To compile the knowledge, attitude and practice questionnaire for primiparas with breast-feeding mastitis and test its reliability and validity.

Guided by the knowledge-attitude-practice (KAP) theory, the first draft of the test questionnaire was formed through literature review, qualitative interviews, the Delphi method and pre-experiments. Totally 623 primiparas who attended a ClassⅢ Grade A obstetrics and gynecology hospital in Shanghai from February to June 2021 were selected by convenient sampling and formally investigated 42 days after delivery. Item analysis was used to select items; exploratory factor analysis, confirmatory factor analysis and expert consultation were employed to evaluate the validity of the questionnaire; test-retest reliability, half-reliability and internal consistency coefficient were used to evaluate the reliability of the questionnaire. A total of 623 questionnaires were distributed and 614 questionnaires were recovered, of which 609 were valid, with an effective recovery rate of 97.75%.

The questionnaire finally contained 26 items. Totally 6 common factors were extracted through exploratory factor analysis, and the cumulative variance contribution rate was 63.141%. Confirmatory factor analysis showed that the ratio of chi-square to degrees of freedom (χ²/df) =1.952, root mean square of root mean square error of approximation (RMSEA) =0.056, comparative fit index (CFI) = 0.922, incremental fit index (IFI) =0.923, parsimonious normed fit index (PNFI) =0.746, and parsimonious comparative fit index (PCFI) =0.806. The content validity index at the questionnaire level was 0.91, and the content validity index at the item level was 0.81~0.98. The Cronbach's α coefficient of the total questionnaire was 0.863、the half-reliability coefficient was 0.714, and the test-retest reliability coefficient was 0.865.

The KAP questionnaire for primiparas with breast-feeding mastitis has good reliability and validity, which can be used to assess the current status of primiparous women's KAP of breast-feeding mastitis.

Mastitis; Primipara; Lactation; Delphi method; Knowledge, attitude and practice; Reliability; Validity