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Assessing hope at the end of life: Validation of an experience of hope scale in advanced cancer patients

Published online by Cambridge University Press:  12 May 2005

CHERYL L. NEKOLAICHUK  and
EDUARDO BRUERA
CHERYL L. NEKOLAICHUK
Affiliation:
Alberta Cancer Board, Edmonton, Alberta, Canada
EDUARDO BRUERA
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Abstract

Objective: The purpose of this study was to gather validity evidence for an innovative experience of hope scale, the Hope Differential-Short (HDS), and evaluate its clinical utility for assessing hope in advanced cancer patients.

Methods: A consecutive sampling approach was used to recruit 96 patients from an inpatient tertiary palliative care unit and three hospice settings. Each participant completed an in-person survey interview, consisting of the following measures: HDS (nine items), Herth Hope Index (HHI), hope visual analog scale (Hope-VAS) and Edmonton Symptom Assessment System (ESAS).

Results: Using factor analytic procedures, a two-factor structure for the HDS was identified, consisting of authentic spirit (Factor I) and comfort (Factor II). The HDS factors had good overall internal consistency (α = 0.83), with Factor I (α = 0.83) being higher than Factor II (α = 0.69). The two factors positively correlated with the HHI, Hope-VAS, and one of the ESAS visual analog scales, well-being (range: 0.38 to 0.64) and negatively correlated with depression and anxiety, as measured by the ESAS (range: −0.25 to −0.42).

Significance of results: This is the first validation study of the HDS in advanced cancer patients. Its promising psychometric properties and brief patient-oriented nature provide a solid initial foundation for its future use as a clinical assessment measure in oncology and palliative care. Additional studies are warranted to gather further validity evidence for the HDS before its routine use in clinical practice.

Keywords

HopeAdvanced cancerEnd of lifeAssessment scale
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 3 , September 2004 , pp. 243 - 253
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

