Development and validation of the infertility stigma scale short form (ISS-SF): A cross-sectional study

Stigma is a pervasive negative psychological attitude among women with infertility, adversely affecting their health and emotional well-being. The existing Infertility Stigma Scale (ISS) has been effectively validated in various countries and regions; however, a more concise tool is lacking. A brief measurement tool is of significant importance for reducing the burden on patients, enhancing research efficiency, and facilitating clinical application. This study aims to simplify the ISS and verify its psychometric properties.

The study is divided into two phases. Initially, we meticulously selected items using the frameworks of classical test theory and item response theory, and further refined the items through cognitive interviews with infertile women to form a simplified scale. Subsequently, we conducted a cross-sectional survey using the simplified scale, with 407 women completing the questionnaire. We assessed the psychometric properties of the simplified scale, evaluating its reliability and validity.

It yielded a 12-item short form of the ISS (ISS-SF), covering four factors: self-devaluation, social withdrawal, public stigma, and family stigma. Exploratory factor analysis revealed that these factors accounted for 79.696 % of the total variance. The ISS-SF demonstrated Cronbach's α, split-half reliability, and test-retest reliability of 0.954, 0.926, and 0.909, respectively, and showed good structural validity, discriminant validity, and convergent validity.

The ISS-SF has been validated as a reliable and effective brief measure for assessing stigma in women with infertility. It may serve as a useful tool for identifying infertile women at high risk of experiencing stigma.