Psychometric Testing of the Modified Breastfeeding Self-Efficacy Scale (Short Form) Among Mothers of Ill or Preterm Infants (original) (raw)
Related papers
2018
Background Research demonstrates better health outcomes for both women and their infants when infants are breast-fed. There is evidence that an increasing number of full-term, normal birth weight infants are being admitted to the Neonatal Intensive Care Unit (NICU) and that these infants receive less breast milk than their well full-term and preterm infant counter parts. The effect of short-term admission of full-term infants to the NICU on maternal breastfeeding selfefficacy and breastfeeding exclusivity and duration, and the facilitators of and barriers to breastfeeding success reported by these mothers, has not been well explored. Purpose The purpose of this study was to explore the relationship of breast feeding self-efficacy to breastfeeding duration and breastfeeding exclusivity of full-term infants discharged from the NICU and to explore the facilitators and barriers that influence breastfeeding success for a woman with a full-term infant in the NICU. Factors that may affect the breastfeeding selfefficacy of mothers with a full-term infant in the NICU were also explored. Method This was a mixed method study where quantitative and qualitative data were collected concurrently. The Critical Incident Technique (CIT) was used to identify the facilitators and barriers to breastfeeding success. The breastfeeding self-efficacy scale for preterm and ill infants (BFSE-SF-IP) was used to measure the mothers' breastfeeding self-efficacy. One week after the infant's discharge, the researcher contacted the mothers, who completed the BSFE and described what they thought facilitated or hindered their breastfeeding success. Mothers were contacted three weeks later to ascertain breastfeeding status and formula usage. Data on other maternal and infant variables were also collected. All data was interpreted and integrated to form a phenomenon of a successful mother breastfeeding a full-term infant in the NICU. Results The sample was comprised of 41 ethnically diverse postpartum women who were predominately married, well educated, first-time mothers, and delivered by cesarean section. Most had no prior breastfeeding experience. The Cronbach's alpha of the BSEF-SF-IP in this sample was .953. Regression analyses using the BFSE score and other factors revealed the BFSE to be the only significant predictor of breastfeeding duration and exclusivity at four weeks after discharge and accounted for 47 percent of the variance in the amount of formula used at four weeks. There was a positive correlation between breastfeeding experience, number of live births, breastfeeding at one and four weeks and BFSE scores. There was also a strong negative correlation between breastmilk pumping at one week, formula usage at one and four weeks and BFSE scores. Mothers identified 67 critical incidents as facilitators for and barriers to breastfeeding success in the NICU and one week postpartum. The most frequently cited facilitators in the NICU were nurses/lactation consultant support, and breastfeeding skills. The most common cited barriers to breastfeeding success were feeding the infant formula, separation from the baby, scheduled feedings and not enough breastmilk. After the baby was home for one week, mothers most often reported the facilitators to be family support, determination, and staying with the baby. Not having enough milk and infant not taking the breast were the most frequently cited barriers to breastfeeding success at one week.
Development and psychometric testing of the Breastfeeding Self-Efficacy Scale
Research in Nursing & Health, 1999
Many new mothers discontinue breastfeeding prematurely. Researchers have shown that maternal confidence is an important factor in the continuation of breastfeeding. The purpose of this methodological study was to develop and conduct preliminary psychometric assessment of an instrument to measure confidence in new breastfeeding mothers. Using self-efficacy theory as a conceptual framework, the Breastfeeding Self-Efficacy Scale (BSES) was developed and content validity was judged by a panel of experts and through interviews with experienced breastfeeding mothers. Following a pilot test, the revised BSES was assessed with 130 in-hospital breastfeeding mothers for reliability and validity, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated with positive correlations between BSES scores and infant feeding patterns at 6 weeks postpartum. Following further testing, this instrument may be used to identify new mothers with low breastfeeding confidence who are at high risk to prematurely discontinue breastfeeding.
