The Spanish version of the Breastfeeding Self-Efficacy Scale-Short Form: Reliability and validity assessment

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Abstract

Background

Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breastfeeding self-efficacy is a mother's confidence in her ability to breastfeed and is highly predictive of breastfeeding behaviors. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was developed among English-speaking mothers to measure breastfeeding self-efficacy.

Objectives

To translate the BSES-SF into Spanish and assess its psychometric properties.

Design

Methodological study.

Setting

One public hospital in Orihuela, Spain.

Participants

A convenience sample of 135 in-hospital breastfeeding women was recruited on their second day postpartum.

Methods

The BSES-SF was translated into Spanish using forward translation, back-translation and pilot testing. Internal consistency, construct validity and predictive validity were assessed. A battery of self-report questionnaires was administered on the second day postpartum including: a questionnaire on sociodemographic variables and breastfeeding status, the translated BSES-SF, the Spanish adaptation of the General Self-Efficacy Scale and the Stress Management Self-Efficacy Scale. Also, data on breastfeeding status at three weeks postpartum were collected by telephone interviews.

Results

The Cronbach's alpha coefficient for internal consistency was 0.92. The translated BSES-SF presented a unidimensional structure with factor loadings of >0.30. In addition, demographic response patterns and correlations with self-efficacy scales provided further evidence of construct validity. In-hospital BSES-SF scores significantly predicted exclusive breastfeeding at 3 weeks postpartum.

Conclusions

The results of this study indicate that the Spanish translation of the BSES-SF can be considered a valid and reliable measure of maternal breastfeeding self-efficacy in Spain.

Introduction

Only a minority of European infants are breastfed in accordance with international recommendations, which advocate exclusive breastfeeding for 6 months and continued breastfeeding until at least 2 years of age. By 6 months of age, only 39% of Spanish infants are receiving any breastmilk and exclusive breastfeeding rates are even lower. To address this issue, the Spanish National Health System's Quality Plan urges health professionals to incorporate breastfeeding support interventions into their practices (Spanish Ministry of Health and Social Policy, 2010).

Maternal breastfeeding self-efficacy is a mother's perceived ability to breastfeed her infant and has been showed to predict breastfeeding duration and exclusivity rates among women in the immediate postpartum period.

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was developed to measure a mother's confidence in her ability to breastfeed her new infant and has been successfully translated and psychometrically tested among women from diverse cultures (Alus-Tokat et al., 2010, Dennis, 2003, Gregory et al., 2008, McCarter-Spaulding and Dennis, 2010, Wutke and Dennis, 2007, Zubaran et al., 2010). However, it has not been translated and psychometrically tested among mothers in Spain. The purpose of this study is to translate and psychometrically test the BSES-SF among Spanish-speaking mothers in Spain.

Section snippets

Participants

Study participants were recruited by three of the authors at 2 days postpartum from a public hospital in Orihuela, Spain. All participants were in-hospital breastfeeding mothers who were over 18 years old, were able to read and speak Spanish and who had given birth after the 36th week of gestation, since a majority of infants can breastfeed fully at that gestational age (Nyqvist et al., 1999). Women were excluded if they had a factor which could significantly interfere with breastfeeding, such

Description of sample

A convenience sample of 135 women met inclusion criteria and were invited to participate in the study. All women approached agreed to study participation and completed the study questionnaires before hospital discharge. No mothers were loss to follow-up at the 3-week telephone assessment. Average age was 30.1 ± 5.03 years old. Mean score for the global breastfeeding self-efficacy item was 89.27 ± 18.93. Mean scores for the translated BSES-SF, SMSE and GSE scales were 51.94 ± 11.22, 26.19 ± 4.0 and 38.6 ±

Discussion

The results of this study provide evidence of the international applicability of the BSES-SF scale, and reflect those of the other versions of the scale.

Cronbach's α coefficient for the translated BSES-SF scale is above the minimum value recommended for conducting individual and group comparisons. The results also provide evidence of construct and predictive validity, and all hypotheses suggested were confirmed. As with other versions of the scale (Zubaran et al., 2010), a large proportion of

Acknowledgement

The authors would like to thank Marisol Rodríguez Herrero for her collaboration in obtaining clinical data.

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