Development and psychometric testing of an instrument to assess existential aspects of mother's initial breastfeeding difficulties (ExBreastS).


University of Borås, Faculty of Caring Science, Work Life and Social Welfare, 501 90 Borås, Sweden. Electronic address: [Email]


OBJECTIVE : Mothers who have negative breastfeeding experiences due to initial breastfeeding difficulties are in demanding existential situations. Therefore, it is important for healthcare professionals to identify and address such breastfeeding problems. The aim of this study was to develop an instrument designed to assess existential aspects of mothers' initial breastfeeding difficulties and evaluate its psychometric properties.
METHODS : This study reports on the development of a new instrument and was carried out in three steps: (1) a questionnaire about various existential aspects of initial breastfeeding difficulties, based on 66 items derived from two phenomenological studies, was developed; (2) information was collected using the questionnaire; (3) and the resulting data were statistically analysed. Spearman's correlation coefficient was used to assess comparative validity; exploratory factor analysis with principal axis factoring and varimax rotation were used to assess construct validity; and Cronbach's alfa was used to assess internal consistency and reliability. Three hundred and nine Swedish-speaking mothers aged 20-46 participated in the study.
RESULTS : Correlation and factor analysis of the 66 items revealed that 16 of the items were of psychometric value and valid. Factor analysis generated three factors that accounted for 62.9% of the total variance: Mother-Child Interdependency, Exposure and Vulnerability and Security and Trust. The instrument shows adequate sensitivity to identify existential aspects of mothers' initial breastfeeding difficulties.
CONCLUSIONS : The instrument satisfactorily assesses existential aspects of initial breastfeeding difficulties and can be used as a sensitive tool by healthcare professionals to screen for and identify mothers who have negative breastfeeding experiences.


Breastfeeding,Existential,Experiences,Initiating breastfeeding,Psychometric,Scale,