Psychometric properties of the paternal breastfeeding self-efficacy scale-short form: a confirmatory factor analysis of fathers in Taiwan

Abstract Background Fathers’ confidence in supporting their partners’ breastfeeding is crucial for successful breastfeeding outcomes. The paternal version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is a globally recognised tool for measuring fathers’ perceived confidence in supporting their partners’ breastfeeding. However, this scale has yet to be validated in Taiwan. This study aimed to evaluate the reliability and validity of the paternal BSES-SF among Taiwanese fathers. Methods A cross-sectional study was conducted at a baby-friendly hospital in northern Taiwan. Internal consistency and test–retest reliability were examined. Construct validity was evaluated using confirmatory factor analysis and correlations with depressive and anxiety symptoms. Known-groups comparisons were also conducted. Results A total of 198 fathers completed the study during their partners’ postpartum hospitalisation; of these 76 completed the two weeks retest. The initial one-factor model demonstrated suboptimal fit; after theoretically justified residual covariances were specified, the modified one-factor model achieved acceptable model fit (χ2/df = 2.95; RMR = 0.045; CFI = 0.93; TLI = 0.91; AIC = 278.63). Excellent internal consistency (Cronbach’s alpha = 0.95, 95% confidence interval, CI = 0.94–0.96) and moderate test–retest reliability (intraclass correlation coefficient, ICC = 0.70, 95% CI = 0.53–0.81) were observed. Fathers’ breastfeeding self-efficacy exhibited a significant negative correlation with anxiety ( r = -0.24, p < 0.001) and depressive ( r = -0.18, p = 0.013) symptoms. Evidence of known-groups validity was observed, with significantly higher paternal BSES-SF scores among fathers with two or more children ( p = 0.007) and those whose partners exclusively breastfed ( p < 0.001). Additionally, scores were significantly lower among fathers with education above college level ( p = 0.009) and those with a monthly income above NTD 100,000 ( p = 0.010). After adjustment, higher monthly income remained associated with lower scores, whereas having two or more children and having a partner who exclusively breastfed were associated with higher scores. Conclusion The paternal BSES-SF demonstrates acceptable psychometric properties for assessing breastfeeding self-efficacy among fathers during the early postpartum period in Taiwan. Healthcare professionals can use this validated tool for timely screening and to offer tailored programs that enhance fathers’ support for sustained breastfeeding.