Abstract
Objective
Assessing the sucking behavior of preterm newborns is highly significant for monitoring their nutrition and development in the early stages. Such evaluations play a critical role in the early detection and intervention of preterm infants’ feeding abilities. This study was conducted to determine the validity and reliability of the “Preterm Infant Breastfeeding Behavior Scale (PIBBS)” for the Turkish population.
Methods
This methodological research was carried out with newborns and their mothers at a hospital in a province in the northern region of Türkiye. The study included premature newborns born between the 31<sup>st</sup> and 37<sup>th</sup> gestational weeks and monitored alongside their mothers postpartum and neonatal nurses (n=172). Data were collected using the PIBBS and a descriptive information form containing individual characteristics of mothers, infants, and nurses. The data were analyzed using IBM SPSS V27 and LISREL 8.7.
Results
In the nurses’ evaluations, the total Cronbach’s α coefficient of the scale was calculated as 0.801, and the Guttman split-half coefficient was 0.761. In the mothers’ evaluations, the total Cronbach’s α coefficient was calculated as 0.827, and the Guttman split-half coefficient was 0.830. Confirmatory factor analysis revealed model fit indices in the nurses’ application as χ<sup>2</sup>/df=1.94; root mean squared error of approximation (RMSEA)=0.07, goodness of fit index (GFI)=0.97; adjusted goodness of fit index (AGFI)=0.92; non-normed fit index (NNFI)=0.95; comparative fit index (CFI)=0.97; standardized root mean square residual (SRMR)=0.04. In the mothers’ application, the values were χ<sup>2</sup>/df=2.18; RMSEA=0.079; GFI=0.96; AGFI=0.91; NNFI=0.96; CFI=0.98; SRMR=0.04.
Conclusion
This study demonstrated that the Turkish version of the PIBBS is a valid and reliable measurement tool. Analyses of linguistic validity, construct validity, and reliability support both mothers and nurses’ Turkish version of the scale.
Keywords: Preterm, infant, breastfeeding behavior, reliability and validity, scale
References
World Health Organization. Preterm birth. 2018. Erişim tarihi: 18.02.2025. Erişim adresi: https://www.who.int/news-room/fact-sheets/detail/preterm-birth#cms
Quinn JA, Munoz FM, Gonik B, et al. Preterm birth: case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine. 2016;34:6047-56.
Briere CE, McGrath JM, Cong X, Brownell E, Cusson R. Direct-breastfeeding in the neonatal intensive care unit and breastfeeding duration for premature infants. Appl Nurs Res. 2016;32:47-51.
Gennattasio A, Perri EA, Baranek D, Rohan A. Oral feeding readiness assessment in premature infants. MCN Am J Matern Child Nurs. 2015;40:96-104.
Lau C, Geddes D, Mizuno K, Schaal B. The development of oral feeding skills in infants. Int J Pediatr. 2012;2012:572341.
Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827-41.
Committee on Nutrition; Nutritional needs of low-birth-weight infants. Pediatrics may. 1985;75: 976-86.
Varışoğlu Y, Güngör Satılmış İ. Preterm doğumlarda anne sütü ve anne sütünü artırmaya yönelik alternatif yöntemler. İzmir Democracy University Health Sciences Journal. 2019;2:99-113.
Fucile S, Milutinov M, Timmons K, Dow K. Oral sensorimotor intervention enhances breastfeeding establishment in preterm infants. Breastfeed Med. 2018;13:473-8.
Hackman NM, Alligood-Percoco N, Martin A, Zhu J, Kjerulff KH. Reduced breastfeeding rates in firstborn late preterm and early term infants. Breastfeed Med. 2016;11:119-25.
TNSA. Türkiye Nüfus ve Sağlık Araştırması. 2018. Erişim tarihi: 18.02.2025. Erişim adresi: http://www.sck.gov.tr/wp-content/uploads/2020/08/TNSA2018_ana_Rapor.pdf
Jensen D, Wallace S, Kelsay P. LATCH: a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs. 1994;23:27-32.
