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Open Access 01-12-2024 | Research

Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review

Authors: Cindy-Lee Dennis, Karen McQueen, Justine Dol, Hilary Brown, Cheryl Beck, Shefaly Shorey

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

The Breastfeeding Self-Efficacy Scale and its short-form were developed in Canada and have been used internationally among numerous maternal populations. However, the psychometric properties of the scales have not been reviewed to confirm their appropriateness in measuring breastfeeding self-efficacy in culturally diverse populations. The purpose of this research was to critically appraise and synthesize the psychometric properties of the scales via systematic review.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Three databases (EMBASE, MEDLINE, and PsycINFO) were searched from 1999 (original publication of the Scale) until April 27, 2022. The search was updated on April 1, 2023. Studies that assessed the psychometric properties of the BSES or BSES-SF were included. Two researchers independently extracted data and completed the quality appraisals.

Results

Forty-one studies evaluated the psychometrics of the BSES (n = 5 studies) or BSES-SF (n = 36 studies) among demographically or culturally diverse populations. All versions of the instrument demonstrated good reliability, with Cronbach's alphas ranging from .72 to .97. Construct validity was supported by statistically significant differences in mean scores among women with and without previous breastfeeding experience and by correlations between the scales and theoretically related constructs. Predictive validity was demonstrated by statistically significant lower scores among women who ultimately discontinued breastfeeding compared to those who did not.

Conclusion

The BSES and BSES-SF appear to be valid and reliable measures of breastfeeding self-efficacy that may be used globally to (1) assess women who may be at risk of negative breastfeeding outcomes (e.g., initiation, duration and exclusivity), (2) individualize breastfeeding support, and (3) evaluate the effectiveness of breastfeeding interventions.

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Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90. https://doi.org/10.1016/S0140-6736(15)01024-7.CrossRefPubMed

World Health Organization. Infant and young child feeding. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. 2021. Accessed 5 Jan 2022.

World Health Organization. Comprehensive implementation plan on maternal, infant, and young child nutrition. https://apps.who.int/iris/bitstream/handle/10665/113048/WHO_NMH_NHD_14.1_eng.pdf. 2014. Accessed 5 Jan 2022.

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491–504.CrossRefPubMed

Brockway M, Benzies K, Hayden KA. Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: a systematic review and meta-analysis. J Hum Lact. 2017;33(3):486–99. https://doi.org/10.1177/0890334417707957.CrossRefPubMed

Chipojola R, Chiu HY, Huda MH, Lin YM, Kuo SY. Effectiveness of theory-based educational interventions on breastfeeding self-efficacy and exclusive breastfeeding: a systematic review and meta-analysis. Int J Nurs Stud. 2020;109:103675. https://doi.org/10.1016/j.ijnurstu.2020.103675.CrossRefPubMed

Dennis CL. Theoretical underpinnings of breastfeeding confidence: a self-efficacy framework. J Hum Lact. 1999;15(3):195–201. https://doi.org/10.1177/089033449901500303.CrossRefPubMed

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215. https://doi.org/10.1037/0033-295X.84.2.191.CrossRefPubMed

Dennis CL, Faux S. Development and psychometric testing of the breastfeeding self-efficacy scale. Res Nurs Health. 1999;22(5):399–409. https://doi.org/10.1002/(SICI)1098-240X(199910)22:5<399::AID-NUR6>3.0.CO;2-4.CrossRefPubMed

10.

Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs. 2003;32(6):734–44. https://doi.org/10.1177/0884217503258459.MathSciNetCrossRefPubMed

11.

Galipeau R, Baillot A, Trottier A, Lemire L. Effectiveness of interventions on breastfeeding self-efficacy and perceived insufficient milk supply: a systematic review and meta-analysis. Matern Child Nutr. 2018;14(3):e12607. https://doi.org/10.1111/mcn.12607.CrossRefPubMedPubMedCentral

12.

