School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
BMC Pregnancy Childbirth. 2023 Mar 2;23(1):138. doi: 10.1186/s12884-023-05439-2.
The evaluation of mothers' breastfeeding behaviour within 6 weeks postpartum could help health workers comprehensively identify maternal breastfeeding shortcomings, clarify nursing problems, and provide targeted interventions. However, no prior study was found, therefore this study aimed to develop and validate the reliability and validity of the mothers' breastfeeding behaviour scale within 6 weeks postpartum.
A main two-step approach was used: (1) a qualitative pilot study using the purposive sampling method was adopted to test the fitness, simplicity, and clarity of items with 30 mothers; (2) a cross-sectional survey using the convenient sampling method was conducted for item analysis and psychometric validation with 600 mothers.
The final version of the scale consisted of 36 items with seven dimensions, explaining 68.852% of the total variance. The Cronbach's α, split-half, and retest coefficients were 0.958, 0.843, and 0.753, respectively. The validity of the scale: (1) Content validity: content validity index (CVI) range of items was between 0.882 and 1.000. The scale-level-CVI was 0.990. (2) Structure validity: The fitting indices were as follows: χ/ⅆf =2.239, RMR = 0.049, RMSEA = 0.069, TLI = 0.893, CFI = 0.903, IFI = 0.904, PGFI = 0.674, and PNFI = 0.763. (3) Convergent validity: The composite reliability and average variance extracted (AVE) of the seven dimensions were between 0.876 and 0.920 and between 0.594 and 0.696. (4) Distinguish validity: The correlation coefficients were less than the square root of the AVE, except for self-decision behaviour, self-coping behaviour, and self-control behaviour. However, the fit index of the original three-factor model was better than that of the other new models, with significant differences (P < 0.001). (5) Calibration validity: The area under the curve was 0.860 or 0.898 when the scale was used to predict exclusive or any breastfeeding at 42 days. The correlation coefficients of the maternal breasting feeding evaluation scale, breastfeeding self-efficacy short-form scale, and the scale were 0.569 and 0.674, respectively.
The newly developed mothers' breastfeeding behaviour scale within 6 weeks postpartum consists of 36 items belonging to seven dimensions with good reliability and validity and is a reliable and valid instrument to be used in future maternal breastfeeding behaviour assessments and interventions.
评估产后 6 周内母亲的母乳喂养行为可以帮助卫生工作者全面识别母亲母乳喂养的不足，明确护理问题，并提供有针对性的干预措施。然而，目前尚未发现先前的研究，因此本研究旨在开发和验证产后 6 周内母亲母乳喂养行为量表的信度和效度。
采用主两步法：（1）采用目的抽样法进行定性试点研究，对 30 位母亲进行测试，以检验项目的适应性、简单性和清晰度；（2）采用便利抽样法进行横断面调查，对 600 位母亲进行项目分析和心理测量验证。
量表的最终版本由 36 个项目组成，分为 7 个维度，解释了总方差的 68.852%。Cronbach's α、分半信度和重测信度分别为 0.958、0.843 和 0.753。量表的效度：（1）内容效度：项目的内容效度指数（CVI）范围为 0.882 至 1.000。量表水平的 CVI 为 0.990。（2）结构效度：拟合指数如下：χ/df=2.239，RMR=0.049，RMSEA=0.069，TLI=0.893，CFI=0.903，IFI=0.904，PGFI=0.674，PNFI=0.763。（3）收敛效度：七个维度的复合可靠性和平均方差抽取（AVE）在 0.876 至 0.920 和 0.594 至 0.696 之间。（4）区分效度：除自我决策行为、自我应对行为和自我控制行为外，各维度的相关系数均小于 AVE 的平方根。然而，原始三因素模型的拟合指数优于其他新模型，差异具有统计学意义（P<0.001）。（5）校准效度：当量表用于预测第 42 天的纯母乳喂养或任何母乳喂养时，曲线下面积分别为 0.860 或 0.898。母亲母乳喂养评估量表、母乳喂养自我效能简短量表和量表之间的相关系数分别为 0.569 和 0.674。
新开发的产后 6 周内母亲母乳喂养行为量表由 36 个项目组成，属于 7 个维度，具有良好的信度和效度，是未来评估和干预母亲母乳喂养行为的可靠、有效的工具。
