Bushra Naz, Syeda Shahida Batool, Muhammad Kashif Fida, Muhammad Zohaib Khan.
Construction and validation of emotional and social distress scale for men and women diagnosed with infertility: further evidence of its construct validity and psychometric properties.
Khyber Med Uni Med J Jan ;14(3):147-57.

OBJECTIVE: To develop a valid and reliable tool to measure infertility-specific emotional and social distress (ESD) among men and women. METHODS: This mixed-method study was conducted in infertility treatment centers of Lahore Pakistan. In Phase-I, in-depth interviews of diagnosed infertile patients, spouses, and infertility experts were conducted to explore and identify the phenomenon of ESD due to infertility. Item pool was generated through thematic analysis. Content validity of each item was vetted by eight experts. A pilot study was conducted and 74 items were finalized. In Phase-II, the developed scale was administered on a larger sample (N=504) to establish factorial validity. Four factors/subscales emerged through exploratory factor analysis (1. Distress & identity, 2. well-being, 3. feelings of insecurity; 4. sexual & marital issues) with 35 items explaining 44.35% of the variance, evidencing significant construct validity of the scale. RESULTS:  Confirmatory factor analysis (CFA) indicated that the model is well-fitted having acceptable model fit indices χ2/df=1.84, CFI=0.92, GFI=0.90, RMSEA=0.04, and TLI=0.91. The reliability estimates of alpha coefficients (α=0.92) and item-total correlation (ranging from 0.37 to 0.64, p<0.001) supported the high internal consistency of 34 items of ESD-Scale. Convergent and discriminate validity of the instrument was established with a Fertility Problems Inventory and Satisfaction with Life Scale, it was found moderately high (r =0.35, p<0.01), (r= -0.45, p<0.01). The statistical measures depicted significant construct validity and acceptable psychometric properties of the ESD-scale. CONCLUSIONS: The constructed ESD-scale consisted of 34 Items with four subscales and showed evidence of validity, reliability, and psychometric properties.

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