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http://dx.doi.org/10.4040/jkan.22068

The Reliability and Validity of Korean Version of the Infertility Stigma Scale (K-ISS)  

Kim, Miok (Department of Nursing, College of Nursing, Dankook University)
Ban, Minkyung (Department of Nursing, Dongju College)
Publication Information
Journal of Korean Academy of Nursing / v.52, no.6, 2022 , pp. 582-597 More about this Journal
Abstract
Purpose: This study aimed to translate the Infertility Stigma Scale (ISS) into Korean and to evaluate its reliability and validity in the Korean context. Methods: Data were collected from 350 women who underwent in vitro fertilization (IVF). Data were analyzed using SPSS WIN 25.0 and AMOS 22.0. Content validity was analyzed using the item-level content validity index (I-CVI) and scale-level content validity index/averaging (S-CVI/Ave). The preliminary survey was conducted on 20 women who had experienced IVF at least once to check the level of understanding of the tool and the time required to fill out the questionnaire. Exploratory and confirmatory factor analyses were used to test construct validity. Additionally, hypothesis-testing construct validity were tested. Cronbach's α was used to assess the reliability. Results: The Korean-ISS (K-ISS) consists of 25 items, excluding two items from the original ISS questionnaire. Exploratory factor analysis identified four factors, which explained 75.6% of the total variance. The four distinct factors were infertility stigma with self-devaluation (56.8%), public stigma (8.1%), social withdrawal (6.5%), and family stigma (4.2%). In the confirmatory factor analysis, the 25 items in the four-factor structure were validated (χ2 /df ≤ 3, RMSEA ≤ 10). The hypothesis-testing construct validity of K-ISS against FPI (r = .58~.71, p < .001) and FQI (r = - .49~- .65, p < .001) was tested and found to be significant. The internal consistency reliability of the K-ISS, assessed using Cronbach's α, was .97. Conclusion: The K-ISS has satisfactory construct validity and reliability; therefore, it can help minimize the negative impact of stigma by measuring the stigma associated with women experiencing infertility.
Keywords
Infertility, Female; Stigma, Social; Assisted Reproductive Technique; Factor Analysis;
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Times Cited By KSCI : 3  (Citation Analysis)
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1 Lee IO, Lee EO. Concept analysis of stigma. The Journal of Rheumatology Health. 2006;13(1):53-66.
2 Taebi M, Kariman N, Montazeri A, Alavi Majd H. Infertility stigma: A qualitative study on feelings and experiences of infertile women. International Journal of Fertility and Sterility. 2021;15(3):189-196. https://doi.org/10.22074/IJFS.2021.139093.1039   DOI
3 Lee YH, Park JS. Factors affecting the infertility-related quality of life among the infertility women. Journal of the Korean Society of Maternal and Child Health. 2019;23(3):191-201. https://doi.org/10.21896/jksmch.2019.23.3.191   DOI
4 Ryu SJ. Infertility, the social context of deferred motherhood: A qualitative inquiry based on an online infertility community. The Journal of Asian Women. 2019;58(2):5-38. https://doi.org/10.14431/jaw.2019.08.58.2.5   DOI
5 Younesi SJ, Akbari-Zardkhaneh S, Behjati Ardakani Z. [Evaluating stigma among infertile men and women in Iran]. Journal of Reproduction & Infertility. 2006;6(5):531-545. Persian.
6 Hasanpoor-Azghdy SB, Simbar M, Vedadhir A. The social consequences of infertility among Iranian women: A qualitative study. International Journal of Fertility & Sterility. 2015;8(4):409-420. https://doi.org/10.22074/ijfs.2015.4181   DOI
7 Jeon HS, Kim DS. The experience of infertility treatment among women in relation to medical environment. The Journal of Asian Women. 2022;61(1):211-246. https://doi.org/10.14431/jaw.2022.4.61.1.211   DOI
8 Goffman E. Stigma: Notes on the management of spoiled identity. New York (NY): Simon and Schuster; 1963. p. 1-40.
9 Ergin RN, Polat A, Kars B, Oztekin D, Sofuoglu K, Caliskan E. Social stigma and familial attitudes related to infertility. Turkish Journal of Obstetrics and Gynecology. 2018;15(1): 46-49. https://doi.org/10.4274/tjod.04307   DOI
10 Jeong YM, Kang SK. A phenomenological study on infertile experiences of women: "Waiting for Meeting". Studies on Life and Culture. 2017;44:271-319.
