Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)

Breastfeeding Self-Efficacy Scale-Short determine (BSES-SF)The objectives of this analyze were to determine the dependableness and harshness of a Malayan-version questionnaire Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) among respondents.METHODSParticipantTarget population for this study is primiparous gravels who gave birth to a single, healthy, term infant who were planning on breastfeeding were eligible to participate in this study. The study applied convenience sampling, in which researcher recruited volunteer primiparous mother who consider delivered despoil and hospitalized at postnatal ward, Hospital USM between one to triple age. Mothers were excluded if they had a factor that could signifi shtuptly interfere with breastfeeding, such as a mother whose illness, have maternity complication or infant admitted to the Neonatal intensifier Care Unit (NICU) and the infant had a condition that prevented ingestion of breast draw via the breast such as cleft pala te.Sample SizeFor the consume size, the study needed 38 of respondents to validate the questionnaire base on the internal consistency of the circumstances from preceding(prenominal) study. Cronbachs alpha will be used to measure reliability because it is the most common form of internal consistency reliability coefficient. The Cronbachs alpha coefficient for internal consistency of the accompaniments from previous study was 0.89 (Wutke, Dennis, 2006). The sample size was intractable by using Stats ToDo software. The questionnaire will be administered to primiparous mothers which breastfed their baby after delivered to one week postpartum. Sample size calculation whereType I shift () = 0.05 Cronbachs Alpha expected or required = 0.8 Power (1-) = 0.8 Testing Null Hypothesis against Ref Alpha of = 0.6 Number of items = 14 Delta (= (1-Ref Alpha) / (1 Alpha)) = 2Sample size required = 38InstrumentBreastfeeding Self-Efficacy ScaleThe confidence level will be measured by using the Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF) which was adapted from a previous study (Dennis, 1999, 2003) with the permission from the author. The BSES-SF is used to assess breastfeeding confidence among mothers intending to breastfeed and has had extensive use and evaluation in a wide variety of settings and populations (Dai Dennis, 2003 Dennis, 1999 Dennis, 2002 Dennis, 2003 Dennis, Hodnett, Gallop, Chalmers, 2002). Breastfeeding confidence and self-efficacy have sometimes been used interchangeably in prior literature. For the purposes of this study, the term of confidence is preferred. It is a 14 item self-report creature developed to measure a mothers perceived ability to breastfeed her infant. All items are preceded by the phrase I can always and use a five-point Likert scale for evaluation from 1 (not at all confident) to 5 (always confident). Items ratings will be summed to produce a total score from 14 to 70, with higher scores indicating higher confidence. Th e means score points will be used as the cut-off point between high and low scorers. This instrument is base on the breastfeeding self-efficacy theory, and was synthesized from a longer tool. It has been utilized in women as early as 36 weeks gestation and found to predict breastfeeding continuation up to lead months postpartum. Dennis, (2003) who also were using the BSES-SF, found that BSES-SF was a good measurement tool for evaluating breastfeeding self-efficacy. The master copy BSES-SF ( side of meat version), the Cronbachs alpha coefficient for internal consistency of the items is 0.89 (Wutke Dennis, 2006). This questionnaire will take roughly six to ten minutes to fill up.Translation mathematical operationThe Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF) in English version will be translated into national language which is Malay language in order to help the respondent regard the questions. The translation was done by two people who are experts in both English an d Malay language using back translation technique. The questionnaire was sent to linguistic department and two bilingual experts were invited in translation process. Back translation is the process of translating a document that has already been translated into a foreign language back to the original language. Thus, through the translation and back-translation process and expert review, minor alterations were made to the instrument to improve clarity and eliminate cultural bias and translation inaccuracies. Then, the content and face rigor will be done.VALIDITY TESTContent validityValidityis theabilityof aninstrumenttomeasurewhatit is supposedtomeasure. This questionnaire has been validated by five experts from obstetrics and gynecology specialist, midwifery, and health education, linguistics and statistician to determine the validity of the content. The experts were invited to review, evaluated and provide feedback on the content of each BSES-SF item. This is to entertain up wit h the recommendations Sekaran which is to ensure reliability, the question shall be given to the experts made the correction and evaluation called Expert Judgment Validity (Sekaran, 2005). Based on this evaluation, five modifications were made (1) the item I can always motivate myself to breastfeed successfully was changed to I can always motivate myself to do well at breastfeeding, (2) the item I can always breastfeed my baby without using ordinance as a supplement was changed to I can exclusively breastfed my baby without using formula as a supplement to at least 4 months, (3) the item I can always refrain from bottle feeding for the first 4 weeks was changed to I can refrain from exclusively bottle feeding for the first month, (4) the item I can always feed my baby with breast milk only was changed to I can always feed my baby with breast milk only for at least 4 months, and (5) the item I can always keep feeling that I really want to breastfeed my baby for at least 6 weeks was changed to I can always keep feeling that I really want to breastfeed my baby for at least one and a half months. The modified instrument was presented to the experts a nett time and after several discussions, all items were considered relevant to Malay speaking mothers.Face validityFinally, the translated BSES-SF was