• Low-pressure Area
• Thomas D Meyer
• Martin Hautzinger

Hope includes the dimensions of time, goals, control, relations and personal characteristics. 2005 arctic cat f7 repair manual. Existing tools that measure it vary in length and psychometric properties and cover different parts of its overall concept.This study aimed to develop an instrument that integrates all relevant aspects of hope is concise, easy to use and shows good psychometric properties.Three pre-existing instruments (Miller Hope Scale, Herth Hope Index, Snyder Hope Scale) covering complementary and overlapping aspects of hope were administered cross-sectionally to a general population sample (n = 489).

Factor analysis was used for item reduction. Reliability and validity were tested using factor analysis and item correlations between the new scale and quality of life and depression scales.The study was set in Austria. Participants were sampled from the general population using a quota sampling strategy.The initial 60 items were reduced to a 23-item scale with four dimensions: 'trust and confidence', 'positive future orientation', 'social relations and personal value' and 'lack of perspective'. The new scale's factor structure was highly stable and its internal consistency high (alpha = 0.92 for the overall scale, 0.80-0.85 for its subscales).

Hope scores were negatively correlated with depression (r = -0.68) and positively with quality of life (r = 0.57), with the factor analysis and item discriminant validity supporting the new scale's construct validity.The new scale comprehensively covers the concept of hope is significantly shorter than previous scales and shows satisfactory reliability and validity. Background Hope includes the dimensions of time, goals, control, relations and personal characteristics. Existing tools that measure it vary in length and psychometric properties and cover different parts of its overall concept.Objectives This study aimed to develop an instrument that integrates all relevant aspects of hope is concise, easy to use and shows good psychometric properties.Design Three pre‐existing instruments (Miller Hope Scale, Herth Hope Index, Snyder Hope Scale) covering complementary and overlapping aspects of hope were administered cross‐sectionally to a general population sample ( n = 489). Factor analysis was used for item reduction. Reliability and validity were tested using factor analysis and item correlations between the new scale and quality of life and depression scales.Setting and participants The study was set in Austria. Participants were sampled from the general population using a quota sampling strategy.Results The initial 60 items were reduced to a 23‐item scale with four dimensions: ‘trust and confidence’, ‘positive future orientation’, ‘social relations and personal value’ and ‘lack of perspective’. The new scale’s factor structure was highly stable and its internal consistency high (alpha = 0.92 for the overall scale, 0.80–0.85 for its subscales).

Hope scores were negatively correlated with depression ( r = −0.68) and positively with quality of life ( r = 0.57), with the factor analysis and item discriminant validity supporting the new scale’s construct validity.Conclusions The new scale comprehensively covers the concept of hope is significantly shorter than previous scales and shows satisfactory reliability and validity. IntroductionHope has been of interest across centuries and diverse cultures gaining particular relevance in times of crisis and desired change. It may be seen as a common sense notion that is part of everyone’s understanding or as a philosophical topic. In the last decades, hope has also been the subject of medical and psychological research across a range of health conditions, e.g. In healthy people and in those with severe physical illness, hope is, for example, related to better psychosocial functioning, diminished stress reactivity and more effective coping, global life satisfaction, well‐being and better quality of life., In people with mental illness, hope contributes to therapeutic effectiveness while loss of hope can predict suicide., It is negatively correlated with depression, anxiety and distress and positively correlated with personal resilience, self‐efficacy and subjective health. Moreover, both patients and therapists consistently identify hope as a key factor in psychotherapy.Hope has been conceptualized in numerous ways and against various theoretical backgrounds.

To just provide a brief overview of the vast literature, hitherto proposed hope theories and their corresponding scales fall into four broad and widely overlapping categories: (i) mainly emotion‐based concepts, e.g. Ref.; (ii) mainly cognition‐based concepts, e.g. Ref.; (iii) concepts combining emotion and cognition, e.g.