Ghazanfarpour M, Afiat M, Babakhanian M, Akrami FS, Kargarfard L, Dizavandi FR, et al. A systematic review of psychometric properties of breastfeeding self-efficacy scale-short form (BSES-SF). Int J Pediatr. 2018;6(12):8620. https://doi.org/10.22038/ijp.2018.33254.2935.CrossRef

13.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, The PRISMA, et al. statement: an updated guideline for reporting systematic reviews. BMJ. 2020;2021:372. https://doi.org/10.1136/bmj.n71.CrossRef

14.

Shrestha SD, Pradhan R, Tran TD, Gualano RC, Fisher JRW. Reliability and validity of the Edinburgh postnatal depression scale (EPDS) for detecting perinatal common mental disorders (PCMDs) among women in low-and lower-middle-income countries: a systematic review. BMC Pregnancy Childbirth. 2016;16:72. https://doi.org/10.1186/s12884-016-0859-2.CrossRefPubMedPubMedCentral

15.

Mirza I, Jenkins R. BMJ. 2004;328(7443):794. https://doi.org/10.1136/bmj.328.7443.794.CrossRefPubMedPubMedCentral

16.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150:782–6. https://doi.org/10.1192/bjp.150.6.782.CrossRefPubMed

17.

Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: construction and validation. Psychological Reports. 1982;51(2):663–71. https://doi.org/10.2466/pr0.1982.51.2.663.CrossRef

18.

Chipojola R, Dennis C, Kuo S. Psychometric assessment of the paternal breastfeeding self-efficacy scale-short form: a confirmatory factor analysis of Malawian fathers. J Hum Lact. 2022;38(1):28–36. https://doi.org/10.1016/j.ijnurstu.2020.103675.CrossRefPubMed

19.

Dennis CL, Brennenstuhl S, Abbass-Dick J. Measuring paternal breastfeeding self-efficacy: a psychometric evaluation of the breastfeeding self-efficacy scale–short form among fathers. Midwifery. 2018;64(March):17–22. https://doi.org/10.1016/j.midw.2018.05.005.CrossRefPubMed

20.

Küçükoğlu S, Sezer H, Dennis CL. Validity and reliability of the Turkish version of the paternal breastfeeding self-efficacy scale - short form for fathers. Midwifery. 2023;116(103513). https://doi.org/10.1016/j.midw.2022.103513

21.

Tokat MA, Semra E, Hulya O, Meryem OH. Psychometric assessment of Turkish modified breastfeeding self-efficacy scale for mothers of preterm infants. J Organ Behav. 2020;1(1):29–40.

22.

Wheeler BJ, Dennis CL. Psychometric testing of the modified breastfeeding self-efficacy scale (short form) among mothers of ill or preterm infants. J Obstet Gynecol Neontal Nurs. 2013;42(1):70–80. https://doi.org/10.1111/j.1552-6909.2012.01431.x.CrossRef

23.

Yang Y, Guo L, Shen Z. Psychometric properties of the modified breastfeeding self-efficacy scale–short form (BSES-SF) among Chinese mothers of preterm infants. Midwifery. 2020;91:102834. https://doi.org/10.1016/j.midw.2020.102834.CrossRefPubMed

24.

Handayani L, Kosnin AMD, Jiar YK, Solikhah G. Translation and validation of breastfeeding self-efficacy scale-short form (BSES-SF) into Indonesian: a pilot study. Jurnal Kesehatan Masyarakat (Journal of Public Health). 2013;7(1):21–6. https://doi.org/10.12928/kesmas.v7i1.1023.CrossRef

25.

Mituki D, Tuitoek P, Varpolatai A, Taabu I. Translation and validation of the breast feeding self-efficacy scale into the Kiswahili language in resource restricted setting in Thika-Kenya. GJMEDPH. 2017;61(3):1-9.

26.

