1 Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.

2 Assistant Professor, Infertility Fellowship, Women's Health research center, Obstetrics and Gynecology Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Student Research Committee, Psychiatry and Behavioral Research Centre, Mazandaran University of Medical Sciences. Sari, Mazandaran, Iran.

4 Department of Clinical Psychology, School of Humanities and Social Sciences, Islamic Azad University, Science and Research Branch, Tehran, Iran.

5 Instructor of Fatemeh School Nursing and Midwifery, Shiraz University of Medical Sciences, Iran.

6 Department of Medical Education, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

7 Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.


Background: The breastfeeding self-efficacy is one of the psychological factors affecting the duration of breastfeeding; the Breastfeeding self-efficacy measured by the breastfeeding self-efficacy scale-short form (BSES-SF). It was validated and reliable in several studies. The current systematic review aimed to comprehensively review the validity and reliability of the BSES-SF in various versions to give comprehensive information for authorities in this field.
Materials and Methods: We searched English databases, including Medline (via PubMed), Scopus, Cochran library and Web of Science since inception to May 2018 to find all previously published reports the psychometric dimensions of the Breastfeeding Self-Efficacy. Two reviewers read independently extracted data assessed. The quality of the studies was carried out by the Consensus-based standards for the selection of health status Measurement instruments (COSMIN) checklist.
Results: In this systematic review, reliability was measured using Cronbach’s alpha; inter coefficient of correlation (ICC) as well as an analysis of the item-total correlation. Cronbach’s alpha of breast-feeding self-efficacy for whole scale ranged from 0.76 to 0.95 considered moderate to excellent. Only two studies assessed test-retest reliability. One study reported correlation between two time intervals that was high (r=0.94) and another study measured test-retest reliability using ICC. It was ranged from 0.69 to 0.78 that consider suitable. Item-total correlation ranged from 0.23 to 0.85. Construct validity was tested using factor analysis. Original one- factor structure was confirmed in Spanish, Chinese, American, Canadian, Brazilian and Creation version. Some studies reported four and six –factor structure.  Confirmatory factor analysis (CFA) confirmed one-factor structure.
Conclusion:Original one- factor structure was confirmed in Spanish, Chinese, American, Canadian, Swedish, and Japanese, creation, Turkish, Portuguese, Brazilian and Creation; version six and four- factor need to further test in future studies. This study provides evidence also that the modified BSES-SF may be a valid and reliable measure of breastfeeding self-efficacy.