Development and preliminary psychometric evaluation of the vaginal douching practice scale

Vaginal douching remains common in several settings despite its association with adverse reproductive health outcomes. A standardized instrument for assessing how frequently women perform vaginal douching in specific circumstances is lacking.

To develop the Vaginal Douching Practice Scale (VDPS) and examine preliminary evidence for its content validity, factor structure, and reliability among married women.

This methodological study included 423 married women aged 18 years and older. An initial 17-item pool was generated from the literature, reviewed for content, and pilot-tested with 50 women. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted sequentially in the same sample; therefore, the CFA was treated as an internal model check rather than an independent confirmation.

The mean age of participants was 33.34 ± 8.55 years. The Kaiser-Meyer-Olkin value was 0.959, and Bartlett's test of sphericity was significant (χ2 = 8,750.245, p < 0.001). EFA yielded a one-factor solution explaining 71.89% of the variance, with loadings ranging from 0.694 to 0.920. Internal consistency was very high (Cronbach's alpha = 0.97), split-half reliability was 0.93, and the two-week test-retest correlation in 31 participants was 0.92. CFA loadings ranged from 0.642 to 0.937; however, global model fit was inadequate (χ ²/df = 4.428, GFI = 0.786, RMSEA = 0.123, 90% CI = 0.116-0.131) despite several incremental indices exceeding 0.90. Composite reliability was 0.975 and average variance extracted was 0.694, but these values do not compensate for the poor global fit.

The VDPS showed strong internal consistency and promising exploratory evidence; however, the proposed one-factor structure was not adequately supported by CFA. The instrument should be regarded as preliminary and requires item refinement and independent validation before routine clinical or research use.