Creedy DK, Dennis CL, Blyth R, Moyle W, Pratt J, De Vries SM. Psychometric characteristics of the breastfeeding self-efficacy scale: data from an Australian sample. Res Nurs Health. 2003;26(2):143–52. https://doi.org/10.1002/nur.10073.CrossRefPubMed

27.

Husin H, Isa ZM, Ariffin R, Rahman SA, Ghazi HF. The Malay version of antenatal and postnatal breastfeeding self-efficacy scale-short form: reliability and validity assessment. Malaysian Health Med. 2017;17(2):62–9.

28.

Amini P, Omani-Samani R, Sepidarkish M, Almasi-Hashiani A, Hosseini M, Maroufizadeh S. The breastfeeding self-efficacy scale-short form (BSES-SF): a validation study in Iranian mothers. BMC Res Notes. 2019;12:1–6. https://doi.org/10.1186/s13104-019-4656-7.CrossRef

29.

Sandhi A, Dennis CL, Kuo SY. Psychometric assessment of the breastfeeding self-efficacy scale - short form among Indonesian mothers. Clin Nurs Res. 2022;31(8):1520–8. https://doi.org/10.1177/10547738221112756.CrossRefPubMed

30.

Dai X, Dennis CL. Translation and validation of the breastfeeding self-efficacy scale into Chinese. J Midwifery Women’s Health. 2003;48(5):350–6. https://doi.org/10.1016/S1526-9523(03)00283-6.CrossRef

31.

Eksioglu AB, Ceber E. Translation and validation of the breast-feeding self-efficacy scale into Turkish. Midwifery. 2011;27(6):e246–53. https://doi.org/10.1016/j.midw.2010.10.009.CrossRefPubMed

32.

Molina Torres MM, Torres RRD, Rodríguez AMP, Dennis CL. Translation and validation of the breastfeeding self-efficacy scale into Spanish: data from a Puerto Rican population. J Hum Lact. 2003;19(1):35–42. https://doi.org/10.1177/0890334402239732.CrossRefPubMed

33.

Oriá MOB, Ximenes LB, de Almeida PC, Glick DF, Dennis CL. Psychometric assessment of the Brazilian version of the breastfeeding self-efficacy scale. Public Health Nurs. 2009;26(6):574–83. https://doi.org/10.1111/j.1525-1446.2009.00817.x.CrossRefPubMed

34.

Asgarian A, Hashemi M, Pournikoo M, Mirazimi TS, Zamanian H, Amini-Tehrani M. Translation, validation, and psychometric properties of breastfeeding self-efficacy scale—short form among Iranian women. J Hum Lact. 2020;36(2):227–35. https://doi.org/10.1177/0890334419883572.CrossRefPubMed

35.

Balaguer-Martínez JV, García-Pérez R, Gallego-Iborra A, Sánchez-Almeida E, Sánchez-Díaz MD, Ciriza-Barea E. Predictive capacity for breastfeeding and determination of the best cut-off point for the breastfeeding self-efficacy scale-short form. Anales de Pediatría (English Edition). 2022;96(1):51–8. https://doi.org/10.1016/j.anpede.2020.12.018.CrossRefPubMed

36.

Basu S, Garg S, Sharma A, Arora E, Singh M. The Hindi version of the breastfeeding self-efficacy scale-short form: reliability and validity assessment. Indian J of Community Med. 2020;45(1):348–52. https://doi.org/10.4103/ijcm.IJCM_378_19.CrossRef

37.

Boateng GO, Martin SL, Tuthill EL, Collins SM, Dennis CL, Natamba BK, et al. Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding. BMC Pregnancy Childbirth. 2019;19:1–14. https://doi.org/10.1186/s12884-019-2217-7.CrossRef

38.

Brandão S, Mendonça D, Dias CC, Pinto TM, Dennis CL, Figueiredo B. The breastfeeding self-efficacy scale-short form: psychometric characteristics in Portuguese pregnant women. Midwifery. 2018;66:49–55. https://doi.org/10.1016/j.midw.2018.07.014.CrossRefPubMed

39.

