Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review

Dennis, Cindy-Lee; McQueen, Karen; Dol, Justine; Brown, Hilary; Beck, Cheryl; Shorey, Shefaly

doi:10.1186/s12889-024-17805-6

BMC Public Health

Table 3 Psychometric properties of the modified versions of the BSES AND BSES-SF for all included studies

From: Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review

Author Year	Cronbach’s alpha	Predictive Validity Assessment		Construct Validity Assessments
		Predictive Validity Assessment		Known groups analysis		Correlation with related constructs
		Behaviour / factor predicted	Predictive ( p < 0.05)	Comparator groups	Construct validity supported	Related construct used	Time of assessment of related construct	Correlation coefficient ® ( p < 0.001 unless specified)	Construct validity supported?
Breastfeeding Self-Efficacy Scale (BSES)
Creedy 2003 [26]	Antenatal = .97	Antenatal BSES vs. 1-week BF practices and 16 weeks EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	HHLS	Antenatal	0.73^*	Yes
	Postnatal = .96	1-week BSES vs. 16 weeks EBF	Yes				4-weeks	0.88^*	Yes
	Postnatal = .96	1-week BSES vs. 16 weeks EBF	Yes				16-weeks	0.88^*	Yes
Dai 2003 [30]	.93	Feeding method, 4 and 8 weeks	Yes	NA	NA	EPDS	4-weeks	-0.35	Yes
Dai 2003 [30]	.93	Feeding method, 4 and 8 weeks		NA	NA	EPDS	8-weeks	-0.20^**	Yes
Eksioglu 2011 [31]	1 week = .91 4 weeks = .92	1, 4, 8 weeks BSES vs. EBF	Yes	NA	NA	NA	NA	NA	NA
Milina Torres 2003 [32]	.96	BSES vs. EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	NA	NA	NA	NA
Oriá 2009 [33]	.88	NI	NA	Primiparas vs. multiparas	No	NI	NA	NA	NA
Oriá 2009 [33]	.88	NI	NA	Satis vs. unsatisfactory BF experiences	Yes	NI	NA	NA	NA
Breastfeeding Self-Efficacy Scale- Short Form (BSES-SF)
Amini 2019 [28]	.91	NI	NA	Primiparas vs. multiparas	No	EPDS	NR	-0.273	Yes
Amini 2019 [28]	.91	NI	NA	Primiparas vs. multiparas	No	PSS-10	NR	-0.068 (NS)	No
Asgarian 2020 [34]	.92	NI	NI	Primiparas vs Multiparas	No	NI	NA	NA	NA
Balaguer-Martinez 2022 [35]	NR	NI	NI	NI	NI	NI	NI	NI	NI
Basu 2020 [36]	.87	NI	NI	Primiparas vs Multiparas	No	EPDS	NR	NR	Yes
Basu 2020 [36]	.87	NI	NI	Primiparas vs Multiparas	No	MSPSS	NR	NR	Yes
Boateng 2019 [37]	4-week: Cognitive = .82 Functional = .77 12-week: Cognitive = .85 Functional = .79	4-week: BSES-SF vs. 4, 12, 24 weeks EBF 12-week: BSES-SF vs. 12 and 24 weeks EBF	Yes, but not at 24 weeks Yes	Primiparas vs Multiparas Correct vs. Incorrect BF knowledge	No Yes -Cognitive Subscale No-Functional Subscale	EBFSS	4 and 12 weeks	Cognitive Subscale Informational EBFSS: 0.23; Emotional EBFSS:0.28 BSES-SF Functional Subscale Instrumental EBFSS:0.31; Informational EBFSS: 0.39; Emotional EBFSS:0.47	Yes
						CESD	4 and 12 weeks	BSES-SF Functional Subscale and depression: -.014	Yes
Brandão 2018 [38]	.92	Antenatal BSES-SF vs. 4 weeks EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	STAI	Antenatal and 4, 12, 24 weeks	NI	Yes
Brandão 2018 [38]	.92	Antenatal BSES-SF vs. 12- and 24-weeks EBF	No	Intention to BF for > 24 weeks vs. < 24 weeks	Yes	EPDS (> 9)	Antenatal and 4, 12, 24 weeks	NI	Yes
Chipojola 2022 [18]	.90	NI	NI	Primiparas vs. multiparas	Yes	WHOQoL-BREF	NR	Psychological well-being = 0.23 Social relations = 0.28 The environment = .30 Physical well-being = .01	Yes, except for physical well-being
