Development and validation of an Infertility Stigma Scale for Chinese women

Objective: To develop and validate a scale of stigma for infertile Chinese women. Method(s): Infertile women admitted to the Xiangya Hospital, the Second Xiangya Hospital, and the Third Xiangya Hospital of Central South University for treatment were approached to participate in this study. The Infertility Stigma Scale (ISS) development involved: [1] item generation based on literature, interview (experts/patients: N = 5/N = 20) and related scale; [2] pre-test questionnaire formation with both experts' ratings (N = 9) and infertile women's feedbacks (N = 30); [3] the component structure assessed by principal components analysis with varimax rotation (N = 334); [4] convergent validity assessed with Social Support Rating scale, Self-Esteem scale, Family APGAR Index (N = 334); and [5] reliability identified by internal consistency Cronbach's alpha (N = 334), split-half reliability (N = 334), test-retest reliability (N = 20). Result(s): This study yielded a 27-item ISS with 4 factors (self-devaluation, social withdrawal, public stigma, and family stigma). Exploratory factor analysis indicated that these 4 factors accounted for 58.17% of total variances. The Cronbach's alpha, split-half coefficient and test-retest correlation coefficient for the whole scale was 0.94, 0.90, and 0.91, respectively. The associations of the ISS with other measures suggested good convergent validity. The Content Validity Index (CVI) was 0.92. Conclusion(s): The ISS appears to be a reliable and valid measure to assess levels of stigma experienced by infertile Chinese women. It may be a useful tool to help identify infertile women at greater risks of distress. (C) 2014 Elsevier Inc. All rights reserved.