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

Palliat Support Care. 2004 Sep;2(3):243-53. doi: 10.1017/s1478951504040337.


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 (alpha = 0.83), with Factor I (alpha = 0.83) being higher than Factor II (alpha = 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Emotions*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Palliative Care / psychology*
  • Psychometrics
  • Sampling Studies
  • Sickness Impact Profile
  • Surveys and Questionnaires*