And (iv) multidimensional concepts, e.g. Emotion‐based concepts have been criticized as being unclear and difficult to measure, while cognition‐based concepts tend to frame hope in a narrow or one‐sided fashion. The most prominent example of a concept combining cognitive and emotional aspects is that by Snyder et al. Whose scale was criticized not to reflect all the complexities of its theoretical underpinnings.

Finally, multidimensional hope concepts were developed with different populations and hence also emphasize differing and often limited aspects of the overall concept.A comprehensive literature review incorporating all hitherto published definitions of hope identified a number of key dimensions integral to the overall concept. These include time, covering past experience and the important future reference of hope; broad or specific goals; control, which may be internal (personal activity) and/or external (environmental and contextual factors); relations, including partnerships, the relational aspect of medical care or treatment, trust, spirituality or a sense of meaning and purpose in life; and personal characteristics such as inner strength, motivation and energy to pursue one’s goals. The concept includes a reality reference, in that the desired outcomes or goals are subjectively perceived as being possible, and it allows for hope to arise both from a negative as well as a positive starting point, i.e. As a desire for the improvement of an undesirable or an already satisfactory situation.Given its central role in psychiatry and psychotherapy, the adequate measurement of hope should be carefully considered. Existing hope scales, however, cover differing and often limited aspects of the complex concept and show varying length and psychometric properties.

To assess hope adequately and comparably in different populations, a measure of hope would be expected to be (i) based on the most comprehensive definition of the concept available; (ii) feasible in terms of length, complexity and mode of application; and (iii) psychometrically robust. None of the existing measurement tools meets all these criteria.Hence, the aim of the present study was (i) to develop a new, easy to use and widely applicable scale that covers all relevant components of hope and (ii) to investigate, on a preliminary basis, its psychometric properties in a representative sample of the Austrian general population.

ScalesTo meet the above demands, we based the new scale on a combination of three pre‐existing scales that together cover all established dimensions of hope and reflect its different theoretical underpinnings: the Miller Hope Scale (MHS), the Herth Hope Index (HHI) and the Snyder Hope Scale (SHS). The MHS largely covers the dimensions of hope but does not explicitly refer to spirituality and is a lengthy tool with an unstable factor structure. The HHI and the SHS reflect different and complementary components of the construct. The HHI prominently comprises aspects of spirituality, trust, meaning and purpose in life, individual characteristics and the dimension of time, while the SHS reflects goal setting and pursuit.The SHS is an eight‐item scale using a four‐point continuum (1, definitely false, to 4, definitely true). Cronbach’s alpha for the scale ranges between 0.74 and 0.84, the test–retest reliability between 0.73 and 0.85. The SHS does not provide one overall but two subscores called ‘agency’ and ‘pathways’. The HHI consists of 12 items in a four‐point Likert format (1, strongly disagree, to 4, strongly agree).

Its internal consistency lies between 0.75 and 0.94 and its test‐retest reliability between 0.89 and 0.91. The scale provides one overall score with three suggested dimensions: (i) ‘temporality and future’; (ii) ‘positive readiness and expectancy’; and (iii) ‘interconnectedness’. The MHS is a 40‐item scale using a six‐point Likert format (1, strongly disagree, to 6, strongly agree), with good construct and divergent validity, high internal consistency (α = 0.93) and an overall test–retest reliability of 0.82. A three factor solution was suggested for the scale: (i) ‘satisfaction with self, others and life’; (ii) ‘avoidance of hope threats’; and (iii) ‘anticipation of a future’, which, however, is not strongly supported empirically. On all scales, higher scores indicate higher hopefulness.Previous research found hope to be negatively correlated with depression and positively correlated with the quality of life. Hence, to establish concurrent and construct validity, depression and quality of life were assessed using the ‘Allgemeine Depressionsskala’ (ADS) and the WHOQOL‐BREF.

