Tuthill Emily L, McGrath Jacqueline M, Graber Melanie, Cusson Regina M, Young Sera L
University of Connecticut School of Nursing, Storrs, CT, USA Center for Health Intervention and Prevention, University of Connecticut, Storrs, CT, USA
University of Connecticut School of Nursing, Storrs, CT, USA.
J Hum Lact. 2016 Feb;32(1):35-45. doi: 10.1177/0890334415599533. Epub 2015 Aug 28.
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 most common. Content, construct, and predictive validity were strong for most scales. Some, but not all, have been successfully adapted to novel settings. In sum, there are several measurements of breastfeeding self-efficacy that can and should be employed to better understand reasons for suboptimal breastfeeding rates and the effects of interventions on breastfeeding self-efficacy. Instrument selection should be based on domains of primary interest, time available, peripartum timing, and assessment of previous adaptations. Failure to apply appropriate measures in research may garner results that are inconclusive, inaccurate, or nonrepresentative of true study effects.
提高美国的母乳喂养率是一项国家优先事项。然而，母乳喂养的开始率和持续时间仍低于国家目标。母乳喂养自我效能已被证明是母乳喂养开始和持续时间的有力预测指标，因此是一个能够进行测量的重要特征。然而，目前有大量用于测量母乳喂养自我效能的工具，这使得选择合适的工具变得困难。因此，我们的目的是识别、比较并严格审查现有的母乳喂养自我效能工具。在一项系统评价中，识别出了6种母乳喂养自我效能工具。分析了这些工具的目的、理论框架、最终量表的编制以及在5个最新环境中的应用。这6种母乳喂养自我效能工具在其编制过程中应用了多种理论和概念框架，其中班杜拉的社会认知理论最为常见。大多数量表的内容效度、结构效度和预测效度都很强。一些工具（但并非全部）已成功应用于新环境。总之，有几种测量母乳喂养自我效能的方法可以而且应该被用来更好地理解母乳喂养率不理想的原因以及干预措施对母乳喂养自我效能的影响。工具的选择应基于主要关注的领域、可用时间、围产期时间以及对先前应用情况的评估。在研究中未能应用适当的测量方法可能会得出不确定、不准确或不能代表真实研究效果的结果。