The Breastfeeding Self-Efficacy Scale: Psychometric Assessment of the Short Form
Journal of Obstetric, Gynecologic, and Neonatal Nursing, 2003
The purpose of this study was to reduce the number of items on the original Breastfeeding Self-Efficacy Scale (BSES) and psychometrically assess the revised BSES-Short Form (BSES-SF). Design: As part of a longitudinal study, participants completed mailed questionnaires at 1, 4, and 8 weeks postpartum. Setting: Health region in British Columbia. Participants: A population-based sample of 491 breastfeeding mothers. Main Outcome Measures: BSES, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. Results: Internal consistency statistics with the original BSES suggested item redundancy. As such, 18 items were deleted, using explicit reduction criteria. Based on the encouraging reliability analysis of the new 14-item BSES-SF, construct validity was assessed using principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated through significant mean differences between breastfeeding and bottlefeeding mothers at 4 (p < .001) and 8 (p < .001) weeks postpartum. Demographic response patterns suggested the BSES-SF is a unique tool to identify mothers at risk of prematurely discontinuing breastfeeding. Conclusions: These psychometric results indicate the BSES-SF is an excellent measure of breastfeeding self-efficacy and considered ready for clinical use to (a) identify breastfeeding mothers at high risk, (b) assess breastfeeding behaviors and cognitions to individualize confidence-building strategies, and (c) evaluate the effectiveness of various interventions and
Factors Associated with Breastfeeding Self-Efficacy of Mothers Within 6 Weeks of Delivery
Journal of Holistic Nursing and Midwifery, 2017
Introduction: Promoting and maintaining breastfeeding is an important part of the healthcare, nutrition and other social measures required to promote proper growth and development of infants, and a major component of primary healthcare. Several factors affect onset and duration of breastfeeding. Self-efficacy is one of those factors that can be modified, but has been less studied. Objective: The present study aimed to determine some risk factors associated with breastfeeding self-efficacy of mothers within 6 weeks of delivery. Materials and Methods: This cross-sectional descriptive-analytical study recruited 767 mothers presenting to Family Health and Research Center in Rasht in 2013, using consecutive sampling (for 6 months). Data was collected using demographic questionnaires and Dennis Breastfeeding Self-Efficacy Scale (BSEF).Data was collected in two phases: on the 3 rd-5 th days and the 6 th week after delivery. The minimum and maximum breastfeeding self-efficacy scores in BSEF are 14 and 70, respectively. If a subject's score is above average, she has high breastfeeding self-efficacy and vice versa. Descriptive statistics (mean, standard deviation) and inferential statistics (chi-square test, Mann-Whitney test, Pearson's correlation coefficient and multiple regressions) were used to analyze the data. The confidence interval of 95% and a significance level of P<0.05 were considered. Results: The results showed that the mean and standard deviation of breastfeeding selfefficacy score were 57.64±9.94 and 62.66±7.57, respectively on the 3 rd-5 th days and the 6 th week after delivery. The group that exclusively breastfed their newborns had higher than average breastfeeding self-efficacy scores compared to other mothers. The multivariate regression model showed that the variables of educational level (secondary school P=0.002, B=2.25; and high school diploma, P=0.03, B=1.51), pain (P=0.01, B=1.6), breastfeeding discontinuation because of pain (P=0.02, B=2.67), having a successful breastfeeding experience (P=0.01, B=1.93), and exclusive breastfeeding (P=0.01, B=6.28) had statistically significant relationships with breastfeeding self-efficacy. Conclusion: According to the results, breastfeeding self-efficacy influenced the status and type of breastfeeding, hence, necessary interventions should be made to remove the barriers to and resolve the problems of mothers for exclusive breastfeeding.
Journal of Human Lactation, 2018
Background: Breastfeeding self-efficacy and breastfeeding intention are two modifiable factors that influence rates of breastfeeding initiation. Research Aims: (1) To develop a scale to measure prenatal breastfeeding self-efficacy, and (2) test its psychometric properties by determining the internal consistency and reliability, and (3) assess the relationships between prenatal breastfeeding self-efficacy and breastfeeding intention. Methods: Cross-sectional prospective one-group survey design was used. A convenience sample of pregnant patients attending an obstetrics and gynecology clinic ( N=124) completed a survey at the recruitment site that assessed demographics, breastfeeding intention, and breastfeeding self-efficacy theory constructs. Retest surveys ( n=14) were taken home and returned to the researcher by mail after completion. Results: Cronbach’s alpha for the 39-item scale was .98 (test) and .97 (retest) with an item-to-total correlation range of .54 to .78. A four-factor ...
Identifying predictors of breastfeeding self-efficacy in the immediate postpartum period
Research in Nursing & Health, 2006
Researchers have found evidence that breastfeeding self-efficacy is an important variable that significantly influences initiation and duration rates. The purpose of this study was to develop a multi-factorial predictive model of breastfeeding self-efficacy in the first week postpartum. As part of a longitudinal study, a population-based sample of 522 breastfeeding mothers in a health region near Vancouver, British Columbia completed mailed questionnaires at 1-week postpartum. Bivariate correlations were used to select variables for the multiple regression analysis. The best-fit regression model revealed eight variables that explained 54% of the variance in Breastfeeding Self Efficacy Scale (BSES) scores at 1-week postpartum: maternal education, support from other women with children, type of delivery, satisfaction with labor pain relief, satisfaction with postpartum care, perceptions of breastfeeding progress, infant feeding method as planned, and maternal anxiety. The BSES may be used to identify risk factors, enabling health professionals to improve quality of care for new breastfeeding mothers.
