Development Of Breastfeeding Resilience Scale For Employed Women After Returning To Work

【Objective】The study was aimed to develop a breastfeeding resilience scale for employed women after returning to work,test the reliability and validity of the scale,and provide a specific tool for this group.【Methods】1.Based on Kumpfer’s resilience framework which focused on the dynamic interaction between environment and individuals,the initial version of the scale was formed through literature review,group discussion.2.The Delphi method was used to rate the dimensions and items of the scale and modifications was made to refine the test version of the scale.The final test version of the scale was adjustmented by testing 15 women who experienced breastfeeding after returning to work.Further refinements of the scale was proceeded according to feedback from these participants.3.Data was collected through the test version scale.Though item statistical analysis,internal consistency assessment and exploratory factor analysis to analyze the scale items to generate the protocol of the scale.4.The protocol of the scale was used for data collection.To test the reliability of the scale by internal consistency reliability and split-half reliability.To test the validity of scale by content validity,construct validity,convergent validity,discriminant validity and criterion validity.The effective rate and the response time were used to evaluate the feasibility of the scale,and the final version of the scale was decided.【Results】1.Initial version of the scale:through literature review,the prototype of initial version of the scale had 76 items in 5 dimensions,including mental,emotional,cognitive,social and physical.After deleting or adjusting by 3 rounds of group discussion,the number of items was reduced to 53.2.Test version of the scale:after the Delphi expert consultation,a 5-dimensions,29-items test version scale was formed.After the pre-test,the language accuracy of 5items was modified to generate the final test version of the scale.3.The protocol of the scale:item statistical analysis,internal consistency assessment and exploratory factor analysis were used to filter items.Five items were deleted to refine the protocol of the scale.4.Formal version of the scale:(1)Reliability test:the Cronbach’sαcoefficient of this scale was 0.897,and the Cronbach’sαcoefficient of each dimension was 0.863,0.867,0.875,0.756 and 0.750,respectively;the split-half coefficient for the overall scale was 0.787.(2)Validity test:(1)Content validity:this scale has good content validity.(2)Construct validity:five common factors were extracted by exploratory factor analysis,and the cumulative variance interpretation rate was 63.139%,and the slope tended to be gentle after the fifth factor,and the factor loading of each item was greater than 0.5.The results of confirmatory factor analysis showed that the value of X~2/df was 1.654,RMSEA was 0.057,and the values of GFI,CFI,NFI,IFI and TLI were all greater than 0.80,which meant that the model adaptation indexes were all up to standard,indicating that the 5-factor model of the scale was suitable.(3)Convergent validity and discriminant validity:AVE value of each dimension of the scale ranged from 0.441 to 0.570,CR of each dimension ranged from 0.755 to 0.876,correlation coefficients among dimensions were all less than 0.5,square root of AVE value of each dimension ranged from 0.663 to 0.755,square root of AVE value of each dimension was greater than the correlation coefficient between this dimension and the other four dimensions.(4)Criterion validity:the correlation coefficients between scale dimensions,total score and calibration scale(Connor-Davidson Resilience Scale,CD-RISC)were 0.456,0.463,0.418,0.410,0.513,0.629(all P value<0.01).After the reliability and validity test,the breastfeeding resilience scale for employed women after returning to work was formed with 5 dimensions and 24items(formal version).【Conclusions】In this study,5 dimensions(mental,emotional,cognitive,social,physical)and24 items were included in the breastfeeding resilience scale for employed women after returning to work.All indexes of the scale reliability and validity test meet the requirements of measurement,that is,the scale is reliable and stable.