Table of Contents
Abstract
As medical advancements continue to improve survival rates for breast cancer, clinical priorities have rightfully expanded beyond immediate mortality to encompass long-term survivorship and quality of life. For younger women diagnosed during their childbearing years, the potential loss of fertility due to chemotherapy, radiotherapy, or surgical interventions represents a profound psychological burden. Unfortunately, patients often lack adequate knowledge regarding fertility preservation and may falsely believe that cancer survival and future pregnancy are mutually exclusive. This informational deficit can lead to severe reproductive anxiety and subsequent decision regret.
The Fertility information support Scale was developed to systematically evaluate the extent and quality of fertility-related information and support that young breast cancer patients receive. Grounded in social support theory, this psychometric instrument captures not only the objective data provided to patients but also their subjective emotional experiences and proactive engagement in seeking out such knowledge. By measuring these facets, the scale provides a comprehensive picture of a patient's informational ecosystem during a highly vulnerable period.
For psychometricians and psycho-oncology researchers, this tool represents a significant step forward in survivorship care. Rather than merely assessing a patient's baseline anxiety or desire for children, it quantifies the structural and interpersonal support systems that mitigate those anxieties. Implementing this scale in clinical settings allows healthcare providers to identify specific gaps in patient education, tailor their communication strategies, and ultimately foster more informed, patient-centered reproductive decision-making.
📊 Psychometric Scorecard
17
Multidimensional
0.82
0.979
📍 China
Authors
Purpose
The primary purpose of this instrument is to evaluate the level of fertility-related informational support provided to reproductive-aged women undergoing treatment for breast cancer. While previous psychometric tools in this domain have successfully measured constructs like fertility intention, sexual function, or general reproductive concern, they have largely failed to capture the actual support mechanisms that influence these outcomes. There was a distinct lack of validated measures designed to assess whether patients are receiving adequate, comprehensible, and emotionally supportive information regarding their reproductive options.
This scale fills a critical gap in psycho-oncology by shifting the focus from the patient's internal distress to the external support environment. For clinicians, it serves as a diagnostic tool to pinpoint exactly where communication breakdowns are occurring—whether patients are missing objective facts, feeling emotionally dismissed, or lacking the agency to ask questions. By identifying these specific deficits, healthcare teams can deliver highly personalized educational interventions, thereby reducing the psychological trauma associated with cancer-related infertility.
Construct
The scale is theoretically anchored in social support theory, which posits that interpersonal relationships and community networks provide essential psychological buffering during stressful life events. In the context of this instrument, the overarching construct of 'fertility information support' is operationalized through three distinct but interrelated dimensions: cognitive support, emotional support, and self-support.
Cognitive support evaluates the tangible, objective transmission of knowledge—specifically, how well the patient receives and comprehends factual information about fertility preservation and risks. Emotional support measures the subjective, affective experience of the patient during these clinical interactions, assessing whether they feel genuinely respected, heard, and validated by their healthcare providers. Finally, self-support captures the patient's own behavioral activation and self-advocacy, reflecting their personal initiative in seeking out necessary reproductive information and emotional reassurance. Together, these dimensions provide a holistic view of the informational support dynamic.
Validity
The development of the scale involved rigorous validation procedures to ensure both content and construct validity. Initial content validity was established through qualitative patient interviews, literature reviews, and two rounds of Delphi expert consensus, which helped refine the item pool and ensure cultural and linguistic appropriateness for the target demographic. Items that failed to demonstrate adequate discriminative power (such as those with a critical ratio below 3.0) were systematically eliminated.
Construct validity was robustly supported through both exploratory and confirmatory factor analyses. The exploratory phase successfully extracted the hypothesized three-factor structure without any problematic cross-loadings, indicating clear conceptual boundaries between the subscales. Subsequent confirmatory factor analysis demonstrated excellent model fit, with comparative fit indices well above the standard 0.95 threshold and error approximation metrics falling comfortably below the 0.08 upper limit. These results strongly suggest that the instrument accurately captures the theoretical dimensions of fertility information support it was designed to measure.