Dennis 2011 [39]	Antenatal = .84	Antenatal BSES-SF vs. BF initiation	Yes	Adolescents with prior BF experience vs. those without	Yes (for antenatal but not postnatal)	BAQ	Antenatal	.41	Yes
Dennis 2011 [39]	Postnatal = .93	Antenatal and postnatal BSES-SF vs. 4-week BF duration and exclusivity	Yes	Decided to BF before vs during pregnancy	Yes (for antenatal but not postnatal)	BAQ	Antenatal	.41	Yes
Dennis 2018 [19]	Antenatal = .91 Postnatal = .92	Paternal in-hospital BSES–SF vs. 6-weeks and 12-week EBF	No	Paternal in-hospital BSES–SF vs. Maternal in-hospital BSES–SF	Yes	IIFAS	Antenatal & in-hospital	Antenatal = .26 In-hospital = .40	Yes
		Paternal in-hospital BSES–SF vs. 6-weeks and 12-week EBF	No			Fathers’ perception of breastfeeding importance (designed for study)	In-hospital	.27	Yes
		6-week BSES–SF vs. 12-week EBF	Yes			Involvement in decision making (yes/no)	In-hospital	NR	Yes
		6-week BSES–SF vs. 12-week EBF	Yes			Breastfeeding progress in-hospital (designed for study)	In-hospital	.27	Yes
Dodt 2012 [40]	.74	NI	NI	Primiparas vs. multiparas	No	NI	NI	NI	NI
Dodt 2012 [40]	.74	NI	NI	Previous BF experience vs. none	Yes	NI	NI	NI	NI
Dos Santos 2016 [41]	.82	NI	NI	Primiparas vs. multiparas	No	NI	NI	NI	NI
Dos Santos 2016 [41]	.82	NI	NI	Previous BF experience vs. none	No	NI	NI	NI	NI
Gerhardsson 2014 [42]	.91	BSES-SF vs. EBF	Yes	Primiparas vs. multiparas	Yes	NI	NA	NA	NA
Gerhardsson 2014 [42]	.91	BSES-SF vs. EBF	Yes	Positive vs. negative BF experiences	Yes	NI	NA	NA	NA
Gregory 2008 [43]	.90	In-hospital BSES-SF vs. 4-week EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	NI	NA	NA	NA
Handayani 2013 [24]	.77	NI	NA	NI	NA	NI	NA	NA	NA
Husin 2017 [27]	Antenatal: .94 Postnatal: .95	NI	NA	NA	NA	NI	NA	NA	NA
Iliadou 2020 [44]	.93	3-day BSES-SF vs. 6-month EBF	Yes	NI	NA	EPDS	Antenatal	.23 ^*	Yes
Iliadou 2020 [44]	.93	3-day BSES-SF vs. 6-month EBF	Yes	NI	NA	EPDS	Postnatal (3 ddp)	-.22 ^*	Yes
Ip 2012 [45]	.95	BSES-SF and BF duration	Yes	Women with BF experience vs. those without	Yes	NA	NA	NA	NA
		BSES-SF vs. 4-week EBF	Yes
		BSES-SF vs. 24 weeks EBF	Yes, compared to bottle feeding but not partial BF
Ip 2016 [46]	.94	BSES-SF at 3 dpp predicted EBF	Yes	NI	NA	NI	NA	NA	NA
Küçükoğlu 2023 [20]	.93	NI	NA	NI	NA	NI	NA	NA	NA
Maurer (n.d.) (Maurer, et al.: The breastfeeding self-efficacy scale - short form (BSES): German translation and psychometric assessment, unpublished)	.88	NI	NA	vs. women with two, three or more children	Yes	NI	NA	NA	NA
McCarter-Spaulding 2010 [47]	.94	In-hospital BSES-SF vs. 4-week BF duration	Yes	Women with BF experience vs. those without	Yes	NSB	1-week and 4-weeks postpartum	1 week = .44 4-weeks = .40	Yes
		In-hospital BSES-SF vs. 4-week EBF	Yes	Intention to BF for > 24 weeks vs. < 24 weeks	Yes
		In-hospital BSES-SF vs. 24-weeks BF duration	Yes	Intention to BF for > 24 weeks vs. < 24 weeks	Yes
McQueen 2013 [48]	.95	In-hospital BSES-SF vs. 4-week EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	EPDS	4 weeks postpartum	NR	Yes
McQueen 2013 [48]	.95	In-hospital BSES-SF vs. 8-week EBF	Yes	Primiparas vs. multiparas with BF experience	Yes	EPDS	4 weeks postpartum	NR	Yes
Mituki 2017 [25]	.91	BSES-SF vs. 6-week EBF	Yes	NI	NA	NI	NA	NA	NA
Oliver-Roig 2012 [49]	.92	In-hospital BSES-SF vs. 3 weeks EBF	Yes	Women with BF experience vs. those without	Yes	GSEI	2 dpp	.5	Yes
						GSES	2 dpp	.24^††	Yes
						SMSE	2 dpp	.41	Yes