Matthews MK. Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period. Midwifery. 1988;4:154-65.
McGrath JM, Braescu AV. State of the science: feeding readiness in the preterm infant. J Perinat Neonatal Nurs. 2004;18:353-68.
Viviers M, Kritzinger A, Vinck B. Development of a clinical feeding assessment scale for very young infants in South Africa. S Afr J Commun Disord. 2016;63:e1-e11.
Crowe LM. Assessment of preterm infants’ readiness to commence breastfeeding (Doctor of Philosophy’s thesis). Brisbane: Queensland University of Technology, Institute of Health and Biomedical Innovation; 2010. Available from: file:///Users/galenos/Desktop/Linda_Crowe_Thesis.pdf
Thoyre SM, Shaker CS, Pridham KF. The early feeding skills assessment for preterm infants. Neonatal Netw. 2005;24:7-16.
Fujinaga CI, de Moraes SA, Zamberlan-Amorim NE, Castral TC, de Almeida e Silva A, Scochi CG. Clinical validation of the preterm oral feeding readiness assessment scale. Rev Lat Am Enfermagem. 2013;21:140-5.
Matthews MK. Mothers’ satisfaction with their neonates’ breastfeeding behaviors. J Obstet Gynecol Neonatal Nurs. 1991;20:49-55.
Mulford C. The Mother-Baby Assessment (MBA): an “Apgar score” for breastfeeding. J Hum Lact. 1992;8:79-82.
Ingram J, Johnson D, Copeland M, Churchill C, Taylor H. The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy. Midwifery. 2015;31:132-7.
Nyqvist KH, Rubertsson C, Ewald U, Sjödén PO. Development of the preterm infant breastfeeding behavior scale (PIBBS): a study of nurse-mother agreement. J Hum Lact. 1996;12:207-19.
Nyqvist KH, Sjödén PO, Ewald U. The development of preterm infants’ breastfeeding behavior. Early Hum Dev. 1999;55:247-64.
Tabachnick BG, Fidell LS. Using multivariate statistics. (n.p.): Pearson Education 2012. Available from: https://www.google.com.tr/books/edition/Using_Multivariate_Statistics/yYgsAAAAQBAJ?hl=tr
Creedy DK, Cantrill RM, Cooke M. Assessing midwives’ breastfeeding knowledge: properties of the newborn feeding ability questionnaire and breastfeeding initiation practices scale. Int Breastfeed J. 2008;3:7.
Lober A, Dodgson JE, Kelly L. Using the preterm infant breastfeeding behavior scale with late preterm infants. Clin Lact. 2020;11:121-9.
Özkara H, Fidancı BE, Yıldız D, Kaymakamgil Ç. Emzirme danışmanlığı. TAF Preventive Medicine Bulletin. 2016;15:551-6.
Wild D, Grove A, Martin M, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8:94-104.
Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30:459-67.
Lessen BS. Effect of the premature infant oral motor intervention on feeding progression and length of stay in preterm infants. Adv Neonatal Care. 2011;11:129-39.
Schneider N, Garcia-Rodenas CL. Early Nutritional interventions for brain and cognitive development in preterm infants: a review of the literature. Nutrients. 2017;9:187.
Karakoç AGDFY, Dönmez PDL. Ölçek geliştirme çalışmalarında temel ilkeler. TED. 2014;13:39-4.
Alpar R. Uygulamalı istatistik ve geçerlik-güvenirlik. Ankara: Detay Yayıncılık; 2020. p. 526-602.
Carlson KD, Herdman AO. Understanding the Impact of Convergent Validity on Research Results. Organ Res Methods. 2012;15:17-32.
Aktürk Z, Acemoglu H. Tıbbi araştırmalarda güvenilirlik ve geçerlilik. Dicle Tıp Dergisi. 2012;39:316-9.
Davis LL. Instrument review: getting the most from a panel of experts. Applied Nursing Research. 1992;5:194-7.
