Cross-Cultural Adaptation And Applicative Research Of The Breast Feeding Knowledge Questionnaire(Conocilam)

Objective: To introduce the breastfeeding knowledge questionnaire(Co NOCilam)constructed by Spanish scholar Olga Paloma-Castro et al.,translate and revise the questionnaire into Chinese version according to the procedures and standards of chinesization and intercultural adaptation,and test the reliability and validity of the revised scale.To investigate the knowledge of breastfeeding of expectant mothers and expectant fathers in Yanji,Jilin Province,China,and to analyze the related factors,so as to provide basic data for the research on breastfeeding.Methods:(1)In this study,the Spanish version of the breastfeeding knowledge questionnaire was translated,back-translated and adapted cross-culturally to form the Chinese version of the breastfeeding knowledge questionnaire.(2)A cross-sectional questionnaire was adopted,and the ratio of obstetric beds in two hospitals was used as the basis for the questionnaire distribution.The expectant mothers and expectant fathers who visited two hospitals in Yanji,Jilin Province from January 2020 to December 2020 were selected by convenience sampling for the survey.For reliability and validity test,511 questionnaires were sent out and 464 were effective with an effective recovery rate of 90.8%.143 samples were sent out for the empirical study and 132 valid questionnaires were received with effective recovery of 92.3%.The survey tools included general information questionnaire and Chinese version of breastfeeding knowledge scale.(3)Excel and SPSS26.0 were used for data analysis.Descriptive analysis methods such as mean,standard deviation and percentage were used to describe the score of breastfeeding knowledge and the awareness rate of questionnaire.Mann-Whitney U test and Kruskal-Wallis H test were used to compare scores of breastfeeding knowledge in different ages,ethnic group,educational level,occupation,family monthly average income,and pregnancy frequency,et al.Pearson correlation coefficient and critical ratio method were used to evaluate and screen the items.The content validity of the scale was tested by expert rating.Exploratory factor analysis was used to test the structural validity of the scale.The reliability of the scale was tested by internal consistency reliability,split half reliability and retest reliability.Result:(1)Through the translation,back translation and cross-cultural adaption,the breastfeeding knowledge scale was composed of 23 indicators and 92 items.The item-content validity index(I-CVI)of each item of the scale ranged from 0.83 ～ 1.00.The scale-content validity index/universal agreement(S-CVI/UA)was 0.83.The scale-content validity index/average(S-CVI/AVE)was 0.97.Due to the excessive number of items,the items were divided into three parts and exploratory factor analysis was conducted respectively to extract 7 principal components.The factor load was0.425～0.877,and the cumulative variance contribution rate was 57.502%,42.558% and 52.000%.The calculation method of the scale changed after the classification.Through communication with the author of the original scale,we decided to use the method of the original scale without dimensionality division.The contents and number of items and indicators of the Chinese version of the breastfeeding knowledge scale were consistent with the original scale.The Cronbach’s α coefficient of the scale was 0.829,the split reliability was 0.796,and the retest reliability was 0.630.(2)In this study,the average score of breastfeeding knowledge was90.91±7.59 and the questionnaire awareness rate was 77.8%,which was above the average level.Monofactor analysis showed that the the scores vary in different education levels,occupations,family monthly average income,difficulty in breastfeeding and previous breastfeeding experiences(P<0.05).Conclusion:(1)The Chinese version of the breastfeeding knowledge scale,which contains 23 indicators and contains 92 items,has good reliability and validity and can be used as an effective tool to measure the degree of knowledge about breastfeeding of expectant mothers and expectant fathers.(2)The average score of breastfeeding knowledge of expectant mothers and expectant fathers is 90.91±7.59 and the awareness rate is 77.8%,which is above the average level.The cognition level needs to be improved.(3)There are statistically significant differences in scores between different education levels,occupations and family monthly average income,et al,which suggests that the knowledge level is better in those who get higher education level,higher income,more difficult feelings and more dissatisfied breastfeeding experiences.