administered to five respondents which are primiparous mothers who have breastfeed their baby and hospitalized at postnatal ward during the first to three days postpartum. This recruitment as a part of this study to identify the problems in the translated questionnaire. This method requires researchers to beseech participants to rephrase the items using their own words immediately after answering the items. Respondents suggestions for the improvement of the questions were noted and were being analyzed and discussed with the experts. This allows the researchers to assess whether respondents understand the items totally as well as to evaluate the comprehension and read ability of the Malay BSES-SF version.PILOT TEST AND RELIABILITY TESTResults from content and face validity actually improve the items in the questionnaire to be applied in this study. After making improvements, the questionnaire was done a pilot study on 30 respondents at postnatal ward, Hospital USM to test the reliability of the questionnaire.RESULTInternal Consistency dependability of instrument refers to the extent to which an instruments score is consistent or stable (Ananda, 2007). Reliability is obtained when the same result each time the test is made. Thus, the reliability of the instrument can be defined as a standard of measurement that is clean-handed from error in which they give consistent answers. According to Sekaran (2005), the closer to 1.0 Coefficient of reliability, the reliability is higher. Generally, reliability of less than 0.60 can be defined reliability is low, in the carry of 0.70 if it is acceptable, while above 0.80 indicates higher reliability. Therefo re, the questionnaire in this study can be categorized as good and reliable for use in this study. The IBM SPSS Statistics Version 21 was used for statistical analysis. Results of a pilot study of 30 respondents are as followsThe internal consistency of the translated BSES-SF was evaluated by considering the following (1) item summary statistics (2) inter- item correlations (3) corrected item-total correlations (4) Cronbachs alpha coefficient and (5) the alpha estimate when an item was deleted (Strickland,1996). Poorly functioning items were defined as (1) items that when deleted increased the alpha coefficient by more than 0.10 or (2) items that had a corrected item-total correlation less than 0.30. Cronbachs alpha for the translated BSES-SF was 0.87 there was no increase of more than 0.10 in Cronbachs alpha with removal of all item. The Cronbachs alpha estimated when an item was dropped from the scale ranged from .86 to .87. All corrected item-total correlations were positive ,th e lowest item-total correlation was 0.37 and the highest was 0.73, with 92.8 %, falling within the recommended range of 0.300.70. The mean BSES-SF score was 56.74 (SD _7. 01). The everyplace all item mean was 4.05, ranging from 3.74 to 4.39. The item variance mean was 0.65, ranging from 0.35 to 0.96.Table 1 Reliability Statistics Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF)Cronbachs Alpha N of Items.877 14Table 2ItemCorrected Item-Total CorrelationCronbachs Alpha if Item DeletedSaya sentiasa dapat memastikan bayi saya mendapat susu yang mencukupi.376.876Saya sentiasa dapat mengatasi masalah penyusuan sepertimana tugasan mencabar yang lain.586.867Saya sentiasa dapat memberikan susu ibu kepada bayi saya tanpa menggunakan susu formula sebagai makanan tambahan.500.871Saya sentiasa boleh memastikan mulut bayi saya sentiasa melekap dengan betul bagi keseluruhan tempoh penyusuan.543.868Saya sentiasa dapat menguruskan situasi penyusuan dengan rasa puas hati.595.866Saya sentiasa m ampu menyusu bayi walaupun bayi saya sedang menangis.729.859Saya sentiasa mempunyai keinginan untuk menyusukan bayi.446.873Saya sentiasa dapat menyusu bayi dengan selesa walaupun dengan kehadiran ahli keluarga yang lain.472.872Saya sentiasa berpuas hati dengan pengalaman penyusuan saya.565.868Saya sentiasa dapat menerima hakikat bahawa penyusuan anak memang mengambil masa yang lama.453.873Saya sentiasa dapat menghabiskan penyusuan bayi dengan satu payu dara sebelum beralih kepada payudara yang satu lagi.531.869Saya sentiasa dapat menyusukan bayi setiap kali waktu penyusuan.605.865Saya sentiasa memenuhi keinginan bayi saya apabila dia ingin menyusu.586.866Saya sentiasa tahu apabila bayi saya sudah habis menyusu.640.864Table 3MeanMinimum maximalRangeMaximum / MinimumVarianceItem Means4.0533.7374.395.6581.176.030Item Variances.652.353.956.6022.704.027Inter-Item Correlations.340-.018.683.701-38.161.020Table 4Statistics for ScaleNMeanVarianceSD1456.7449.0647.005ProceduresAfter university and hospital ethics was obtained, eligible mothers were recruited in hospital from the postnatal ward by a researcher. Potential participants were identified by the researcher at 1 to 3 days postpartum from the registry book in the postnatal ward. The eligible participants who are willing to participate in this study has been approached, they will be given come on explanation clearly to understand the aims of the study. Once the participant expressed an interest and willingness to participate, they will be provided with inform consent, which is must be documented and signed. After that, conciliate translated BSES-SF Malay questionnaire was administered to the participants as soon as possible after respondent agreed and volunteer to answer the questions. The respondents were given self-administered questionnaires and the researcher will be waiting until respondents completed answer the questions and the completed answer questionnaire were collected back at the same time after the respondent has finished answering all the questions. point of accumulation of the studyIt is a pilot study, so the small number of samples is the most limitation of the study.DISCUSSIONPsychometrics propertiesThe results from this methodological study are consistent with the original study (Dennis Faux, 1999) and provide evidence that the translated BSES is a reliable measure of BSE among a representative sample of Malay women in Kota Bharu, Kelantan. The Cronbachs a was .88, portentous the recommended a for established instruments (Nunnally Bernstein, 1994).CONCLUSIONThe BSES-SF Malay version is reliable and valid for assessing mothers breastfeeding confidence.1