affective processes in shaping these beliefs. The emotional turbulence experienced by fathers in the NICU—fear, uncertainty, and hesitation—illustrates how affective states influence emerging confidence long before cognitive evaluation occurs. KC functions as an affective corrective experience in which skin-to-skin contact reduces stress, enhances emotional attunement, and gradually transforms anxiety into confidence. This mechanism resonates with Suryomentaram's concept of kramadangsa , which describes how accumulated emotional impressions shape a person's inner stance and sense of capability. From this perspective, each KC session becomes an affective imprint that reorganizes the father's emotional responses, helping maintain high paternal self-efficacy after discharge. Integrating these affective and cultural insights into neonatal nursing practice may improve emotional support for fathers and strengthen family-centered care in the NICU. © 2025 Neonatal Nurses Association.
Department of Guidance and Counseling, Faculty of Education, Universitas Negeri Malang, Malang, Indonesia; Faculty of Defence Studies and Management, National Defence University of Malaysia, Malaysia
