Breastfeeding competency scale (BCS); development and validation of an evaluation instrument on breastfeeding competency in third trimester pregnancy

Abstract

Background: Breastfeeding plays an important role in the early stages of humans and throughout the development process. Breastfeeding competency is a self-assessment of pregnant women’s overall competency to breastfeeding which could predict the breastfeeding behaviours of pregnant women. However, a valid and reliable scale for assessing breastfeeding competency has not yet been developed and validated. This study was conducted to develop and validate an assessment scale designed to assess pregnant women’s breastfeeding competency in the third trimester: the Breastfeeding Competency Scale (BCS). Methods: The BCS was developed and validated over three phases between September 2018 and September 2019, and these phases included item statistical analysis, exploratory factor analysis (EFA), content validation, internal consistency assessment, split-half reliability assessment and confirmatory factor analysis (CFA). Results: The item statistical analysis and EFA resulted in 38 items and 4 factors that explained 66.489% of the total variance. The Cronbach’s α coefficients for the total scale and the 4 factors were 0.970, 0.960, 0.940, 0.822 and 0.931. The split-half reliability of the BCS was 0.894 and 0.890. CFA model showed that the 4-factor model fits the data well. Conclusions: The BCS is a new valid and reliable instrument for assessing the breastfeeding competency of pregnant women in the third trimester.