Dennis CL, Heaman M, Mossman M. Psychometric testing of the breastfeeding self-efficacy scale-short form among adolescents. Journal of Adolesc Health. 2011;49(3):265–71. https://doi.org/10.1016/j.jadohealth.2010.12.015.CrossRef

40.

Dodt RCM, Ximenes LB, Almeida PC, Batista Oriá MO, Dennis CL. Psychometric and maternal sociodemographic assessment of the breastfeeding self-efficacy scale - short form in a Brazilian sample. J Nurs Educ Pract. 2012;2(3):66–73. https://doi.org/10.5430/jnep.v2n3p66.CrossRef

41.

dos Santos LMD, Silveira Rocha R, Lopes Chaves AF, Dodou HD, Pimentel Castelo AR, Rodrigues Feitoza S, et al. Application and validation of breastfeeding self-efficacy scale – short form BSES - SF in adolescent mothers. Int Arch Med. 2016. https://doi.org/10.3823/2078.CrossRef

42.

Gerhardsson E, Nyqvist KH, Mattsson E, Volgsten H, Hildingsson I, Funkquist EL. The Swedish version of the breastfeeding self-efficacy scale-short form: reliability and validity assessment. J Hum Lact. 2014;30(3):340–5. https://doi.org/10.1177/0890334414523836.CrossRefPubMed

43.

Gregory A, Penrose K, Morrison C, Dennis CL, MacArthur C. Psychometric properties of the breastfeeding self-efficacy scale- short form in an ethnically diverse U.K. sample. Public Health Nurs. 2008;25(3):278–84. https://doi.org/10.1111/j.1525-1446.2008.00705.x.CrossRefPubMed

44.

Iliadou M, Lykeridou K, Prezerakos P, Zyga S, Sakellari E, Vivilaki V, et al. Psychometric properties of the Greek version of the breastfeeding self-efficacy scale and correlation with depressive symptomatology. Arch of Hell Med. 2020;37(5):656–62.

45.

Ip WY, Yeung LS, Choi KC, Chair SY, Dennis CL. Translation and validation of the Hong Kong Chinese version of the breastfeeding self-efficacy scale-short form. Res Nurs Health. 2012;35(5):450–9. https://doi.org/10.1002/nur.21493.CrossRefPubMed

46.

Ip WY, Gao LL, Choi KC, Chau JPC, Xiao Y. The short form of the breastfeeding self-efficacy scale as a prognostic factor of exclusive breastfeeding among Mandarin-speaking Chinese mothers. J Hum Lact. 2016;32(4):711–20. https://doi.org/10.1177/0890334416658014.CrossRefPubMed

47.

McCarter-Spaulding DE, Dennis CL. Psychometric testing of the breastfeeding self-efficacy scale-short form in a sample of black women in the United States. Res Nurs Health. 2010;33(2):111–9. https://doi.org/10.1002/nur.20368.CrossRefPubMed

48.

McQueen KA, Montelpare WJ, Dennis CL. Breastfeeding and Aboriginal women: validation of the breastfeeding self-efficacy scale-short form. Can J Nurs Res. 2013;45(2):58–75. https://doi.org/10.1177/084456211304500209.CrossRefPubMed

49.

Oliver-Roig A, D’Anglade-González MLL, García-García B, Silva-Tubio JRR, Richart-Martínez M, Dennis CLL. The Spanish version of the breastfeeding self-efficacy scale-short form: reliability and validity assessment. Int J Nurs Stud. 2012;49(2):169–73. https://doi.org/10.1016/j.ijnurstu.2011.08.005.CrossRefPubMed

50.

Otsuka K, Dennis CL, Tatsuoka H, Jimba M. The relationship between breastfeeding self-efficacy and perceived insufficient milk among Japanese mothers. J Obstet Gynecol Neonatal Nurs. 2008;37(5):546–55. https://doi.org/10.1111/j.1552-6909.2008.00277.x.CrossRefPubMed

51.

