Sun Hee Kim

doi:10.4040/jkan.2009.39.2.259

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Original Article
Development of a Breast Feeding Adaptation Scale (BFAS): Sun Hee Kim; Journal of Korean Academy of Nursing 2009;39(2):259-269.
DOI: https://doi.org/10.4040/jkan.2009.39.2.259
Published online: April 28, 2009

Part-time Lecturer, Department of Nursing Science, Ewha Womans University, Seoul, Korea.

Address reprint requests to: Kim, Sun Hee. Department of Nursing Science, Ewha Womans University, 11-1 Daehyeon-dong, Seodaemun-gu, Seoul 120-750, Korea. Tel: 82-2-3277-2875, Fax: 82-2-3277-2850, carpesun@hanmail.net

• Received: December 3, 2008 • Accepted: March 18, 2009

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The aim of this study was to develop a breast feeding adaptation scale (BFAS) to evaluate adaptation to breastfeeding for breastfeeding mothers and their infants and to test the validity and reliability of the instrument.
Methods
The study was conducted as follows: application of the conceptual framework, identification of the content domains, items generation, and test of validity and reliability. In order to test validity and reliability, two panels of experts reviewed items and subcategories of the preliminary questionnaire and then data were collected from 329 mothers who were up to 4 weeks postpartum and breastfeeding. Descriptive statistics, t-test, factor analysis, and Cronbach's alpha were used to analyze the data.
Results
The conceptual framework was based on the Roy adaptation model. The content domains were developed via literature review, review of instruments, and data acquired from the interviews of breastfeeding mothers and nurses. A total of 69 items belonging to 8 domains were generated. A reduction to 44 preliminary items was accomplished through content validity analysis. Factor analysis extracted 8 factors with a total of 27 items on a 5-point Likert scale. Content validity, construct validity, criterion validity, and reliability of the BFAS were established.
Conclusion
The newly developed BFAS is a reliable and valid instrument with which the adaptation of breastfeeding mothers and their infants to the breastfeeding behavior can be evaluated.
Keywords: Adaptive behavior; Breast feeding

This study is a part of Ph.D. thesis.

Figure 1

Conceptual framework of breastfeeding adaptation.

Table 1

Factor Loading of Each Item of Adaptation to Breastfeeding

Table 2

Eigenvalue, Explained Variance, Cumulative Variance

Table 3

Differences of Adaptation to Breastfeeding according to the Present Type of Feeding and the Past Experience of Breast-feeding (N=329)

^**p<.01.

Table 4

Correlation between Subscales of BFAS and Subscales of HHLS (N=329)

^*p<.05, ^**p<.01.

BFAS=breast feeding adaptation scale; HHLS=H & H lactation scale.

Table 5

Internal reliability of BFAS

BFAS=breast feeding adaptation scale.

