Psychological resilience as a mediator in infertile women: A structural equation modeling analysis of self-efficacy, stigma, and fertility quality of life

Background: Infertility poses significant psychosocial challenges for women, profoundly impacting their well-being and quality of life.Infertility stigma and self-efficacy, reflecting a woman's confidence in managing infertility-related challenges, are key factors influencing this experience.Objectives: This study examined the mediating role of psychological resilience in the associations between infertility stigma, infertility self-efficacy, and fertility-related quality of life (FertiQoL) among infertile women.Methods: A cross-sectional, correlational design was employed, involving 295 infertile women recruited via convenience sampling from fertility clinics in Ahvaz, Iran, in 2024.Data were collected using the Fertility Quality of Life (FertiQoL) scale, Infertility Stigma Scale (ISS), Infertility Self-Efficacy Scale (ISES), and Connor-Davidson Resilience Scale (CD-RISC).Structural Equation Modeling (SEM) was conducted using SPSS and AMOS software to analyze relationships.Results: The model demonstrated a strong fit to the data.Direct paths from infertility stigma and selfefficacy to FertiQoL were non-significant.However, significant direct associations were found between infertility stigma and resilience (=-0.22,P<0.001), and between self-efficacy and resilience (=0.24,P<0.001).Psychological resilience significantly mediated the relationships between infertility stigma and FertiQoL (=-0.06,P=0.001), and between self-efficacy and FertiQoL (=0.01,P=0.001), indicating its critical role in these pathways.The final structural model exhibited good fit to the data (/df=1.60,CFI=0.94,RMSEA=0.04).Conclusion: Psychological resilience serves as a vital protective factor, mitigating the adverse effects of infertility stigma and enhancing the positive influence of self-efficacy on FertiQoL.These findings underscore the importance of fostering resilience in clinical interventions to improve psychological wellbeing and quality of life among infertile women. Implications for Nursing and Midwifery Preventive Care Psychological resilience plays a pivotal role in enhancing FertiQoL among infertile women. Nursing interventions should prioritize resilience-building strategies, such as cognitivebehavioral therapy and mindfulness, to alleviate infertility stigma. Targeted support to enhance self-efficacy further strengthens resilience and emotional well-being. Resilience-focused holistic care empowers women to effectively navigate infertility challenges.