ALMA Scale: development and initial validation for identifying maternal refusal of breastfeeding
Main Article Content
Keywords
Breastfeeding, Decision Making, Mother-Child Relations, Sucking Behavior
Abstract
Introduction: Despite the implementation of nursing interventions promoting breastfeeding, some mothers show resistance to or reject support during this process. This study aimed to develop the ALMA scale—designed with a mnemonic purpose—to identify maternal refusal of breastfeeding and to validate its applicability within the clinical nursing context.
Development: The ALMA scale was initially developed with nursing staff at a secondary-level hospital. The scale comprises four dimensions and 16 indicators and was developed in two phases: content validation via expert review and a pilot test. Expert evaluation yielded a content validity index per criterion (I-CVI) of 1.00 for clarity, relevance, utility, and ease of use, and an average content validity index (S-CVI/Ave) of 1.00. In the pilot test, 95% of the nursing staff rated the scale as clear, 90% reported ease of use, and 77% acknowledged its utility in clinical practice.
Conclusions: This study contributes to the development of nursing instruments that facilitate the assessment of maternal refusal of breastfeeding. Addressing this issue presents a challenge due to the attitudinal, emotional, and social factors that influence the decisions of breastfeeding women.
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