A scale for measuring health-related hope: its development and psychometric testing

Abstract

BACKGROUND Commonly used scales that measure hope in general may not capture how people experience their health and how healthcare affects hope as a patient-reported outcome. Therefore we tested question-items for measuring health-related hope (HR-Hope), and developed a scale for measuring HR-Hope in adults with chronic illnesses. METHODS Using results from a qualitative study, we wrote 45 question-items to measure 3 domains of HR-Hope: health & illness, role & social connectedness, and "something to live for. " We tested those items among 454 patients with chronic kidney disease (stage 3 to stage 5 requiring dialysis) in a cross-sectional survey. Using the results of factor analysis and of analyses based on item-response theory, we chose 18 of the 45 items, and proceeded to the next steps: reliability testing and criterion-based validation testing. RESULTS Exploratory factor analysis indicated unidimensionality. Confirmatory factor analysis showed that the data were consistent with a single second-order factor (health-related hope) and 3 first-order factors (the 3 domains). Coefficient α for total HR-Hope scores was 0.93. The HR-Hope scale was moderately correlated with both domains of Snyder's hope scale. Compared with Snyder's hope scale, the HR-Hope scale was more strongly correlated with the Center for Epidemiologic Studies Depression Scale and with the 8 domains of the Short Form-36-v2. Compared with Snyder's hope scale, the HR-Hope scale was more sensitive to impaired performance status, depression, acceptance of illness, and the presence of family. CONCLUSIONS The 18-item HR-Hope scale can be used to measure health-related hope in people with chronic illness.