Standardization of Three Hope Scales, as Possible Measures at the End of Life, in Iranian Population

Background: Hope is an essential and dynamic life force that grows out of faith, is supported by relationships, resources and work circumstances, which lead to the energy necessary to live for a desired future. Hope gives meaning and happiness. Four central attributes of hope are: experiential, spiritual, relational thought, and relational process. A sound instrument to measure hope, which should be theoretical base, fairly vigorous psychometric and user-friendly, would be a useful complement to interviews for assessing hope in palliative care. Assessment of ‘hope’ is a necessary foundation for enabling the implementation of various intervention strategies to foster hope especially in cancer patients and their family members. There is no suitable instrument to measure hope in palliative care for Iranian patients; therefore the aim of this study was to assess the understandability, reliability, validity and superiority of three relevant instruments to measure hope.

Methods: Three questionnaires including the Herth Hope Index (HHI), Herth Hope Scale (HHS), and Miller Hope Scale (MHS) alongside with a generic health-related quality of life tool (EQ-5D) were completed by 70 normal randomly selected individuals aged 14-73 years.

Result: Cronbach's alpha was 0.76 for HHS, 0.67 for HHI and 0.81 for MHS, indicating satisfactory internal consistency. Concurrent criterion-related validity was assessed by calculating the correlations of the HHS and the MHS (r = 0.43), HHS and HHI (r=0.49) and MHS and HHI (r=0.62), at <0.001 significance level. MHS discriminated significantly better most of EQ-5D components including anxiety and depression, pain, personal and usual activities.

Conclusions: Finding suggested that these instruments have satisfactory reliability and validity to be used in Iranian population. Miller Hope Scale showed superiority among these tools.