Exploration of Hope Among Young Adults with Cancer in Malaysia

Purpose: Hope is vital for cancer patients to cope with their illnesses. It is positively associated with better health outcomes, quality of life, and daily functioning. However, restoring hope after a cancer diagnosis can be challenging, especially for young adult cancer patients. This research aimed to investigate hope among young adults with cancer throughout their cancer experience and the exploration of hope preservation in these individuals. Methods: This qualitative study involved 14 young adults recruited from a closed Facebook group. The median age of the participants was 30.5 years (range 20-39 years), and their median survival year was 3 years (range 1-18 years from the date of diagnosis). Semistructured interviews and a thematic analysis were performed to identify the major themes that emerged from these interviews. Results: The findings identified that young adults expressed hopes for cancer advocacy, good physical and mental health, ease in the afterlife, and uncertain hopes due to thoughts of death. Three areas that influenced their hope are: (1) active hope with cancer peers; (2) cancer prognosis and hope; and (3) hope comes from prayer. Their cultural and religious beliefs influenced the various forms of hope and affected their experiences with cancer. In addition, this study discovered that not all positive communication with their physician resulted in hope. Conclusion: These findings provide important insight to health care professionals (HCPs) by encouraging young adults to discuss hope and improving the existing oncology social work-based intervention. This study suggests that hope is essential for chronic illness patients and should be supported continuously during and after treatments.

Measurement structures of hope: A review of single-factor and two-factor models across hope scales

Snyder's theory of hope has been a cornerstone of hope research for over four decades. The original theory conceptualized hope as a two-factor model representing agency and pathways, however, recent studies have suggested a single-factor model may be the best fit for hope instruments. This has become more apparent as hope scales have been translated into different languages, across different cultures, and examining new domains. Currently, single and multiple factor models have been supported for most hope measures but will continue to be examined as we explore what hope means to unresearched populations and with new and varied contexts.

Clients’ Hope for Counseling as a Predictor of Outcome in Psychotherapy

Researchers have demonstrated links between general hope and symptoms of distress. Findings like these are important given the conceptual role of hope in psychotherapy theories like Frank and Frank’s contextual model. Existing literature, however, has involved researchers employing general hope measures despite hope being variable across domains rather than a general trait. The purpose of this study was to explore the relationships between hope for counseling and clients’ outcomes as well as the working alliance. Self-report data were collected from 103 clients in a doctoral training clinic. Evidence (from multilevel modeling) demonstrated that increases in working alliance predict increases in hope for counseling over the course of treatment and that increases in hope for counseling significantly predict decreases in distress over the course of counseling when working alliance and session number are controlled. We discuss implications for clinical practice and positively-oriented work in counseling psychology.

An intervention for parents with severe personality difficulties whose children have mental health problems: a feasibility RCT

BACKGROUND

The children of parents with severe personality difficulties have greater risk of significant mental health problems. Existing care is poorly co-ordinated, with limited effectiveness. A specialised parenting intervention may improve child and parenting outcomes, reduce family morbidity and lower the service costs.

OBJECTIVES

To develop a specialised parenting intervention for parents affected by severe personality difficulties who have children with mental health problems and to conduct a feasibility trial.

DESIGN

A pragmatic, mixed-methods design to develop and pilot a specialised parenting intervention, Helping Families Programme-Modified, and to conduct a randomised feasibility trial with process evaluation. Initial cost-effectiveness was assessed using UK NHS/Personal Social Services and societal perspectives, generating quality-adjusted life-years. Researchers collecting quantitative data were masked to participant allocation.

SETTING

Two NHS mental health trusts and concomitant children's social care services.

PARTICIPANTS

Parents who met the following criteria: (1) the primary caregiver of the index child, (2) aged 18-65 years, (3) have severe personality difficulties, (4) proficient in English and (5) capable of providing informed consent. Index children who met the following criteria: (1) aged 3-11 years, (2) living with index parent and (3) have significant emotional/behavioural difficulties. Exclusion criteria were (1) having coexisting psychosis, (2) participating in another parenting intervention, (3) receiving inpatient care, (4) having insufficient language/cognitive abilities, (5) having child developmental disorder, (6) care proceedings and (7) index child not residing with index parent.

INTERVENTION

The Helping Families Programme-Modified - a 16-session intervention using structured, goal-orientated strategies and collaborative therapeutic methods to improve parenting, and child and parent functioning. Usual care - standard care augmented by a single psychoeducational session.

MAIN OUTCOME MEASURES

Trial feasibility - rates of recruitment, eligibility, allocation, retention, data completion and experience. Intervention acceptability - rates of acceptance, completion, alliance (Working Alliance Inventory-Short Revised) and experience. Outcomes - child (assessed via Concerns About My Child, Eyberg Child Behaviour Inventory, Child Behaviour Checklist-Internalising Scale), parenting (assessed via the Arnold-O'Leary Parenting Scale, Kansas Parental Satisfaction Scale), parent (assessed via the Symptom Checklist-27), and health economics (assessed via the Client Service Receipt Inventory, EuroQol-5 Dimensions).