Reliability
The instrument demonstrated excellent reliability metrics, indicating that it measures the construct consistently with minimal measurement error. Internal consistency was evaluated using Cronbach's alpha, yielding strong coefficients across the subscales that ranged from approximately 0.81 to 0.89. These values sit in the optimal range for psychometric tools—high enough to indicate that the items within each subscale are highly correlated and measuring the same underlying concept, but not so high as to suggest problematic item redundancy.
Furthermore, the temporal stability of the scale was assessed via a test-retest reliability protocol conducted over a two-week interval. The resulting correlation coefficient exceeded 0.93, providing compelling evidence that the scale produces stable, reproducible results over time in the absence of targeted interventions. This high degree of test-retest reliability makes the scale particularly useful for longitudinal studies tracking changes in patient support throughout the cancer care continuum.
Factor Analysis
The factor structure of the scale was rigorously evaluated using a split-sample approach for exploratory (EFA) and confirmatory factor analyses (CFA). The EFA utilized principal component analysis on an initial set of 17 items, successfully extracting three distinct factors that aligned perfectly with the theoretical framework: cognitive support, emotional support, and self-support. All items demonstrated strong primary factor loadings (ranging from 0.54 to 0.88) with no significant cross-loadings, and the three factors cumulatively explained over 63% of the total variance.
The structural integrity of this three-factor model was subsequently verified using CFA in AMOS on an independent sample. The a priori model yielded highly favorable fit statistics. The Comparative Fit Index (CFI) and Incremental Fit Index (IFI) both reached 0.979, indicating an excellent fit relative to a baseline model. Additionally, the Root Mean Square Error of Approximation (RMSEA) was 0.055, which is well below the conservative threshold of 0.06 for a good fitting model. All path coefficients in the model were statistically significant, confirming that the 17 items serve as strong, reliable indicators of their respective latent constructs.
Subscales
| Subscale | Items | Description |
|---|---|---|
| Cognitive support | Measures the degree to which the patient receives, understands, and utilizes objective, factual information regarding reproduction and fertility preservation. | |
| Emotional support | Assesses the patient's subjective emotional experience during clinical interactions, specifically whether they feel respected, understood, and emotionally supported by medical staff. | |
| Self-support | Evaluates the patient's proactive behavior and personal initiative in seeking out fertility-related information and emotional support from healthcare providers. |
Instrument
| Test Type | Self-report questionnaire |
| Format | 17 items |
| Language | Chinese |
| Population | Medical patients |
| Age Group | Reproductive age (<49 years) |
| Administration | Paper survey and digital (Questionnaire Star) |
Sample
The validation phase (Sample 2 for CFA) included 252 reproductive-aged Chinese women diagnosed with breast cancer, recruited between April 2023 and July 2023.
Cite This Paper
Yuqiao Xiao, Jinhua Li, Jing Lei, Lu Han, Jiao Zhao, Mingxia Yao, Yiou Fu (2023). Fertility information support Scale. Asia-Pacific journal of oncology nursing. https://doi.org/10.1016/j.apjon.2023.100313
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Fertility Information Support Scale Items
Items are not yet available
The scale author has been contacted to obtain permission to share the items. This section will be updated once the items are provided.
Cite this article
Mohammed looti (2026). Fertility Information Support Scale. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/fertility-information-support-scale-for-reproductive-aged-patients-with-breast-cancer/
Mohammed looti. "Fertility Information Support Scale." PSYCHOLOGICAL SCALES, 12 Aug. 2026, https://scales.arabpsychology.com/s/fertility-information-support-scale-for-reproductive-aged-patients-with-breast-cancer/.
Mohammed looti. "Fertility Information Support Scale." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/fertility-information-support-scale-for-reproductive-aged-patients-with-breast-cancer/.
Mohammed looti (2026) 'Fertility Information Support Scale', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/fertility-information-support-scale-for-reproductive-aged-patients-with-breast-cancer/.
[1] Mohammed looti, "Fertility Information Support Scale," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.
Mohammed looti. Fertility Information Support Scale. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.