The purpose of this research was to develop and evaluate psychometrically an abbreviated instrument to assess hope in adults in clinical settings. The Herth Hope Index (HHI), a 12-item adapted version of the Herth Hope Scale (HHS), was tested with a convenience sample of 172 ill adults. Alpha coefficient was 0.97 with a 2-week test-retest reliability of 0.91. Criterion-related validity was established by correlating the HHI with the parent HHS (r = 0.92), the Existential Well-Being Scale (r = 0.84) and the Nowotny Hope Scale (r = 0.81). Divergent validity with the Hopelessness Scale was established (r = -0.73). Construct validity was supported through the factorial isolation of three factors: (a) temporality and future; (b) positive readiness and expectancy; (c) interconnectedness. These three factors accounted for 41% of the total variance in the measure.

This study explored the meaning of hope and identified strategies that are used to foster hope in a convenience sample of 30 terminally-ill adults using the technique of methodological triangulation (interview, Herth Hope Index and Background Data Form). Cross-sectional data were collected on 20 of the subjects, and longitudinal data were collected on 10 of the subjects in order to provide a clearer understanding of the hoping process during the dying trajectory. Hope was defined as an inner power directed toward enrichment of 'being'. With the exception of those diagnosed with AIDS, overall hope levels among subjects were high and were found to remain stable over time and across the background variables. Seven hope-fostering categories and three hope-hindering categories were identified based on the interview responses. The findings could serve as a guide for the development of interventions to foster hope in terminally-ill people.

Enhancing hope in people with a first recurrence of cancer Researchers and clinicians have identified the need for well-defined intervention studies to test the efficacy of interventions designed to strengthen hope. This quasi-experimental study sought to determine if a specific nursing intervention program designed to enhance hope would positively influence levels of hope and quality-of-life (QOL) in a convenience sample of 115 people with a first recurrence of cancer who were randomly assigned to one of three groups: treatment group (hope), attention control group (informational), or control group (usual treatment). The Herth Hope Index (HHI) and the Cancer Rehabilitation and Evaluation Systems, Short Form (CARES-SF) were administered prior to intervention, immediately after intervention and at 3, 6, and 9-month intervals. Treatment and control groups differed significantly with regard to level of hope (P=0.02) and QOL (P=0.03). Both the level of hope and QOL were significantly increased (P=0.03) immediately after intervention and across time (3, 6 and 9 months). This study was a preliminary attempt to design, implement, and evaluate a theory-driven hope intervention program. Knowledge about the effectiveness of specific interventions designed to enhance hope is vital if nurses are to significantly influence hope in those whom are in their care.

This longitudinal study explored the meaning of hope, the influence of specific background characteristics on hope, and identified strategies that are used to foster hope in a convenience sample of 25 family caregivers of terminally ill family members from two hospice programmes using the technique of methodological triangulation (interview, Herth Hope Index and Background Data Form). Hope was defined as a dynamic inner power that enables transcendence of the present situation and fosters a positive new awareness of being. Six hope-fostering categories and three hope-hindering categories were identified based on the interview responses. With the exception of those providing care to a family member diagnosed with AIDS and those caregivers experiencing poor personal health, a high fatigue level, severe sleep deprivation and more than two concurrent losses, overall hope levels among participants were found to remain stable across the background variables. Across time, hope levels were found to be low at interview time one, rise significantly by time two and then level off for the remainder of the time. An understanding of hope from the perspective of the family caregiver could provide a basis upon which to develop interventions that foster hope.