Kaye Herth

HOPE IN OLDER ADULTS IN COMMUNITY AND INSTITUTIONAL SETTINGS

This study explored the meaning of hope, the influence of specific background characteristics on hope, and identified strategies that are used to foster hope in a convenience sample of 60 older adults using the technique of methodological triangulation (interview, Hope Index, and Background Data Form). Hope was described as an expectation of a brighter tomorrow for self and/or others. Perceptions of hope were found to be influenced by place of residence, age, energy level, functional ability, and health status. With the exception of those participants experiencing severe fatigue and those residing in a long-term care facility, overall hope levels among subjects were high and were found to remain stable across the background variables. Eight hope-fostering categories and four hope-hindering categories were identified based on the interview responses. Implications for practice and research are presented.

Engendering hope in the chronically and terminally ill: Nursing interventions

Nurses assume a primary role in the care of chronic and terminally ill individuals in their homes and are in a strategic position to foster or hinder hope. Using a descriptive survey design, home health care nurses and hospice nurses were asked to rate proposed hope interventions as to use and effectiveness in facilitating hope in their chronically ill and terminally ill clients. One hundred and fifty-eight registered nurses, representative of six hospice agencies and six home care agencies in a Midwestern state, completed the Hope Intervention Questionnaire. Provision of comfort and pain relief emerged as the most effective and most frequently used hope interventions by both the home health care nurses and the hospice nurses. The top 15 interventions, though ranked in slightly different order, were the same for hospice nurses and the home health care nurses and were reflective of the multidimensions of hope. The findings of this study have practical importance to nursing practice as they provide a framework for selecting strategies to foster hope in the chronically ill and terminally ill population.

Contributiors of humor as perceived by the terminally ill

Humorasatherapeuticintervention has receivedincreasingattentionin recentyears.Folk wisdomhasforages heldthathumorhelpsus to bearlife’s burdens.1But, whenlife is nearingits end, doeshumorhavea role?Do the terminally ill perceivehumorasanappropriateandeffectivestrategyin light of the magnitudeof emotional and physical pain and loss? Doeshumor belonginhospicecare?Tobegintofind answersto thosequestionsthe author conducteda smallpilot studythatinvolved interviewing 14 tenninally ill adults regardingtheir perceptionsof andexperienceswith humor.Thepurposewas to clarify the conceptof humorandits contributionsduringterminal illness from the perspectiveof thosewho areterminally ill, sothatthe potentialroleof humorinhospicecare canbedelineated. Thefindingsareimportanttonursingbecausenursesarein a strategicposition to assistthe terminally ill and presentlyassumea majorrole inprovidinghospicecare.

A Spanish-Language Version of the Herth Hope Scale: Development and Psychometric Evaluation in a Peruvian Sample

Hope is a motivational/cognitive attribute that is theoretically necessary to initiate and sustain action toward goal attainment. The Herth Hope Scale (HHS) not only appears to tap into some of the same Agency and Pathways content of the commonly used Adult Hope Scale developed by Snyder et al. but also contains some more spiritual and social support-oriented content as well as more optimism content. The purpose of the current study was the development and initial psychometric evaluation of a Spanish-language version of the HHS, using a Latino sample. The study participants were 315 college students from a private university in Lima, Peru. Both first-order and a hierarchical, second-order factor analyses were conducted, yielding evidence of a theoretically salient four-factor structure similar to that found with the English version. Internal consistency of scores on the total and factor-analytically derived subscales were found to be satisfactory. It was concluded that the Spanish-language translation of the HHS appears to yield psychometrically sound scores and should have utility for studies of hope in Spanish-speaking samples.

Recruitment and retention of older adolescent and young adult female survivors of childhood cancer in longitudinal research.

PURPOSE/OBJECTIVES To describe the challenges encountered in the recruitment and retention of a sample of older adolescent and young adult female survivors of childhood cancer for a longitudinal study testing a targeted psychosocial intervention aimed at enhancing hope. DATA SOURCES Published literature on constructing longitudinal intervention studies and strategies in the recruitment and retention of childhood cancer survivors in research was used to develop the protocol of this study. DATA SYNTHESIS Using empirical literature to construct the studys design resulted in achieving certain goals for the design, but not in the recruitment and retention of study participants. Using online technology to deliver the intervention and collect data was efficient and effective. Traditional approaches to recruitment and retention of those survivors, however, were not effective. Use of more novel approaches to enroll study participants demonstrated only modest success. CONCLUSIONS Additional research is needed on strategies to successfully recruit and retain older adolescents and young adult female survivors of childhood cancer in longitudinal intervention studies. IMPLICATIONS FOR NURSING The improvement in the psychological well-being of female survivors of childhood cancer remains an important outcome in ongoing care. The need to continue to identify creative and effective ways to recruit and retain those survivors is warranted.

Where There's Life, There's Hope, And Where There Is Hope, There Is

Using the Hearth Hope Index, we describe the level of hopefulness among hospital patients and compare it to that reported by community persons and family members in a surgical waiting room. We also correlate these results with depression and self-esteem scores. As measured by these selected instruments, the results suggest that the level of hopefulness is not significantly different among the three samples, that it is positively correlated with self-esteem and negatively associated with depression, and that, among the demographic variables, only the respondents age and frequency of attendance at worship significantly influence hope scores. The results suggest that pastoral caregivers can encourage hopefulness among those under their care by bolstering self-esteem and giving attention to depressive symptoms. They also suggest that those who need the most pastoral support are younger adults with limited education. Pastoral caregivers can use these results, we think, to inform their work in giving pastoral care.

A New Perspective on Loneliness in Later Life

Loneliness in later life remains a serious problem despite extensive research across the life span. Unfortunately, most studies of loneliness that include older adults focus on individuals who are already lonely; findings suggest interventions dependent upon external factors such as socialization and functional status. Such interventions are not always feasible for older adults, who may have experienced social and functional losses. Nurses must adopt a new perspective in examining loneliness in later life. This new perspective should include a more positive approach that focuses on older adults who are not lonely even though they may have experienced decreased socialization or physical function. Identification of strategies employed by these older individuals may be used to help many elders avoid loneliness and help others cope with the related losses so frequent in later life.

Developing the Evidence Base in Pediatric Oncology Nursing Practice for Promoting Health-Related Quality of Life in Pediatric Oncology Patients.

Research has shown that self-esteem and hopefulness are positively related among female childhood cancer survivors (CCS) and contribute to their health-related quality of life (HRQOL). HRQOL remains a significant outcome of treatment for CCS. This study examined the relationships among self-esteem, hopefulness, and HRQOL in young adult female CCS to inform the development of evidence-based practice guidelines for pediatric oncology nursing practice. An online survey was conducted with a sample of young adult female CCS from 58 treatment centers across the United States at 4 time points: at baseline and at 6 weeks, 3 months, and 6 months after initial measurement time. The relationships between self-esteem, hopefulness, and HRQOL were statistically significant (Time 1, P = .05; Times 2, 3, and 4, P = .01) across all measurement times. These findings identify hopefulness and self-esteem as determinants of HRQOL and suggest that caring practices among pediatric oncology nurses that support psychosocial adjustment through promoting self-esteem and hopefulness have the potential to support HRQOL among young adult female CCS. These outcomes support the development of evidence-based practice guidelines to influence HRQOL outcomes among these survivors.