11 Hwang NM. Factors related to the depression of infertile women. Health and Social Welfare Review. 2013;33(3):161-187.   DOI
12 Justo JMRM, Vieira CFSP, Costa EV. Stigma consciousness and self-efficacy in infertile couples: Correlation and gender differences. International Journal of Developmental and Educational Psychology. 2010;2(1):17-24.
13 Kang H. A guide on the use of factor analysis in the assessment of construct validity. Journal of Korean Academy of Nursing. 2013;43(5):587-594. https://doi.org/10.4040/jkan.2013.43.5.587   DOI
14 Han SS, Lee SC. Using the SPSS/Amos nursing and health statistical analysis. Rev. ed. Seoul: Hannarae Publishing; 2018. p. 512-520.
15 Boateng GO, Neilands TB, Frongillo EA, Melgar-Quinonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: A primer. Frontiers in Public Health. 2018;6:149. https://doi.org/10.3389/fpubh.2018.00149   DOI
16 Hair JF Jr, Black WC, Babin BJ, Anderson RE. Multivariate data analysis: A global perspective. 7th ed. Upper Saddle River (NJ): Pearson Prentice Hall; 2010. p. 109-136.
17 Yu JP. The criticisms and considerations of structural equation modeling. Journal of Product Research. 2016;34(4):83-93. https://doi.org/10.36345/kacst.2016.34.4.009   DOI
18 Yokota R, Okada H, Okuhara T, Goto E, Furukawa E, Shirabe R, et al. Development of the Japanese version of the infertility stigma scale: Examination of its reliability and validity. Healthcare. 2022;10(3):505. https://doi.org/10.3390/healthcare10030505   DOI
19 Phillips SK. Offenders' perceptions of stigma: Importance and measurement [master's thesis]. Philadelphia (PA): Drexel University; 2016. p. 1-47.
20 Hwang NM. Unknown causes of infertile couple support projects and policy tasks. Health-Welfare Issue & Focus. 2016;(313):1-4.
21 El Kissi Y, Romdhane AB, Hidar S, Bannour S, Ayoubi Idrissi K, Khairi H, et al. General psychopathology, anxiety, depression and self-esteem in couples undergoing infertility treatment: A comparative study between men and women. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;167(2):185-189. https://doi.org/10.1016/j.ejogrb.2012.12.014   DOI
22 Jansen NA, Saint Onge JM. An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States. Social Science & Medicine. 2015;147:184-189. https://doi.org/10.1016/j.socscimed.2015.11.002   DOI
23 Naab F, Brown R, Heidrich S. Psychosocial health of infertile Ghanaian women and their infertility beliefs. Journal of Nursing Scholarship. 2013;45(2):132-140. https://doi.org/10.1111/jnu.12013   DOI
24 Fu B, Qin N, Cheng L, Tang G, Cao Y, Yan C, et al. Development and validation of an infertility stigma scale for Chinese women. Journal of Psychosomatic Research. 2015;79(1):69-75. https://doi.org/10.1016/j.jpsychores.2014.11.014   DOI
25 Capik A, Aksoy M, Yilmaz E, Yilmaz F. Infertility stigma scale: A psychometric study in a Turkish sample. Perspectives in Psychiatric Care. 2019;55(2):328-335. https://doi.org/10.1111/ppc.12360   DOI
26 Kaya Z, Oskay U. Stigma, hopelessness and coping experiences of Turkish women with infertility. Journal of Reproductive and Infant Psychology. 2020;38(5):485-496. https://doi.org/10.1080/02646838.2019.1650904   DOI
27 Johnson KM, Fledderjohann J. Revisiting "her" infertility: Medicalized embodiment, self-identification and distress. Social Science & Medicine. 2012;75(5):883-891. https://doi.org/10.1016/j.socscimed.2012.04.020   DOI
28 Jing X, Gu W, Xu X, Yan C, Jiao P, Zhang L, et al. Stigma predicting fertility quality of life among Chinese infertile women undergoing in vitro fertilization-embryo transfer. Journal of Psychosomatic Obstetrics & Gynaecology. 2022;43(1):35-41. https://doi.org/10.1080/0167482X.2020.1778665   DOI
29 Kim SH. Male subjects in the reproductive medical field: The invisibilization of infertile men in the use of assisted reproductive technology in South Korea. Economy and Society. 2019;124:12-43. https://doi.org/10.18207/criso.2019..124.12   DOI
30 Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. Journal of Evaluation in Clinical Practice. 2011;17(2):268-274. https://doi.org/10.1111/j.1365-2753.2010.01434.x   DOI