The ADS is a screening instrument for depression containing 20 items rated on a four‐point scale with higher scores indicating higher depressive symptoms. The WHOQOL‐BREF is a 26‐item scale employing a five‐point format to assess subjective quality of life, spanning the domains of physical health, psychological health, social relationships, environment and global quality of life. Higher scores indicate higher subjective quality of life. Scales were administered in the order given here. Translation and content validationThe MHS, HHI and SHS were translated from English into German according to the World Health Organisation’s recommendations. This involved the professional translation of the original scales into German followed by the examination of the translation by a group of three bilingual German and English speaking psychiatrists and a unilingual German speaking group of 30 people from different sociodemographic backgrounds. The translation was amended according to their comments and back‐translated to English by a different professional translator.

The back‐translation was sent to the authors of the original scales for comments. These were positive throughout, and no further adaptation was deemed necessary.

Sample and data collectionThe study was conducted using a cross‐sectional design. The target sample characteristics were derived from the latest Population Census in Austria and involved people (≥ 16 years) residing in urban ( 100 000 inhabitants) and rural (. Scale developmentThe reduction of the 60 candidate items from the three original hope scales involved a series of steps: (i) exploratory factor analysis was used to assess the structure of the evolving new scale.

(ii) the resulting factor solutions proposed by the different analytical procedures were discussed among the researchers and item reduction was based on both statistical and theoretical considerations by consensus. We excluded items with redundant content, factor loadings lower than 0.40 on the suggested underlying latent structure and with cross‐loadings onto another sub‐dimension of hope while all components of hope proposed by the underlying literature review were preserved in the questionnaire. This process was repeated three times until no further reduction in questions was deemed appropriate in order not to lose any relevant information. Statistical analysisData were analysed using spss version 15.0 (SPSS Inc., Chicago, IL, USA).

To assess the underlying factors of hope, a principal axis factoring method (PAF) was used in the reduction process as well as for evaluating the resulting new hope scale. Given the hypothesis that the sub‐dimensions of hope are correlated to each other, oblique rotation (direct oblimin) was used to achieve the best solution for the factor loadings and the underlying structure.

To evaluate the stability of the factor solution, the Kaiser–Meyer–Olkin (KMO) coefficient was calculated. In the resulting scale, PAF was additionally applied to a random half of the sample and the subgroups of women/men and rural/urban inhabitants, respectively.Because one crucial task of the factor analysis was to determine how many factors and items to retain, four different decision rules came into operation: (i) Kaiser’s criterion, with factors with an eigenvalue greater than one being retained, and (ii) scree plot, which plots a graph of each eigenvalue against the factor with which it is associated. However, the eigenvalues‐greater‐than‐one rule typically overestimates the number of components and the scree plot involves visual judgements of plots for sharp demarcations between the eigenvalues for major and trivial factors, usually resulting in a low reliability of its interpretation.

Hence, additionally applied decision rules were (iii) the parallel analysis and (iv) the Velicer’s MAP test. Both were calculated with the syntax of O’Connor.The new scale’s internal consistency was estimated using Cronbach’s alpha coefficient for both the entire scale and its individual factors. The new hope scale was correlated with the quality of life and depression to test its concurrent validity. Construct validity was examined in two ways: (i) discriminant validity was assessed by calculating each item’s correlation with its scale and the competing scales and (ii) convergent validity was tested by calculating item correlations within the subscales of hope using PAF. To estimate concept coverage, the Integrative Hope Scale (IHS) and its sub‐dimensions were correlated with the three pre‐existing scales excluding those items that were similarly contained in both dimensions, respectively.

Normal distribution for each utilised item was explored by examining the histograms and Q‐Q‐plots. Pearson and Spearman’s rho correlation coefficient were used as appropriate. SampleGeneral populationDepression mean (SD)General populationQuality of life mean (SD)General populationSample sizen = 489n = 6 679 444n = 489n = 2005n = 489n = 2055Men: number (%)212 (43.35)(48.42)Age: mean (SD) years41.55 (15.–89≥ 1512.58 (9.56)11.69 (9.03)73.23 (19.86)67.59 (17.93)Highest education: number (%)No formal education76 (15.64)(35.66)17.57 (10.61)12.02 (9.17)67.17 (19.79)n/aPrimary education215 (44.24)(45.46)13.53 (9.63)71.12 (20.89)n/aSecondary education152 (31.28)(11.43)9.92 (8.18)77.71 (16.96)n/aUniversity, or similar43 (8.85)(7.45)9.06 (7.48)9.84 (7.94)79.72 (19.99)n/a. ADS, ‘Allgemeine Depressionsskala’.Compared with the Austrian general population, the study sample includes more working‐age participants with middle and higher education while retired people and those with low education are underrepresented. In comparison with normative data from Germany, participants in our sample were overall younger than the reference population and tended to have more depressive symptoms but higher than expected quality of life scores. Apart from these differences, scores roughly reflect the expected distribution with depressive symptoms being more likely at an older age and in less educated people and quality of life scores behaving inversely.