RESULTS

The findings broadly supported trial feasibility using non-diagnostic screening criteria. Parents were mainly referred from one site (75.0%). Site and participant factors delayed recruitment. An estimate of eligible parents was not obtained. Of the 86 parents referred, 60 (69.7%) completed screening and 48 of these (80.0%) were recruited. Participants experienced significant disadvantage and multiple morbidity. The Helping Families Programme-Modified uptake (87.5%) was higher than usual-care uptake (62.5%). Trial retention (66.7%, 95% confidence interval 51.6% to 79.6%) exceeded the a priori rate. Process findings highlighted the impact of random allocation and the negative effects on retention. The Helping Families Programme-Modified was acceptable, with duration of delivery longer than planned, whereas the usual-care condition was less acceptable. At initial follow-up, effects on child and parenting outcomes were detected across both arms, with a potential outcome advantage for the Helping Families Programme-Modified (effect size range 0.0-1.3). For parental quality-adjusted life-years, the Helping Families Programme-Modified dominated usual care, and child quality-adjusted life-years resulted in higher costs and more quality-adjusted life-years. At second follow-up, the Helping Families Programme-Modified was associated with higher costs and more quality-adjusted life-years than usual care. For child quality-adjusted life-years, when controlled for baseline EuroQol-5 Dimensions, three-level version, usual care dominated the Helping Families Programme-Modified. No serious adverse events were reported.

CONCLUSION

The Helping Families Programme-Modified is an acceptable specialised parenting intervention. Trial methods using non-diagnostic criteria were largely supported. For future work, a definitive efficacy trial should consider site selection, recruitment methods, intervention efficiency and revised comparator condition.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN14573230.

FUNDING

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 14. See the NIHR Journals Library website for further project information.

Recovery as Life Transformation: Examining the Relationships between Recovery, Hope, and Relapse

Models of holistic recovery that focus on wellbeing in recovery are emerging in the field of substance use treatment, but the literature shows little research on the mechanisms of change within these models. The authors present hope as significant factor. Although hope is a considered a vital factor of substance use recovery, empirical research on the relationships between recovery and hope is sparse. Objectives: The objectives of the study were to examine (a) the association between recovery progress on risk of relapse and (b) the mediating role of hope in the relationship between recovery progress and risk of relapse. Methods: Our cross-sectional study included a community sample of 412 U.S. adults. Using a structural equation model, we examined relationships among recovery progress, risk of relapse, and hope. Results: The mediation model indicated a significant negative relationship between recovery progress and risk of relapse. Furthermore, it demonstrated that hope partially mediates the effect of recovery progress on risk of relapse. Conclusions: The findings provide empirical support for holistic recovery models of recovery and prevention of relapse. Further implications of these findings are discussed.

Development and Initial Validation of the Therapist Hope for Clients Scale

Hope is a critical component of therapeutic change. However, hope does not singularly emanate from clients. Therapists’ hope for their clients represents a specific therapeutic factor that may impact clinical outcomes. Currently no measure exists to assess the uniqueness of therapist’s hope in therapy with specific clients. Our purpose in this study was to develop and initially validate the Therapist Hope for Clients Scale (THCS). Participants ( N = 380) completed the THCS, plus four additional measures to assess therapists’ use of clients’ strengths, self-efficacy in helping skills, working alliance with individual clients, and a general measure of hope. We subjected the THCS to parallel analysis, factor analyses, reliability testing, and validity testing. These steps led to the development of a 10-item measure. THCS scores were positively related to therapists’ use of clients’ strengths, helping skills, self-efficacy, and working alliance. Implications of the THCS are discussed.

Psychometric properties of Hope Scales: A systematic review

INTRODUCTION

Hope is recognised as an important factor in health, illness, and well-being. Many scales to measure hope have been developed and used in various disciplines, yet, their psychometric properties have not been systematically reviewed.

AIM

To systematically review the psychometric properties of hope scales.

DESIGN

Systematic review.

METHODS

Four electronic databases were searched followed by a hand search. The data were extracted and qualitatively evaluated by the COSMIN checklist, an instrument designed as a quality rating tool for systematic reviews of psychometric properties.

RESULTS

From 1271 retrieved abstracts, 68 papers met the inclusion criteria. The most used scale was the Snyder Hope Scale (46%) followed by the Herth Hope Index (16%). All other scales (n = 16) were evaluated in less than 10% of the papers. Structural validity (91%), internal consistency (88%), and hypothesis testing (74%) were the most reported properties. Reliability (34%), cross-cultural validity (34%), content validity (25%), and criterion validity (15%) were reported in less than 50% of the papers. Only two (3%) studies reported responsiveness, and none reported measurement error. Less than 35% of the validation studies achieved excellent or good quality for any of the measurement properties.

CONCLUSION

The results show that no robust and valid scale exists for measuring hope. It highlights important gaps in psychometric properties of hope scales. Despite more than 40 years of research and development of hope scales, the currently available scales do not meet the standards of psychometric evaluation. This calls for efforts to improve the quality of hope scales.