Reliability and Factor Structure of the Bangla Perceived Stress Scale among Infertile Women in Bangladesh

Background: Infertility is frequently accompanied by substantial psychological distress, making accurate assessment of perceived stress an important component of care for affected women. The Perceived Stress Scale (PSS-10) is one of the most widely used instruments for measuring subjective stress appraisal, however, its factor structure and reliability have shown considerable variability across populations, particularly regarding its four reverse-coded items. This study aimed to evaluate the internal consistency and factor structure of the Bangla PSS-10 among infertile women in Bangladesh. Materials and methods: This study presents analysis using a dataset collected as part of a cross-sectional study conducted among 151 married, reproductive-aged women with infertility recruited from two hospitals in Dhaka, Bangladesh. Internal consistency was assessed using Cronbach's alpha and corrected item-total correlations. Exploratory Factor Analysis (EFA) using principal component analysis examined the underlying factor structure, and Confirmatory Factor Analysis (CFA) using the diagonally Weighted Least Squares (WLSMV) estimator, tested the theoretically derived two-factor model of perceived helplessness and perceived self-efficacy. Results: The full 10-item scale showed inadequate internal consistency (Cronbach's α= 0.548). EFA supported a two factor structure, with the six helplessness items loading cleanly (0.450–0.780) but the four reverse-coded self efficacy items loading moreweakly (0.419–0.717). CFA confirmed suboptimal global model fit (χ²(34) = 105.93, CFI = 0.874, TLI = 0.833, RMSEA = 0.119, SRMR = 0.103). Standardized loadings for the perceived helplessness subscale were acceptable (0.387–0.793, α= 0.719, = 0.739), whereas the perceived self-efficacy subscale showed weak loadings (0.252–0.564) and poor reliability (α= 0.394, ω= 0.423), with the two latent factors showing no significant correlation (ϕ= 0.054, p = 0.604). Conclusion: The Bangla PSS-10 performed adequately for its helplessness items but poorly for its reverse-coded self efficacy items among infertile women, a pattern consistent with reverse-wording method effects reported in other cultural adaptations of the scale. A refined six-item helplessness-focused structure may offer a more psychometrically sound alternative for this population, though further validation using bifactor modelling, larger samples, and external validity measures is recommended before clinical or research application. IAHS Medical Journal Vol 9(1), June 2026;102-106