Description of the new IHSThe initial 60 questions on hope were reduced to a concise 23‐items scale. The completion rate (i.e. The rate of participants without missing responses in any of the 23 items) was highly satisfactory with 7.9% of the sample leaving one question unanswered and only 4.3% leaving two or more questions unanswered.The new tool is a self‐rating instrument with items being rated on a six‐point Likert scale from 1, strongly disagree, to 6, strongly agree. It provides an overall score and four dimension scores, obtained by summing up the individual item scores, with negative items being rated inversely. This produces possible overall hope scores ranging from 23 to 138 with higher scores representing higher hopefulness. The scores for the sub‐dimensions vary according to the number of items.The four dimensions contain questions from all three original scales. Questions from the SHS and the HHI congregate in the first factor, while the other three factors are comprised of reassembled questions of the MHS ( ).

The factor ‘trust and confidence’ reflects a reference to past experience, individual characteristics, spirituality and trust, as well as to motivational aspects of goal striving. The factor ‘lack of perspective’ reflects the absence of hope and its constituent aspects, i.e. Not dealing with situations, as well as lack of inner strength, future orientation and support. ‘Positive future orientation’ and ‘social relations and personal value’ are dimensions represented in the two remaining factors.

Four‐factor solutionOne‐factor12341Trust and confidenceI have deep inner strength. HHI0.70−0.000.080.040.61I believe that each day has potential.

HHI0.65−0.090.100.050.65I have a sense of direction. HHI0.64−0.030.05−0.040.63Even when others get discouraged, I know I can find a way to solve the problem. SHS0.62−0.10−0.020.070.54I feel my life has value and worth. HHI0.54−0.080.12−0.190.76I can see possibilities in the midst of difficulties.

Low-pressure Area

HHI0.52−0.100.060.010.56My past experiences have prepared me well for my future. SHS0.520.060.14−0.010.49I’ve been pretty successful in life. SHS0.45−0.090.02−0.110.56I have a faith that gives me comfort. HHI0.450.04−0.17−0.160.36Lack of perspectiveIt is hard for me to keep up my interest in activities I used to enjoy. MHS−0.020.70−0.01−0.12−0.47It seems as though all my support has been withdrawn. MHS0.130.70−0.150.14−0.63I am bothered by troubles that prevent my planning for the future. MHS−0.030.680.080.04−0.54I am hopeless about some parts of my life.

Thomas D Meyer

MHS−0.160.670.120.07−0.63I feel trapped, pinned down. MHS−0.030.65−0.120.12−0.69I find myself becoming uninvolved with most things in life. MHS−0.080.47−0.130.05−0.56Positive future orientationThere are things I want to do in life. MHS0.04−0.000.710.030.46I look forward to doing things I enjoy. MHS−0.00−0.090.56−0.250.62I make plans for my own future. MHS0.18−0.120.55−0.020.61I intend to make the most of life.

Martin Hautzinger

MHS0.20−0.010.53−0.190.67Social relations and personal valueI feel loved. MHS−0.06−0.170.10−0.780.73I have someone who shares my concerns. MHS−0.02−0.080.05−0.700.60I am needed by others. MHS0.18−0.000.03−0.580.61I am valued for what I am. MHS0.340.020.07−0.500.70Explained variances (unrotated solution)36.7%5.59%3.91%3.59%36.15%Sum49.84%36.15%.