Many new mothers discontinue breastfeeding prematurely because of difficulties encountered rather than maternal choice. Research has shown that a significant predictor of breastfeeding duration is a mother's confidence in her ability to breastfeed. To measure breastfeeding confidence, the Breastfeeding Self-Efficacy Scale (BSES) was developed and psychometrically tested at 1 week postpartum. The purpose of this methodological study was to psychometrically test the BSES antenatally and at 1 week and 4 months postpartum in a sample of Australian women and to determine predictive validity. The psychometric assessment of the original BSES study was replicated, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with a similar construct. Support for predictive validity was demonstrated through positive correlations and significant mean differences between antenatal BSES scores and infant-feeding method at 1 week and 4 months postpartum. The BSES is now considered ready for both research and clinical use (a) to identify new mothers with low breastfeeding confidence who require additional assistance, (b) to assess breastfeeding behaviors and cognitions in order to have individualized confidence-building strategies, and (c) to assist in the evaluation of various nursing interventions. 相似文献
Objectives: The Stoma-QOL questionnaire is a patient-reported outcome (PRO) used to measure quality of life in patients with ileostomy or colostomy. This study assesses the Stoma-QOL’s overall and item-level psychometric characteristics in patients with temporary stomas, and whether stoma-related quality of life differs by demographic characteristics.
Materials and methods: Analysis of cross-sectional observational PRO data from hospitals in Vancouver, Canada. Patients registered for elective ileostomy or colostomy closure, over the age of 18, and able to read English were eligible for participation. Emergent and cancer-related cases were excluded. One-way analysis of variance was used to test for demographic differences in Stoma-QOL scores. Cronbach’s alpha was used for reliability, and Rasch item-response theory was used to assess overall and item characteristics.
Results: 120 patients were included. No statistically significant difference in Stoma-QOL scores was found by age, sex, or socioeconomic status. Reliability was 0.93. Mean item responses ranged from 1.77 to 3.55 and item-total correlation ranged from 0.51 to 0.77. The Rasch item-response theory model demonstrated significant misfit, likely due to the misfit of item 9, which asks about sexuality, and high residual correlations between item pairs 6 and 8 about fatigue, and items 16 and 17 about social relationships.
Conclusions: The Stoma-QOL questionnaire is a well-designed PRO for measuring stoma-related quality of life. Demographic variables do not appear to have a strong influence on Stoma-QOL scores. Item 9 demonstrated misfit but removal likely does not improve the instrument. Future research should focus on revising items 6, 8, 16, and 17. 相似文献
Background The Edinburgh Postnatal Depression Scale (EPDS) has been widely used to assess maternal depression following childbirth in
a range of English speaking countries, and increasingly also in translation in non-English speaking ones. It has performed
satisfactorily in most validation studies, has proved easy to administer, is acceptable to women, and rates of depression
in the range of 10–20% have been consistently found.
Methods The performance of the EPDS was compared across different population samples in Australia: (i) Women born in Australia or
in another English speaking country who completed the EPDS in English as part of the 1994 postal Survey of Recent Mothers
(SRM) 6–7 months after birth (n = 1166); (ii) Women born in non-English speaking countries who also completed the EPDS in English in the same survey (n = 142); and (iii) Women born in Vietnam (n = 103), Turkey (n = 104) and the Philippines (n = 106) who completed the EPDS 6–9 months after birth in translation in the Mothers in a New Country Study (MINC) study (total
n = 313). The pattern of item responses on the EPDS was assessed in various ways across the samples and internal reliability
co-efficients were calculated. Exploratory factor analyses were also conducted to assess the similarity in the factor solutions
across the samples.
Results The EPDS had good construct validity and item endorsement by women was similar across the samples. Internal reliability of
the scale was also very satisfactory with Cronbach’s alpha for each sample being ≥8. Between 39 and 46% of the variance in
each of the three main samples was accounted for by one principal factor ‘depression’ (6–7 items loading), with two supplementary
factors ‘loss of enjoyment’ (2 items loading) and ‘despair/self-harm’ (2–3 items loading) accounting for a further 20–25%
of the variance. Alternative one and two factor solutions also showed a great deal of consistency between the samples.
Conclusions The good item consistency of the EPDS and the relative stability of the factor patterns across the samples are indicative
that the scale is understood and completed in similar ways by women in these different English speaking and non-English speaking
population groups. With the proviso that careful translation processes and extensive piloting of translations are always needed,
these findings lend further support to the use of the EPDS in cross-cultural research on depression following childbirth. 相似文献