Development and psychometric properties of Female Infertility Stigma Instrument (ISI-F): A sequential mixed method study

BACKGROUND: Infertility stigma is a hidden burden that overshadows the dimensions of reproductive and sexual health in infertile women. The aim of this study was to develop and evaluate the psychometric properties of the Female Infertility Stigma Instrument (ISI-F). METHODS: This mixed method study with sequential exploratory design was conducted in qualitative and quantitative phases. In the first phase, the initial item pool of the Female Infertility Stigma Instrument (ISI-F) was generated using in-depth interviews. In the quantitative phase, psychometric properties of the ISI-f including content, face and construct validity, as well as reliability (internal consistency and stability) were assessed. Exploratory factor analysis was performed on the collected data from 300 infertile women for evaluation of construct validity. Data was analyzed using SPSS version 20. This study has followed the Mixed Methods Article Reporting Standards checklist. RESULTS: The final version of ISI-F had 20 items. Total CVI and CVR were 0.94 and 0.87, respectively. Explanatory factor analysis identified 3 main factors that explained 54.013% of the variance. These factors consisted of stigma profile (7 items), self-stigma (6 items) and escaping from stigma (7 items). Internal consistency and stability of the ISI-F has been approved by Cronbach’s alpha, McDonald's Omega (0.909, 0.916) and Intraclass Correlation Coefficient (ICC = 0.878). CONCLUSION: The Female Infertility Stigma Instrument (ISI-F) is a valid and reliable tool for evaluation of the perceived female infertility stigma, that was developed in this study.