Maternal and Child Health Journal, 2014
Breastfeeding self-efficacy interventions are important for improving breastfeeding outcomes. However, the circumstances that may influence the effectiveness of the interventions are unclear, especially in the context of hospitals with suboptimal infant feeding practices. Thus, we aimed to evaluate the effect of a self-efficacy intervention on breastfeeding self-efficacy and exclusive breastfeeding, and further assessed the difference in its effect by hospital-routine type. In this intervention study with a control group, 781 pregnant women were recruited from 2 ''Baby-Friendly''-certified hospitals (BFH) and 2 non-Baby-Friendly Hospitals (nBFH) in Japan, and were allocated to an intervention or control group. Participants in the intervention group were provided with a breastfeeding self-efficacy workbook in their third trimester. The primary outcome was breastfeeding self-efficacy and the secondary outcome was infant feeding status. All analyses were stratified by the type of hospital, BFH or nBFH. In BFHs, the intervention improved both breastfeeding selfefficacy through 4 weeks postpartum (p = 0.037) and the exclusive breastfeeding rate at 4 weeks postpartum (AOR 2.32, 95 % CI 1.01-5.33). In nBFHs, however, no positive effect was observed on breastfeeding self-efficacy (p = 0.982) or on the exclusive breastfeeding rate at 4 weeks postpartum (AOR 0.97, 95 % CI 0.52-1.81); in nBFHs, supplementation was provided for breastfed infants and the mother and infant were separated in the vast majority of cases. Infant feeding status at 12 weeks was not improved in either hospital type. The intervention improved breastfeeding self-efficacy and exclusive breastfeeding at 4 weeks postpartum only in BFHs. When breastfeeding self-efficacy interventions are implemented, hospital infant feeding practices may need to be optimized beforehand.
BMC Pregnancy and Childbirth
Background: Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6 months, could prevent an estimated 823,000 child deaths annually. Self-efficacy is an important determinant of breastfeeding behaviors. However, existing measures do not specifically assess exclusive breastfeeding self-efficacy, but rather self-efficacy for any breastfeeding. Hence, we sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy. Methods: We modified and added items from Dennis' Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). It was then implemented in an observational cohort in Gulu, Uganda at 1 (n = 239) and 3 (n = 238) months postpartum (clinicaltrials.gov NCT02925429). We performed inter-item and adjusted item-test correlations, as well as exploratory factor analysis and parallel analysis at 1 month postpartum to remove redundant items and determine their latent factor structure. We further applied confirmatory factor analysis to test dimensionality of the scale at 3 months postpartum. We then assessed the reliability of the scale and conducted tests of predictive and discriminant validity. Known group comparisons were made by primiparous status and correct breastfeeding knowledge. Results: The modification of the original BSES-SF to target exclusive breastfeeding produced 19 items, which were reduced to 9 based on item correlations and factor loadings. Two dimensions of the adapted scale, the Breastfeeding Self-Efficacy Scale to Measure Exclusive Breastfeeding BSES-EBF emerged: Cognitive and Functional subscales, with alpha coefficients of 0.85 and 0.79 at 3 months postpartum. Predictive and discriminant validity and known group comparisons assessments supported its validity. Conclusions: This version of the Breastfeeding Self-Efficacy scale, the BSES-EBF Scale, is valid and reliable for measuring exclusive breastfeeding self-efficacy in northern Uganda, and ready for adaptation and validation for clinical and programmatic use elsewhere.
Prenatal breastfeeding self efficacy scale: validity and reliability study
2018
Aim To determine the validity and the reliability of the Prenatal Breastfeeding Self-Efficacy Scale. Material and Methods This was a methodologic study. The sample of the research comprised 200 pregnant women who presented to the outpatient clinic of Gynecology between April and June 2015. An introductory information form and the Prenatal Breast Self-Efficacy Scale were used to collect the data. In the analysis of the data, descriptive statistics, content validity index for coverage validity, exploratory factor analysis, and confirmatory factor analysis for construct validity, and Cronbach-alfa α for reliability were used. Results In the explanatory factor analysis of the scale, the Kaiser-Meyer-Olkin floor number was 0.84 and the Barlett's sphericity test results were χ2=1812.608; df=171; p<0.001. The contribution of the factors to total variance was 59.06%. According to confirmatory factor analysis of the scale, the Chi-square test result was as follows: χ2=254.23 (p<0.0...
Breastfeeding Self-efficacy: A Critical Review of Available Instruments
Journal of human lactation : official journal of International Lactation Consultant Association, 2015
Increasing breastfeeding rates in the United States is a national priority. Yet, initiation and duration of breastfeeding remains below national targets. Breastfeeding self-efficacy has been shown to be a strong predictor of both breastfeeding initiation and duration and is therefore an important characteristic to be able to measure. However, there is currently a myriad of instruments for measuring breastfeeding self-efficacy, which makes selection of an appropriate instrument difficult. Thus, our aim was to identify, compare, and critically review available breastfeeding self-efficacy instruments. In a systematic review, 6 breastfeeding self-efficacy instruments were identified. The instruments' purposes, theoretical framework, final scale development, and application in 5 most recent settings were analyzed. The 6 breastfeeding self-efficacy instruments apply a number of theoretical and conceptual frameworks in their development, with Bandura's social cognitive theory being...