Psychometric evaluation of the Indonesian version of paternal breastfeeding self-efficacy scale- short form: A confirmatory factor analysis

Background: Fathers play a significant role in supporting sustaining exclusive breastfeeding. It is crucial to assess paternal confidence in assisting mothers during breastfeeding. Research aim: This study evaluated the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale- Short Form among Indonesian fathers. Methods: A cross-sectional study was conducted among 462 fathers whose wives gave birth to the baby in public hospitals in Indonesia. The internal consistency and test-retest reliability were examined using Cronbach's alpha and intraclass correlation coefficient. We evaluated the convergent, divergent, predictive, and construct validity. Results: Confirmatory factor analysis demonstrated a one-factor structure model with satisfactory fit indices. The Cronbach's alpha (0.96), McDonald's Omega coefficient (0.97), and intraclass correlation coefficient (0.99) indicated an excellent reliability of the scale. The father's breastfeeding self-efficacy was positively correlated with the mother's breastfeeding self-efficacy (r= 0.251, p < .001), and negatively associated with symptoms of depression (r = -0.150, p < .01) and anxiety (r = -0.314, p < .001). We also found a positive correlation between BSES-SF and exclusive breastfeeding at two weeks postpartum (r = 0.538, p < .001). Fathers who were employed and their partner was multipara, had a vaginal birth, practiced skin-to-skin contact and rooming-in, and exclusive breastfeeding were more confident to support their partner's breastfeeding. Conclusions: The Indonesian version of the paternal Breastfeeding Self-Efficacy Scale- Short Form is a reliable and valid tool for screening and assessing fathers’ confidence in assisting mothers in breastfeeding.