REFERENCES

1. Academy of Breastfeeding Medicine Korea. New mother's guide to breastfeeding. 2006;Seoul, E*PUBLIC.
2. Ahluwalia IB, Morrow B, Hsia J. Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System. Pediatrics. 2005;116:1408–1412.Article PubMed PDF
3. American Academy of Pediatrics (AAP) Section on breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506.Article PubMed PDF
4. Cadwell K, Turner-Maffei C, O'Connor B, Blair AC, Arnold LD, Blair EM. Maternal and infant assessment for breastfeeding and human lactation: A guide for the practitioner. 2006;2nd ed. Sudbury, MA, Jones and Bartlett Publishers.
5. Chezem J, Friesen C, Boettcher J. Breastfeeding knowledge, breastfeeding confidence, and infant feeding plans: Effects on actual feeding practices. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2003;32:40–47.Article
6. Dennis CL. Breastfeeding initiation and duration: A 1990-2000 literature review. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2002;31:12–32.Article
7. Dennis CL, Faux S. Development and psychometric testing of the breastfeeding self-efficacy scale. Research in Nursing & Health. 1999;22:399–409.Article
8. Hill PD, Humenick SS. Development of the H & H Lactation Scale. Nursing Research. 1996;45:136–140.Article PubMed
9. Huggins K, Ziedrich L. The nursing mother's guide to weaning. 2007;Boston, MA, The Harvard Common Press.
10. Clinical guidelines for the establishment of exclusive breastfeeding. International Lactation Consultant Association (ILCA). 2005;06;Retrieved June 20, 2007. from http://www.ilca.org/ClinicalGuidelines2005.pdf.
11. Isabella PH, Isabella RA. Correlates of successful breastfeeding: A study of social personal factor. Journal of Human Lactation. 1994;10:257–264.PubMed
12. Jeong GH. Effects of the nursing intervention program on promoting the breastfeeding practice in primipara. 1997;Seoul, Ewha Womans University. Unpublished doctoral dissertation.
13. Kendall-Tackett K, Sugarman M. The social consequences of long-term breastfeeding. Journal of Human Lactation. 1995;11:179–183.Article PubMed PDF
14. Kim HS. Potential determinant factors of insufficient milk supply syndrome. Journal of Korean Academy of Nursing. 1994;24:33–46.Article PDF
15. Kim HS. Analysis of the content of telephone counseling with breastfeeding mothers. Journal of Korean Academy of Nursing. 1995;25:17–29.Article PDF
16. Kim SH. Breastfeeding knowledge and attitude of the female university students. 2001;Seoul, The Catholic University of Korea. Unpublished master's thesis.
17. Kim SJ, Yang SJ. A study of primiparous women's breastfeeding experience. Journal of Korean Academy of Nursing. 1997;27:477–488.Article PDF
18. Kim YM. Effects of breastfeeding empowerment program on exclusive breastfeeding. 2006;Seoul, Seoul National University. Unpublished doctoral dissertation.
19. Kong SK, Lee DT. Factors influencing decision to breastfeed. Journal of Advanced Nursing. 2004;46:369–379.Article PubMed
20. Lawson K, Tulloch MI. Breastfeeding duration: Prenatal intentions and postnatal practices. Journal of Advanced Nursing. 1995;22:841–849.Article PubMed
21. Lee KH, Park YJ, Byeon SJ, Yu EG, Lee MR, Lee YS, et al. Women's health nusing I. 1998;Seoul, HyeonMoonSa.
22. Lee SO, Chung ES, Ahn SH, Moon GN, Park NH. A study of predictors of breastfeeding. Korean Journal of Child Health Nursing. 2003;9:368–375.
23. Lee YS, Im HS, Ahn HS, Jang NS. Nutrition throughout the life cycle. 2006;2nd ed.Paju, KyoMunSa.
24. Leff EW, Jeffereis SC, Gagne MP. The development of the Maternal Breastfeeding Evaluation Scale. Journal of Human Lactation. 1994;10:105–111.Article PubMed PDF
25. 2005 Korean national health and nutrition survey: Nutrition survey. Ministry of Health and Welfare. 2006;07 05 Retrieved October 12, 2007. from http://www.mw.go.kr/front/al/sal0301vw.jsp?.
26. Moran VH, Dinwoodie K, Bramwell R, Dykes F. A critical analysis of the content of the tools that measure breast-feeding interaction. Midwifery. 2000;16:260–268.Article PubMed
27. Punthmatharith B, Singh J. A psychometric assessment of the H & H lactation scale in a sample of Thai mothers using a repeated measurement design. Nursing Research. 2005;54:313–323.Article PubMed
28. Roy SC, Andrews HA. The Roy adaptation model. 1999;2nd ed. Stamford, CT, Appleton & Lange.
29. Streiner DL, Norman GR. Health measurement scales: A practical guide to their development and use. 2003;3rd ed. New York, NY, Oxford University Press.
30. Tinsley HE, Tinsley DJ. DeVellis RF. Uses of factor analysis in counseling psychology research. In: Scale development: Theory and applications. 1987;Thousand Oaks, CA, Sage Publications. 137.

Figure & Data

Figure 1

Conceptual framework of breastfeeding adaptation.

Table 1

Factor Loading of Each Item of Adaptation to Breastfeeding

Table 2

Eigenvalue, Explained Variance, Cumulative Variance

Table 3

Differences of Adaptation to Breastfeeding according to the Present Type of Feeding and the Past Experience of Breast-feeding (N=329)

^**p<.01.

Table 4

Correlation between Subscales of BFAS and Subscales of HHLS (N=329)

^*p<.05, ^**p<.01.

BFAS=breast feeding adaptation scale; HHLS=H & H lactation scale.

Table 5

Internal reliability of BFAS

BFAS=breast feeding adaptation scale.