31 Fang M, Li G, Kang X, Hou F, Lv G, Xu X, et al. The role of gender and self-esteem as moderators of the relationship between stigma and psychological distress among infertile couples. Psychology, Health & Medicine. 2021;26(10):1181-1194. https://doi.org/10.1080/13548506.2020.1808233   DOI
32 Brooks Holliday S, King C, Heilbrun K. Offenders' perceptions of riskfactors for self and others: Theoretical importance and some empirical data. Criminal Justice and Behavior. 2013;40(9):1044-1061. https://doi.org/10.1177/0093854813482308   DOI
33 Worthington AK, Burke EE, Leahy C. A comprehensive examination of infertility stigma among fertile and infertile women in the United States. Fertility and Sterility. 2019;112(3 Suppl):e378. https://doi.org/10.1016/j.fertnstert.2019.07.1082   DOI
34 Yilmaz E, Kavak F. The effect of stigma on depression levels of Turkish women with infertility. Perspectives in Psychiatric Care. 2019;55(3):378-382. https://doi.org/10.1111/ppc.12319   DOI
35 Gong JS. The effect of ex-prisoner's perception of stigma on trust in interpersonal relationship. Korean Security Journal. 2018;(57):57-84. https://doi.org/10.36623/kssa.2018.57.3   DOI
36 Lin YT, Wang AW, Wei S, Hong JS, Hsu WY. The relationship between infertility family stigma, self-stigma and psychological well-being in female first-visit patients at a reproductive medicine center in Taiwan. Health Psychology Report. 2022;10(2):122-128. https://doi.org/10.5114/hpr.2021.107335   DOI
37 Carter J, Applegarth L, Josephs L, Grill E, Baser RE, Rosenwaks Z. A cross-sectional cohort study of infertile women awaiting oocyte donation: The emotional, sexual, and quality-of-life impact. Fertility and Sterility. 2011;95(2):711-716.e1. https://doi.org/10.1016/j.fertnstert.2010.10.004   DOI
38 Ozturk R, Bloom TL, Li Y, Bullock LFC. Stress, stigma, violence experiences and social support of US infertile women. Journal of Reproductive and Infant Psychology. 2021;39(2):205-217. https://doi.org/10.1080/02646838.2020.1754373   DOI
39 Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research, and Evaluation. 2005;10:7. https://doi.org/10.7275/jyj1-4868   DOI
40 Comrey AL, Lee HB. A first course in factor analysis. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1992. p. 217.
41 Newton CR, Sherrard W, Glavac I. The Fertility Problem Inventory: Measuring perceived infertility-related stress. Fertility and Sterility. 1999;72(1):54-62. https://doi.org/10.1016/s0015-0282(99)00164-8   DOI
42 World Health Organization (WHO). Process of translation and adaptation of instruments [Internet]. Geneva: WHO; [cited 2022 Jun 10]. Available from: https://www.coursehero.com/file/30372721/WHO-Process-of-translation-and-adaptation-of-instrumentspdf/.
43 Kim JH, Shin HS. A structural model for quality of life of infertile women. Journal of Korean Academy of Nursing. 2013;43(3):312-320. https://doi.org/10.4040/jkan.2013.43.3.312   DOI
44 Boivin J, Takefman J, Braverman A. The fertility quality of life (FertiQoL) tool: Development and general psychometric properties. Human Reproduction. 2011;26(8):2084-2091. https://doi.org/10.1093/humrep/der171   DOI
45 Cho MJ, Kim KH. Diagnostic validity of the CES-D(Korean version) in the assessment of DSM-III-R major depression. Journal of Korean Neuropsychiatric Association. 1993;32(3):381-399.
46 Lynn MR. Determination and quantification of content validity. Nursing Research. 1986;35(6):382-386. https://doi.org/10.1097/00006199-198611000-00017   DOI
47 Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. https://doi.org/10.1002/nur.20199   DOI
48 DeVellis RF. Scale development: Theory and applications. 4th ed. Thousand Oaks (CA): Sage Publications; 2016. p. 205-232.
49 Yu JP. The concept and understanding of structural equation modeling. Seoul: Hannare Publishing Co.; 2012. p. 160-370.
50 Han JS. China, which used to encourage abortion, now sets target for artificial insemination in fertility hospitals [Internet]. Seoul: The Herald Corp.; c2022 [cited 2022 Sep 10]. Available from: http://news.heraldcorp.com/view.php?ud=20220104000689.