Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Herth Hope Index in Adolescents and Young Adults with Cancer

Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Herth Hope Index in Adolescents and Young Adults with Cancer

Article excerpt

The Herth Hope Index (HHIndex), originally developed for adults, was examined for appropriateness in two studies of adolescents and young adults with cancer-those at various stages of treatment (N = 127) and those newly diagnosed (N = 74). The internal consistency reliability (Cronbach's alpha) of the index was .84 and .78, respectively, in the two samples. Construct validity was supported by discriminant correlations in the moderate to low range between the HHIndex and measures of uncertainty in illness and symptom distress, and by moderate convergent correlations with measures of resilience (self-esteem, self-confidence, and self-transcendence) and quality of life (index of well-being). A four-step factor analysis procedure was done, and confirmatory factor analysis suggested that a one-factor solution best fit the data in this population. Findings indicate that the HHIndex is a reliable measure of hope in adolescents and young adults with cancer. Evidence of discriminant and convergent validity in measuring hope in adolescents and young adults with cancer was also generated. Further exploration of the HHIndex factor structure in adolescents and young adults is needed.

Keywords: adolescents; young adults; cancer; hope; instrumentation

Hope is recognized as an important variable that affects both the experience and the outcomes of dealing with cancer. Some researchers have postulated that hope is a prerequisite for effective coping and decision making and has a protective function against the physiological and psychological stress of illness (Enskar, Carlsson, Golsater, & Hamrin, 1997; Lai et al., 2003; Molassiotis, Van Den Akker, Milligan, & Goldman, 1997). In adolescents and young adults with cancer, hopefulness may affect their sense of well-being and commitment to treatment (Hinds, 1988; Hinds & Martin, 1988; Hinds et al., 1999). Hope is also a protective factor for enhancing resilience and quality of life in adolescents and young adults with cancer (Haase, Heiney, Ruccione, & Stutzer, 1999).

Over the past three decades, there has been an increasing scientific interest in the concept of hope; however, research efforts have been hampered by the lack of adequate instruments to measure hope (Farran, Herth, & Popovich, 1995; Herth, 1991; Hinds, 1984; Miller & Powers, 1988; Nowotny, 1989; Owen, 1989). In response to this need, several psychometrically sound measures for measuring hope in the adult cancer population were developed (Herth, 1991, 1992; Miller & Powers, 1988; Nowotny, 1989). One cannot assume that scales used with adults are appropriate for children or adolescents/young adults. Currently, the Hopefulness Scale for Adolescents (HSA) is the only scale specifically designed to measure hope in adolescents and young adults (Hinds & Gattuso, 1991). The HSA has shown adequate reliability and validity in a number of published studies (Cantrell & Lupinacci, 2004; Connelly, 1998; Hinds et al., 2000; Hinds et al., 1999; Mahat & Scoloveno, 2001; Mahat, Scoloveno, & Whalen, 2002; Ritchie, 2001; Yarcheski, Mahon, & Yarcheski, 2001; Yarcheski, Scoloveno, & Mahon, 1994). However, the HSA has not been tested in the adult population and therefore may not be useful to measure hope in adolescents and young adults with cancer as they transition into adult cancer survivors.

To examine survivorship issues of children, adolescents, and young adults diagnosed with cancer across time and to compare hope across populations of adolescents, young adults, and adults, there is a need to examine whether measures of hope used with adults are also psychometrically appropriate for adolescents and young adults with cancer. The advantages of a scale that has evidence of reliability and validity with both adults and adolescents would include the ability to (a) measure hope across developmental stages, (b) measure changes in hope as adolescents and young adults transition into adult survivors, and (c) compare hope scores among adolescents, young adults, and adults with cancer. …

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