PavicicBosnjak A, Rumboldt M, Stanojevic M, Dennis CL. Psychometric assessment of the Croatian version of the breastfeeding self-efficacy scale-short form. J Hum Lact. 2012;28(4):565–9. https://doi.org/10.1177/0890334412456240.CrossRef

52.

Petrozzi A, Gagliardi L. Breastfeeding self-efficacy scale: validation of the Italian version and correlation with breast-feeding at 3 months. J Pediatr Gastroenterol Nutr. 2016;62(1):137–9. https://doi.org/10.1097/MPG.0000000000000902.CrossRefPubMed

53.

Radwan H, Fakhry R, Boateng GO, Metheny N, Bani issa W, Faris ME, et al. Translation and psychometric evaluation of the Arabic version of the breastfeeding self-efficacy scale-short form among women in the United Arab Emirates. J Hum Lact. 2022;089033442210846. https://doi.org/10.1177/08903344221084623

54.

Tokat MA, Okumuş H, Dennis CL. Translation and psychometric assessment of the breast-feeding self-efficacy scale-short form among pregnant and postnatal women in Turkey. Midwifery. 2010;26(1):101–8. https://doi.org/10.1016/j.midw.2008.04.002.CrossRef

55.

Witten C, Claasen N, Krugger H, Grobler H, Coutsoudis A, Dennis C. Translation and psychometric assessment of the Setswana version of the breastfeeding self-efficacy scale – short form in North West province, South Africa. Int Breastfeed J. 2020;15(76). https://doi.org/10.1186/s13006-020-00320-w

56.

Wutke K, Dennis CL. The reliability and validity of the Polish version of the breastfeeding self-efficacy scale-short form: translation and psychometric assessment. Int J Nurs Stud. 2007;44(8):1439–46. https://doi.org/10.1016/j.ijnurstu.2006.08.001.CrossRefPubMed

57.

Zubaran C, Foresti K, Schumacher M, Thorell MR, Amoretti A, Müller L, et al. The Portuguese version of the breastfeeding self-efficacy scale-short form. J Hum Lact. 2010;26(3):297–303. https://doi.org/10.1177/0890334409359916.CrossRefPubMed

58.

Rosenberg M. Society and the Adolescent Self-Image. New Jersey: Princeton University Press; 2015.

59.

Boateng GO, Martin SL, Collins SM, Natamba BK, Young SL. Measuring exclusive breastfeeding social support: scale development and validation in Uganda. Matern Child Nutr. 2018;14(3):1–12. https://doi.org/10.1111/mcn.12579.CrossRef

60.

Radloff LS. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401. https://doi.org/10.1177/014662167700100306.CrossRef

61.

Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. Journal of evaluation in clinical practice. 2011;17(2):268–74. https://doi.org/10.1111/j.1365-2753.2010.01434.x.CrossRefPubMed

62.

Piwoz EG, Huffman SL. Impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices. Food Nutr Bull. 2015;36(4):373–86. https://doi.org/10.1177/0379572115602174.CrossRefPubMed

63.

Neves PAR, Barros AJD, Gatica-Domínguez G, Vaz JS, Baker P, Lutter CK. Maternal education and equity in breastfeeding: trends and patterns in 81 low- and middle-income countries between 2000 and 2019. Int J Equity Health. 2021;20(1):1–13. https://doi.org/10.1186/s12939-020-01357-3.CrossRef

64.

McQueen KA, Dennis C, Stremler R, Norman CD. A pilot randomized controlled trial of a breastfeeding self-efficacy intervention with primiparous mothers. Journal Obstet, Gynecol & Neonatal Nurs. 2011;40:35–46. https://doi.org/10.1111/j.1552-6909.2010.01210.x.CrossRef

Title: Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review
Authors: Cindy-Lee Dennis
Karen McQueen
Justine Dol
Hilary Brown
Cheryl Beck
Shefaly Shorey
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-17805-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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