In this study, the psychometric properties of SCREENIVF were investigated. We did not face any serious problems during translation and cultural adaptation. Therefore, there was no need to make significant changes to the original version. We made small changes in a tool, such as providing parentheses or changing some words and phrases in the original version of SCREENIVF with more understandable words in Persian. In other words, there is a close connection between the English and Persian versions of SCREENIVF.
Reliability determination means consistency and stability in measuring the size of the characters or constructs in the questionnaire by calculating Cronbach's alpha for determination of internal consistency of the questionnaire and open method of the test (at least 10) to check the reliability of the questionnaire. To evaluate the validity, we used face validity and content validity. Content validity is essentially about the target group understanding the text. The target group should understand this tool to encourage them to participate and respond. To ensure the validity of the content, the content of the questionnaire was examined. When the questionnaire evaluates and measures all test goals, well It has content validity. Experts first assessed content validity. The constant validity of SCREENIVF was good. The CFA represents that five factor structure of SCREENIVF (subscales: depression, anxiety, perceived social support, Helplessness, acceptance of infertility problems) has a good fit to the observe data.
A study by Henrietta D.L Ockhuijsen et al. In 2017 aimed to assess the construct validity and criteria of the Dutch SCREENIVF questionnaire among men and women undergoing fertility treatment. Women (n = 487) were more likely than men(n = 426) to participate in the study. Data collection tools include the SCREENIVF questionnaire and the HADS questionnaire. The couples completed the questionnaire in three items: the first time in the initiation of IVF / ICSI therapy before the first ultrasonography (T1), the second time on the tenth day after embryo transfer (ET) during the expected period of pregnancy (T2), and the last time of the week after ET (T3) because they are the last two time points for the affective disorder(19).
The validation factor(CFA)was used to evaluate the validity of the SCREENIVF structure. RMSEA and CFI were used to evaluate the fit of the model. Two methods were used to evaluate the validity of the SCREENIVF criterion. Sensitivity analysis, feature, positive forecasting value (PVP), and negative predictive value (NPV). The results of this study showed that women (1.52%) were more at risk of emotional disorders than men (31.9%) before starting an IVF / ICSI treatment course on one or more SCREENIVF scales(P = 0.009). In the study of structural validity, CFA was performed separately in men and women. The statistical fit model showed a good fit based on CFI and RMSEA for women and men (for women CFI = 0.992, RMSEA = 0.038, and men CFI = 0.994, RMSEA = 0.026). There was a significant correlation between all 5 SCREENIVF factors(P = .000). Therefore, the validity of the SCREENIVF structure is good.
Criterion validity was also analyzed separately in men and women based on different CFA results. In the validity study, the criterion of sensitivity scores for HADS subscales (anxiety and depression) in women was in the range of 61–98%specificity was 53–65%, PVP was 13–56%, PVN was 70–99%. Sensitivity scores for men were 38–100%, specificity 71–75%, PVP 9–27%, PVN 92–100%. In general, sensitivity and PVN scores had the highest scores in T1. This means that SCREENIVF, which is completed by women and men, is better at identifying patients at risk(sensitivity), and in the right screening of patients who lack affective disorder(PVN) at the beginning of treatment (T1) than during treatment (T2) or after treatment(T3) (19).
These results mean that the employees of infertility treatment clinics using SCREENIVF can be sure that if patients are not classified as "at-risk" starting treatment, they are unlikely to have emotional disorders(14). The study results also showed that the concurrent validity of SCREENIVF is better than its predictive validity(19).
One of the advantages of our study was that we practiced face validity, content validity and construct validity. We used both quantitative and qualitative methods. Each of the qualitative and quantitative approaches was presented differently but complemented the study perspective.
The Persian version of SCREENIVF seems to be valid and reliable. Therefore, it can be used to identify infertile couples at risk of emotional risk factors before starting treatment in research and in infertility treatment clinics, as well as designing appropriate interventions. The Persian version of SCREENIVF has been prepared through translation and cultural adaptation of the original SCREENIVF. The findings showed that despite minor cultural differences, SCREENIVF has acceptable credibility and reliability and is easy to use.