Ahles, T.A., Ruckdeschel, J.C., & Blanchard, E.B. (1984). Cancer-related pain: II. Assessment with visual analogue scales. Journal of Psychosomatic Research, 28, 121–124.Google Scholar
Beck, A.T., Steer, R.A., Kovacs, & M., et al. (1985). Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry, 142, 559–563.Google Scholar
Beck, A.T., Weissman, A., Lester, & D., et al. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861–865.Google Scholar
Benzein, E., Norberg, A., & Saveman, B.I. (2001). The meaning of the lived experience of hope in patients with cancer in palliative home care. Palliative Medicine, 15, 117–126.Google Scholar
Benzein, E. & Saveman, B. (1998). Nurses' perception of hope in patients with cancer: A palliative care perspective. Cancer Nursing, 21, 10–16.Google Scholar
Boyd, N.F., Selby, P.J., Sutherland, & H.J., et al. (1988). Measurement of the clinical status of patients with breast cancer: Evidence for the validity of self-assessment with linear analogue scales. Journal of Clinical Epidemiology, 41, 243–250.Google Scholar
Bruera, E., Brenneis, C., Michaud, & M., et al. (1989). Association between asthenia and nutritional status, lean body mass, anemia, psychological status, and tumor mass in patients with advanced breast cancer. Journal of Pain & Symptom Management, 4, 59–63.Google Scholar
Bruera, E., Carraro, S., Roca, & E., et al. (1984). Association between malnutrition and caloric intake, emesis, psychological depression, glucose taste, and tumor mass. Cancer Treatment Reports, 68, 873–876.Google Scholar
Bruera, E., Kuehn, N., Miller, & M.J., et al. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7, 6–9.Google Scholar
Chimich, W.T. & Nekolaichuk, C.L. (2004). Exploring the links between depression, integrity, and hope in the elderly. Canadian Journal of Psychiatry, 49, 169–174.Google Scholar
Chochinov, H.M., Wilson, K.G., Enns, M., & Lander, S. (1998). Depression, hopelessness, and suicidal ideation in the terminally ill. Psychosomatics, 39, 366–370.Google Scholar
Dufault, K. & Martocchio, B.C. (1985). Hope: Its spheres and dimensions. Nursing Clinics of North America, 20, 379–391.Google Scholar
Elliott, T.R., Witty, T.E., Herrick, & S., et al. (1991). Negotiating reality after physical loss: Hope, depression and disability. Journal of Personality & Social Psychology, 61, 608–613.Google Scholar
Flemming, K. (1997). The meaning of hope to palliative care cancer patients. International Journal of Palliative Nursing, 3, 14–18.Google Scholar
Folstein, M.F., Folstein, S., & McHugh, P.R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Good, M.D., Good, B.J., Schaffer, & C., et al. (1990). American oncology and the discourse on hope. Culture, Medicine, and Psychiatry, 14, 59–79.Google Scholar
Gorsuch, R.L. (1983). Factor Analysis, 2nd ed. Hillsdale, NJ: Erlbaum.
Grossman, S.A., Sheidler, V.R., McGuire, & D.B., et al. (1992). A comparison of the Hopkins Pain Rating Instrument with standard visual analogue and verbal descriptor scales in patients with cancer pain. Journal of Pain & Symptom Management, 7, 196–203.Google Scholar
Hall, B.A. (1990). The struggle of the diagnosed terminally ill person to maintain hope. Nursing Science Quarterly, 3, 177–184.Google Scholar
Hall, B.A. (1994). Ways of maintaining hope in HIV disease. Research in Nursing & Health, 17, 283–293.Google Scholar
Herth, K.A. (1989). The relationship between level of hope and level of coping response and other variables in patients with cancer. Oncology Nursing Forum, 16, 67–72.Google Scholar
Herth, K. (1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 1250–1259.Google Scholar
Herth, K. (1992). Abbreviated instrument to measure hope: Development and psychometric evaluation. Journal of Advanced Nursing, 17, 1251–1259.Google Scholar
Hurny, C., Bernhard, J., Coates, & A., et al. (1996). Responsiveness of a single-item indicator versus a multi-item scale: Assessment of emotional well-being in an international adjuvant breast cancer trial. Medical Care, 34, 234–248.Google Scholar
Huskisson, E.C. (1983). Visual analogue scales. In Pain Measurement and Assessment, Melzack, R. (ed.), pp. 33–37. New York: Raven Press.
Jevne, R.F. (1991). It All Begins with Hope: Patients, Caregivers & the Bereaved Speak Out. San Diego, CA: LuraMedia.
Jevne, R.F. (1994). The Voice of Hope: Heard across the Heart of Life. San Diego, CA: LuraMedia.
Jevne, R.F. & Nekolaichuk, C.L. (2003). Threat and hope in coping with cancer for health care professionals. In Between Stress and Hope, Jacoby, R. & Keinan, G. (eds.), pp. 187–212. Westport, CT: Greenwood Publishers.
Kodish, E. & Post, S.G. (1995). Oncology and hope. Journal of Clinical Oncology, 13, 1817–1822.Google Scholar
Little, M. & Sayers, E.J. (2004). While there's life … hope and the experience of cancer. Social Science & Medicine, 59, 1329–1337.Google Scholar
Messick, S. (1989). Validity. In Educational Measurement, 3rd ed., Linn, R.L. (ed.), pp. 13–103. New York: American Council on Education/Macmillan.
Miller, J.F. (1989). Hope-inspiring strategies of the critically ill. Applied Nursing Research, 2, 23–29.Google Scholar
Miyaji, N.T. (1993). The power of compassion: Truth-telling among American doctors in the care of dying patients. Social Science & Medicine, 36, 249–264.Google Scholar
Moadel, A., Morgan, C., Fatone, & A., et al. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psycho-Oncology, 8, 378–385.Google Scholar
Nekolaichuk, C.L. & Bruera, E. (1998). On the nature of hope in palliative care. Journal of Palliative Care, 14, 36–42.Google Scholar
Nekolaichuk, C.L. & Bruera, E. (1999). Assessing the experience of hope in palliative care patients [Abstract]. Psycho-Oncology, 8(6, Suppl.), 15.Google Scholar
Nekolaichuk, C.L, Jevne, R.F., & Maguire, T.O. (1999). Structuring the meaning of hope in health and illness. Social Science & Medicine, 48, 591–605.Google Scholar
Nuland, S.B. (1994). How We Die: Reflections on Life's Final Chapter. New York: Knopf.
Osgood, C.E., Suci, G.J., & Tannenbaum, P.H. (1957). The Measurement of Meaning. Urbana, IL: University of Illinois Press.
Perakyla, A. (1991). Hope work in the care of seriously ill patients. Qualitative Health Research, 1, 407–433.Google Scholar
Price, D.D., McGrath, P.A., Rafii, & A., et al. (1983). The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 17, 45–56.Google Scholar
Rustoen, T. & Wiklund, I. (2000). Hope in newly diagnosed patients with cancer. Cancer Nursing, 23, 214–219.Google Scholar
Scanlon, C. (1989). Creating a vision of hope: The challenge of palliative care. Oncology Nursing Forum, 16, 491–496.Google Scholar
Staats, S. (1991). Quality of life and affect in older persons: Hope, time frames and training effects. Current Psychology: Research & Reviews, 10, 21–30.Google Scholar
Sutherland, H.J., Lockwood, G.A., & Cunningham, A.J. (1989). A simple, rapid method for assessing psychological distress in cancer patients: Evidence of validity for linear analog scales. Journal of Psychosocial Oncology, 7, 31–43.Google Scholar
Udelman, D.L. & Udelman, H.D. (1985a). A preliminary report on anti-depressant therapy and its effects on hope and immunity. Social Science & Medicine, 20, 1069–1072.Google Scholar
Udelman, H.D. & Udelman, D.L. (1985b). Hope as a factor in remission of illness. Stress Medicine, 1, 291–294.Google Scholar
Udelman, D.L. & Udelman, H.D. (1991). Affects, neurotransmitters, and immunocompetence. Stress Medicine, 7, 159–162.Google Scholar