REFERENCES

1. Academy of Breastfeeding Medicine Korea. New mother's guide to breastfeeding. 2006;Seoul, E*PUBLIC.
2. Ahluwalia IB, Morrow B, Hsia J. Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System. Pediatrics. 2005;116:1408–1412.Article PubMed PDF
3. American Academy of Pediatrics (AAP) Section on breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506.Article PubMed PDF
4. Cadwell K, Turner-Maffei C, O'Connor B, Blair AC, Arnold LD, Blair EM. Maternal and infant assessment for breastfeeding and human lactation: A guide for the practitioner. 2006;2nd ed. Sudbury, MA, Jones and Bartlett Publishers.
5. Chezem J, Friesen C, Boettcher J. Breastfeeding knowledge, breastfeeding confidence, and infant feeding plans: Effects on actual feeding practices. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2003;32:40–47.Article
6. Dennis CL. Breastfeeding initiation and duration: A 1990-2000 literature review. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2002;31:12–32.Article
7. Dennis CL, Faux S. Development and psychometric testing of the breastfeeding self-efficacy scale. Research in Nursing & Health. 1999;22:399–409.Article
8. Hill PD, Humenick SS. Development of the H & H Lactation Scale. Nursing Research. 1996;45:136–140.Article PubMed
9. Huggins K, Ziedrich L. The nursing mother's guide to weaning. 2007;Boston, MA, The Harvard Common Press.
10. Clinical guidelines for the establishment of exclusive breastfeeding. International Lactation Consultant Association (ILCA). 2005;06;Retrieved June 20, 2007. from http://www.ilca.org/ClinicalGuidelines2005.pdf.
11. Isabella PH, Isabella RA. Correlates of successful breastfeeding: A study of social personal factor. Journal of Human Lactation. 1994;10:257–264.PubMed
12. Jeong GH. Effects of the nursing intervention program on promoting the breastfeeding practice in primipara. 1997;Seoul, Ewha Womans University. Unpublished doctoral dissertation.
13. Kendall-Tackett K, Sugarman M. The social consequences of long-term breastfeeding. Journal of Human Lactation. 1995;11:179–183.Article PubMed PDF
14. Kim HS. Potential determinant factors of insufficient milk supply syndrome. Journal of Korean Academy of Nursing. 1994;24:33–46.Article PDF
15. Kim HS. Analysis of the content of telephone counseling with breastfeeding mothers. Journal of Korean Academy of Nursing. 1995;25:17–29.Article PDF
16. Kim SH. Breastfeeding knowledge and attitude of the female university students. 2001;Seoul, The Catholic University of Korea. Unpublished master's thesis.
17. Kim SJ, Yang SJ. A study of primiparous women's breastfeeding experience. Journal of Korean Academy of Nursing. 1997;27:477–488.Article PDF
18. Kim YM. Effects of breastfeeding empowerment program on exclusive breastfeeding. 2006;Seoul, Seoul National University. Unpublished doctoral dissertation.
19. Kong SK, Lee DT. Factors influencing decision to breastfeed. Journal of Advanced Nursing. 2004;46:369–379.Article PubMed
20. Lawson K, Tulloch MI. Breastfeeding duration: Prenatal intentions and postnatal practices. Journal of Advanced Nursing. 1995;22:841–849.Article PubMed
21. Lee KH, Park YJ, Byeon SJ, Yu EG, Lee MR, Lee YS, et al. Women's health nusing I. 1998;Seoul, HyeonMoonSa.
22. Lee SO, Chung ES, Ahn SH, Moon GN, Park NH. A study of predictors of breastfeeding. Korean Journal of Child Health Nursing. 2003;9:368–375.
23. Lee YS, Im HS, Ahn HS, Jang NS. Nutrition throughout the life cycle. 2006;2nd ed.Paju, KyoMunSa.
24. Leff EW, Jeffereis SC, Gagne MP. The development of the Maternal Breastfeeding Evaluation Scale. Journal of Human Lactation. 1994;10:105–111.Article PubMed PDF
25. 2005 Korean national health and nutrition survey: Nutrition survey. Ministry of Health and Welfare. 2006;07 05 Retrieved October 12, 2007. from http://www.mw.go.kr/front/al/sal0301vw.jsp?.
26. Moran VH, Dinwoodie K, Bramwell R, Dykes F. A critical analysis of the content of the tools that measure breast-feeding interaction. Midwifery. 2000;16:260–268.Article PubMed
27. Punthmatharith B, Singh J. A psychometric assessment of the H & H lactation scale in a sample of Thai mothers using a repeated measurement design. Nursing Research. 2005;54:313–323.Article PubMed
28. Roy SC, Andrews HA. The Roy adaptation model. 1999;2nd ed. Stamford, CT, Appleton & Lange.
29. Streiner DL, Norman GR. Health measurement scales: A practical guide to their development and use. 2003;3rd ed. New York, NY, Oxford University Press.
30. Tinsley HE, Tinsley DJ. DeVellis RF. Uses of factor analysis in counseling psychology research. In: Scale development: Theory and applications. 1987;Thousand Oaks, CA, Sage Publications. 137.

Citations

Citations to this article as recorded by

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Development of a Breast Feeding Adaptation Scale (BFAS)

J Korean Acad Nurs. 2009;39(2):259-269. Published online April 28, 2009

DOI: https://doi.org/10.4040/jkan.2009.39.2.259

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Development of a Breast Feeding Adaptation Scale (BFAS)

Figure 1 Conceptual framework of breastfeeding adaptation.

Figure 1

Development of a Breast Feeding Adaptation Scale (BFAS)

Table 1

Factor Loading of Each Item of Adaptation to Breastfeeding

Table 2

Eigenvalue, Explained Variance, Cumulative Variance

Table 3

Differences of Adaptation to Breastfeeding according to the Present Type of Feeding and the Past Experience of Breast-feeding (N=329)

^**p<.01.

Table 4

Correlation between Subscales of BFAS and Subscales of HHLS (N=329)

^*p<.05, ^**p<.01.

BFAS=breast feeding adaptation scale; HHLS=H & H lactation scale.

Table 5

Internal reliability of BFAS

BFAS=breast feeding adaptation scale.

Table 1 Factor Loading of Each Item of Adaptation to Breastfeeding

Table 2 Eigenvalue, Explained Variance, Cumulative Variance

Table 3 Differences of Adaptation to Breastfeeding according to the Present Type of Feeding and the Past Experience of Breast-feeding (N=329)

^**p<.01.

Table 4 Correlation between Subscales of BFAS and Subscales of HHLS (N=329)

^*p<.05, ^**p<.01.

BFAS=breast feeding adaptation scale; HHLS=H & H lactation scale.

Table 5 Internal reliability of BFAS

BFAS=breast feeding adaptation scale.