Cross-cultural adaptation and validation of the ENRICh scale for Chinese infertile patients: a methodological and cross-sectional study

The use of Assisted Reproductive Technology (ART) for infertility treatment imposes a substantial financial strain on patients. However, there is a scarcity of research specifically addressing financial toxicity related to ART. This study adapted and validated the Chinese version of the Economic Strain and Resilience in Cancer (ENRICh) scale to assess financial toxicity among infertile couples undergoing ART in China. A cross-sectional study was conducted among 570 infertile patients from five hospitals in China. Its psychometric properties were assessed using exploratory factor analyses, confirmatory factor analyses, internal consistency reliability, test-retest reliability, and convergent/discriminant validity. The scale demonstrated strong psychometric properties, including excellent internal consistency (Cronbach’s α = 0.90; McDonald’s Ω = 0.94) and a good factor structure (Kaiser-Meyer-Olkin = 0.89). The results identified two distinct factors: “financially affected” and “financially coping”. It showed good convergent validity with the COST and medical expenses. ENRICh promising psychometric properties provide valuable insights for policymakers to address the treatment affordability challenges that may be exacerbated by China’s pronatalist policies.