Development and validation of the distressful female health conditions scale in a Turkish sample

This study aimed to develop and validate the Distressful Female Health Conditions Inventory (D-FHCI), a psychometric instrument assessing information-seeking versus information-avoidance tendencies (monitoring-blunting) in women with gynecological and obstetric conditions. A mixed-methods sequential exploratory design was employed, comprising qualitative item development and quantitative psychometric validation. We developed a 16-item inventory with four clinical scenarios, each containing two monitoring and two blunting response options, following literature review, cognitive interviews, and expert consultation. Validation involved 198 women with physician-confirmed gynecological conditions. Exploratory factor analysis (n = 119) using polychoric correlations and confirmatory factor analysis (n = 79) using the WLSMV estimator were conducted. Convergent validity was assessed using the Miller Behavioral Style Scale and Intolerance of Uncertainty Scale-12, with test–retest reliability evaluated over 2 weeks (n = 30). Measurement invariance was tested across education level and parity status. Factor analyses supported a two-factor solution (monitoring and blunting), explaining 38.2% and 17.5% of variance respectively, with acceptable fit indices (CFI = 0.926, TLI = 0.913, RMSEA = 0.064, SRMR = 0.063). Both subscales demonstrated good internal consistency (Monitoring: α = 0.83, ω = 0.85; Blunting: α = 0.78, ω = 0.80) and test–retest reliability (Monitoring: ICC = 0.81; Blunting: ICC = 0.79). D-FHCI subscales showed moderate correlations with corresponding MBSS subscales (r = 0.52, r = 0.49), confirming convergent validity. Measurement invariance was supported across parity status (full scalar) and education level (partial scalar). Higher education, younger age, and greater perceived severity predicted stronger monitoring tendencies. The D-FHCI demonstrates sound psychometric properties for assessing condition-specific information processing preferences in women with gynecological and obstetric conditions. The instrument may facilitate tailored patient education and early identification of psychological vulnerability in clinical settings.