Development and Validation of the Lactation Psychological Needs Scale

Abstract

Background: According to self-determination theory, when an individual’s psychological needs for autonomy, competence, and relatedness are satisfied, human flourishing can occur. The simultaneous satisfaction of the three needs has not yet been examined in the context of lactation and offers a potential explanation for variations in breastfeeding outcomes and well-being among lactating individuals. Research Aim: To develop and preliminarily validate an instrument measuring lactation-related psychological need satisfaction. Method: Initial items for the Lactation Psychological Needs Scale were developed based on a literature review, and refined based on content validity testing. An online cross-sectional survey was administered in two phases to lactating individuals in the United States (n = 634) to assess validity and reliability. Results: Exploratory (n = 388) and confirmatory factor analyses (n = 246) in separate samples yielded a three-factor solution with excellent goodness-of-fit (chi-square Bollen-Stine adjusted p = 0.05, root mean square error of approximate: ≤ 0.06, comparative fit index > 0.95, and Tucker-Lewis Index > 0.95). The new instrument includes 12 items on three subscales: autonomy, competence, and relatedness. Internal consistency reliability was acceptable for the full scale (0.856) and subscales (0.790–0.861). The full instrument scores and subscale scores were positively correlated with maternal satisfaction with lactation, and negatively correlated with Edinburgh Postnatal Depression Scale scores. Conclusion: The results of this study provide preliminary psychometric support for the novel instrument. Self-determination theory provides an opportunity for a new paradigm in understanding behavior and well-being among lactating individuals. Further validation of the instrument is required.