Background: Surrogacy is one of the options in reproductive medicine that raises a lot of ethical, legal and psychological controversy. Surveying attitudes toward surrogacy plays an important role in building awareness of this phenomenon in the society, which may help eliminate its stigma. In this study authors aimed to develop and validate a scale to assess the attitudes towards surrogacy.
Methods: In this study cross-sectional design was implemented. Development process of the Attitude towards Surrogacy Scale (ATSS) included items development based on literature reviews, other existing questionnaires, confirmatory factor analysis (CFA), and reliability analysis using internal consistence coefficients. A pilot study using adult members of the public was conducted after consultation with the Expert Advisory Panel Board. The final survey, which was used in this study, consisted of 24 items, which were organized into the four subscales: general opinion on surrogacy and its social context (7 items), financing and legalizing surrogacy (8 items), the acceptance of surrogacy (4 items), and attitudes towards the intended parents and children born through surrogacy (5 items). 442 individuals participated in this study.
Results: The final version of Attitude towards Surrogacy Scale (ATSS) consists of 15 items, grouped in three subscales. Final version of the ATSS showed that the three-factor model indicated an acceptable model fit: Chi-square = 320.46, p < 0.01, df = 87, CFI = 0.94, TLI = 0.92, RMSEA = 0.078 (90% C.I.: 0.070-0.086), SRMR = 0.040 Reliability was assessed by calculating the McDonald's omega that ranged from 0.74 for the Surrogacy ethical context subscale to 0.94 for the overall ATSS score.
Conclusion: ATSS was developed to measure general attitude toward surrogacy with satisfying psychometric properties. The analysis of socio-demographic variables with ATSS showed that the most significant predictor of the general attitude towards surrogacy, and three aspects of surrogacy was being a religious person (profess a Catholic religion or profess another religion).
Keywords: Attitude; Attitude Scale; Psychometrics; Surrogacy; Validation.
Surrogacy—is one of the most controversial methods of infertility treatment. This concept is associated with difficult ethical, psychological and social issues, in which each aspect may lead to different trends in attitudes. The study of attitudes in society plays an important role in the analysis of various aspects of a given phenomenon, helps to fill legal gaps and ambiguities, and to transform controversial dimensions into normative concepts. Thus, this study aimed to develop and validate a scale to assess the attitudes towards surrogacy.The survey used in this study, consisted of 24 questions, which were organized into the four subscales: general opinion on surrogacy and its social context (7 items), financing and legalizing surrogacy (8 items), the acceptance of surrogacy (4 items), and attitudes towards the intended parents and children born through surrogacy (5 items). 442 individuals participated in this study. The final version of Attitude towards Surrogacy Scale consists of 15 questions, grouped in three subscales: opinion on surrogacy ethical context, financing and legalizing surrogacy, and an acceptance of surrogacy.This is the first scale in Poland for the assessment of general attitudes towards surrogacy. This measure allows to capture the opinions towards three aspects of surrogacy: surrogacy’s ethical context, the financing and legalizing surrogacy, and acceptance of surrogacy. The scale can be addressed to various groups in the society, not only for studies related to reproductive medicine.
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