Creedy Debra K, Cantrill Ruth M, Cooke Marie
Research Centre for Clinical and Community Practice Innovation, Griffith University, Brisbane, Australia.
National University of Singapore, Singapore.
Int Breastfeed J. 2008 Apr 30;3:7. doi: 10.1186/1746-4358-3-7.
There are few reliable and valid tools to assess lactation and infant feeding knowledge and practices. This study tested the psychometric properties of two new scales, the Newborn Feeding Ability (NFA) questionnaire and Breastfeeding Initiation Practices (BIP) scale to assess midwives' breastfeeding knowledge and practices specific to breastfeeding initiation.
A national postal survey of Australian midwives (n = 3500) was conducted in October 2001. Reliability was determined through Cronbach's alpha coefficient and stability determined by a test-retest. Content validity was established through a critical review of literature and review by an expert panel. Construct validity was informed by an exploratory factor analysis and principle component analysis with varimax rotation. Correlations between NFA and BKQ knowledge subscale scores and BIP and BKQ practice subscale scores assessed criterion validity. A multiple hierarchical regression analysis determined predictive validity of the NFA and BIP.
A response rate of 31.6% (n = 1107) was achieved. Adequate internal consistency was established for both instruments. Five factors on the NFA questionnaire were congruent with knowledge about effects of skin-to-skin contact, physiological stability, newborn innate abilities, work practices and effective breastfeeding. The BIP revealed three factors related to observing pre-feeding behavior, mother/baby care and attachment and positioning practices. Predictive validity of knowledge was moderate (r = 0.481, p < 0.01) and contributed to 31.5% of variance in reported practice. Midwives with high knowledge scores were more likely to report best practice when assisting mothers to initiate breastfeeding. Midwives with more personal breastfeeding experience scored higher on all scales.
The Newborn Feeding Ability questionnaire and the Breastfeeding Initiation Practices scale can contribute to practice development by assessing lactation and infant feeding knowledge and practice deficits. Individual learning needs can be identified, and effectiveness of education interventions evaluated using these tools. Further testing is required with other samples of midwives and health professionals involved in the promotion of breastfeeding.
用于评估泌乳及婴儿喂养知识与实践的可靠且有效的工具较少。本研究测试了两个新量表——新生儿喂养能力（NFA）问卷和母乳喂养启动实践（BIP）量表——的心理测量特性，以评估助产士在母乳喂养启动方面的特定知识与实践。
2001年10月对澳大利亚助产士（n = 3500）进行了全国性邮寄调查。通过克朗巴哈α系数确定信度，通过重测确定稳定性。通过文献的批判性综述和专家小组审查建立内容效度。通过探索性因素分析和具有方差最大化旋转的主成分分析来确定结构效度。NFA与BKQ知识子量表得分以及BIP与BKQ实践子量表得分之间的相关性评估了效标效度。多元层次回归分析确定了NFA和BIP的预测效度。
回复率为31.6%（n = 1107）。两种工具均建立了足够的内部一致性。NFA问卷上的五个因素与关于皮肤接触的影响、生理稳定性、新生儿先天能力、工作实践和有效母乳喂养的知识相符。BIP显示出与观察喂养前行为、母婴护理以及依恋和体位实践相关的三个因素。知识的预测效度中等（r = 0.481，p < 0.01），并导致报告实践中31.5%的方差。知识得分高的助产士在协助母亲启动母乳喂养时更有可能报告最佳实践。有更多个人母乳喂养经验的助产士在所有量表上得分更高。
新生儿喂养能力问卷和母乳喂养启动实践量表可通过评估泌乳及婴儿喂养知识和实践缺陷来促进实践发展。可以确定个体学习需求，并使用这些工具评估教育干预措施的有效性。需要对参与促进母乳喂养的其他助产士和卫生专业人员样本进行进一步测试。