				Women with positive vs. negative BF experiences	Yes	NA	NA	NA	NA
Otsuka 2008 [50]	.95	BSES-SF vs. 4-week EBF	Yes	Primiparas vs. multiparas	Yes	PIM	4 weeks	-.45	Yes
				Women with BF experience vs. those without	Yes
				Intention to EBF vs. not	Yes
Pavicic-Bosnjak 2012 [51]	.86	In-hospital BSES-SF vs. 4- and 24-weeks BF duration	Yes	Primiparas vs. multiparas	Yes	SOC	In-hospital	.32	Yes
Pavicic-Bosnjak 2012 [51]	.86	In-hospital BSES-SF vs. 4 and 24 weeks EBF	Yes	Multiparas with > 24 weeks vs. ≤ 24 weeks of BF	Yes	SOC	In-hospital	.32	Yes
Petrozzi 2016 [52]	.92	In-hospital BSES-SF vs. EBF	Yes	Primiparas vs. multiparas	No	EPDS	In-hospital	− .18^***	Yes
Radwan 2022 [53]	.95	BSES-SF vs. 24-week EBF	Yes	Primiparas vs. multiparas	Yes	EPDS	NR	-.23	Yes
Radwan 2022 [53]	.95	BSES-SF vs. 24-week EBF	Yes	Women with BF experience vs. those without	Yes	EPDS	NR	-.23	Yes
Sandhi 2022 [29]	.90	NI	NR	Primiparas vs. multiparas	Yes	EPDS	NR	-.213	Yes
Sandhi 2022 [29]	.90	NI	NR	Primiparas vs. multiparas	Yes	HADS – depression subscale	NR	-.171 ^*	Yes
Tokat, 2010 [54]	Antenatal = .87 Postnatal = .86	Antenatal BSES-SF vs. 12-weeks BF duration and EBF	Yes	Women with BF experience vs. those without	Yes	HADS – Anxiety subscale	NR	-.147 ^***	Yes
Tokat, 2010 [54]	Antenatal = .87 Postnatal = .86	In-hospital BSES-SF vs. 12-weeks BF duration and exclusivity	Yes	Women with BF experience vs. those without	Yes	HADS – Anxiety subscale	NR	-.147 ^***	Yes
Tokat 2020 [21]	.72	1-week BSES-SF vs. 4-week EBF	Yes	Women with BF experience vs. those without	No	BAI	1 week postpartum	-.219 ^***	Yes
Wheeler 2013 [22]	.88	1-week BSES-SF vs. 6 weeks BF duration	Yes	Women with BF experience vs. those without	Yes	HHLS	1 week	− .84	Yes
Witten 2020 [55]	.83	BSES-SF vs. 4–8 weeks BF duration and exclusivity	Yes	Primiparous vs. multiparas	Yes	EPDS	NR	-.17	No
Wutke 2007 [56]	.89	In-hospital BSES-SF vs. 8- and 16-weeks BF duration	Yes	Primiparous vs. multiparas	Yes	NI	NA	NA	NA
Wutke 2007 [56]	.89	In-hospital BSES-SF vs. 8 and 16-week EBF	Yes	Women with BF experience vs. those without	Yes
Yang 2020 [23]	.973	NI	NA	Primiparous vs. multiparas	Yes	NI	NA	NA	NA
Yang 2020 [23]	.973	NI	NA	Women with BF experience vs. those without	Yes	NI	NA	NA	NA
Zubaran 2010 [57]	.71	BSES-SF vs. EBF	Yes	Primiparous vs. multiparas	No	EPDS	Between 2–12 weeks postpartum	-.41	Yes

BAQ Breastfeeding Attitudes Questionnaire, BAI Beck Anxiety Inventory, BSES Breastfeeding Self-Efficacy Scale, BSES-SF Breastfeeding Self-Efficacy Scale-Short Form, CESD Center for Epidemiologic Studies Depression Scale, dpp days postpartum, EPDS Edinburgh Postnatal Depression Scale, GSEI Global Self-Efficacy Index, GSES General Self-efficacy Scale, HAS Hospital Anxiety and Depression Scale, HHLS Hill & Humenick Lactation Scale, MSPSS Multidimensional Scale of Perceived Social Support, NA Not Applicable, NI Not Indicated, NSB Network Support for Breastfeeding Tool, PIM Perception of Insufficient Milk, PPV positive predictive value, NPV negative predictive value, PSS Perceived Stress Scale, QMIDAT Questionnaire Measure of Individual Differences in Achieving Tendency, RSES Rosenberg Self-esteem Scale, SMSE Stress Management Self-Efficacy Scale, SOC Sense of Coherence Scale, week weeks postpartum
^* p = < 0.01
^** p = 0.04
^*** p = < 0.05
^†† p = 0.005

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