Simplified Infertility-Related Stress Scale And Its Application

Research background:Infertility-related stress puts a tremendous amount of physical and psychological pressure on patients,especially female patients.There is no doubt that the rapid identification of infertility stress in patients is a crucial process,and timely assessment of infertility stress allows healthcare professionals to provide effective and appropriate interventions.In addition,the potential mechanisms regarding the impact of infertility experiences on patients’life satisfaction are currently unknown.In summary,this study aimed to explore a simplified scale of infertility-related stress and to discuss the impact of infertility-related stress on life satisfaction in Chinese women with infertility and the possible underlying mechanisms between them.Research objectives:（1）To explore a simplified version of the Fertility Problems Stress（FPI）measure for infertile women that is applicable to our society,simple and reliable.（2）The equivalence of the FPI simplified scale was examined across literacy levels and different lengths of infertility measured.（3）To explore the impact of infertility-related stress on life satisfaction and the possible underlying mechanisms between them.Research methods:The development of a simplified FPI scale was completed based on multiple statistical methods and the meaning of the entries,and the reliability of the simplified FPI scale was analyzed,and the scale was tested for measurement equivalence using multi-cluster validated factor analysis,and finally the relationship between infertility-related stress and life satisfaction and possible mediators or moderators between them was explored.Result:（1）The original FPI scale entries were screened by multiple statistical approaches,and the final FPI simplified scale contained 15 entries.The explored FPI simplified scale had a Cronbachɑcoefficient of 0.73,and the correlation coefficient between each entry and the total score ranged from 0.689 to 0.755.The Cronbach’sɑcoefficients for each dimension were 0.63（SC）,0.71（S）,0.58（RC）,0.65（ROC）,and0.73（NP）,The results of the validation factor analysis showed that the second-order first-order five-factor model had better fit indices for each item.the FPI simplified version of the scale was significantly and positively correlated with the original scale total score,anxiety and depression.（2）The FPI simplified version has measurement invariance in weak equivalence and strong equivalence at cross-cultural level and measurement invariance in weak equivalence and strong equivalence at cross-cultural level.（3）There was a significant positive effect of infertility on life domain stress on parental role importance(B=0.3106,t=4.5827^***),a non-significant direct effect of infertility on life satisfaction（B=-0.1611,t=-1.3473）,and a significant negative effect of parental role importance on life satisfaction（B=-0.2487,t=-2.4393^*）.Marital satisfaction had a significant negative effect on parental role importance（B=-0.132,t=-2.5318^*）.Conclusion:（1）The Fertility Related Stress（FPI）simplified scale has good reliability and validity and can be used for initial rapid validation of fertility-related stress in infertile women.（2）The simplified version of the Fertility Problems Inventory（FPI）has weak equivalence and strong equivalence with respect to measurement invariance across cultural levels.Weak equivalence,strong equivalence,and strict equivalence exist across infertility duration.（3）The effect of infertility on life domains had a significant negative indirect effect on life satisfaction by increasing parental role importance,and marital satisfaction moderated the relationship between infertility on life domain stress and parental role importance.