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Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN

Borona, G., Gualdana, G., Maga, G. , Del Bo, E., Arrigoni, C., Brigante, L., Daniele, M. ORCID: 0000-0002-5666-9489, Caruso, R. & Magon, A. (2023). Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN. Journal of Human Lactation, 39(4), pp. 595-614. doi: 10.1177/08903344231190624


Breastfeeding self-efficacy has been proven to play a predictive role in enhancing breastfeeding initiation and continuation. Breastfeeding self-efficacy measurement tools have facilitated healthcare professionals’ early identification and support of women at higher risk of early discontinuation of breastfeeding.

Research Aim:
The aim of this study was to assess the psychometric properties of breastfeeding self-efficacy measurement tools.

A systematic review was carried out in three phases. Phase One comprised a systematic literature review performed in PubMed, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews from February 2021 to January 2023, including 36 studies for final analysis. Phase Two provided a quality appraisal of the psychometric properties of each of the seven breastfeeding self-efficacy measurement tools, according to COnsensus-based Standards for the selection of health Measurement Instrument checklist (COSMIN) guidelines. Phase Three summarized and graded the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) modified approach.

The included articles comprised 9,225 participants and seven breastfeeding self-efficacy measurement tools. The Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale – Short Form (BSES-SF), and Prenatal Breastfeeding Self-Efficacy Scale were supported by Grade A evidence sustaining their validity and reliability to assess breastfeeding self-efficacy in the continuum of maternity care. The BSES-SF is the most feasible tool in clinical practice and the most utilized internationally, available in 15 languages.

This systematic review provided a Grade A recommendation on breastfeeding measurement tools that will be helpful both for clinical and research purposes.

Publication Type: Article
Additional Information: © The Author(s) 2023. Reuse is restricted to non-commercial and no derivative uses.
Publisher Keywords: breastfeeding, Breastfeeding Self-Efficacy Scale (BSES & BSES-SF), Breastfeeding Self-Efficacy Scale – Short Form, consensus-based standards for the selection of health, easurement instrument checklist self-efficacy, development and evaluation, Grading of Recommendations Assessment systematic review, Prenatal Breastfeeding Self-Efficacy Scale, Psychometrics, public health
Subjects: R Medicine > RG Gynecology and obstetrics
Departments: School of Health & Psychological Sciences > Midwifery & Radiography
SWORD Depositor:
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