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Abstract
Hope is a basic human need and has the ability to restore health. Hope enhances quality of life, promotes health and healing, and has been shown necessary for recovery. Patients with an acute illness may have feelings of hopelessness or reduced hope. Hospitalized patients experience health/illness transitions which require preparation for discharge. If patients experience healthy transitions they may have a better sense of well-being about their health/illness condition upon discharge. Nurses play a role in fostering hope during health/illness transitions such as patient hospitalization. Nurse patient relationships, communication, and nurse actions may influence patients’ perception of hope. The National League for Nursing identifies caring as one of the core values for nursing of which promoting hope is an essential component. However, with increased emphasis on cost control and productivity, time for hope-engendering nurse interventions may be in jeopardy. There is a paucity of research about nurses’ influence on patients’ perception of hope in the acute care medical-surgical setting, therefore the need for this study.
The purpose of this descriptive correlational study was to explore patients’ perceptions of hope, patients’ perceptions of hope-engendering nurse interventions; and to explore the relationship between patients’ perceptions of hope-engendering nurse interventions and patients’ perceptions of hope during a health/illness transition.
A convenience sample of 97 patients from five acute care medical-surgical hospital settings participated. Patients completed the Hope-Engendering Nurse Intervention – Patient Version (HENI – PT) Instrument, the Herth Hope Index (HHI), and a demographic questionnaire at the bedside. The HENI – PT instrument was developed and pilot tested prior to use in this study. The instrument measures perceptions of hope-engendering nurse interventions, which are behaviors designed to promote patients’ feelings of hope for positive outcomes. The HENI – PT contains four subscales, which are attributes of hope-engendering nurse interventions. The 44 item instrument has a 5-point Likert Scale and consists of two parts, Part A with ratings for the frequency of nurse actions and Part B the effectiveness of nurse actions. For this study, the Cronbach’s alpha reliability coefficient was .97 for the HENI – PT total scale. The HHI measures patients’ perceptions of hope. The instrument has three subscales, which are factors associated with hope. The 12 item instrument has a 4-point Likert Scale. The HHI is used extensively and is reported to be valid and reliable. For this study, the Cronbach’s alpha reliability coefficient was .88 for the HHI total scale.
Descriptive and inferential statistics were computed using SPSS®. Patients’ perceptions of hope were high, with a mean score of 41.92 for the total scale, and a possible range of scores from 12 to 48. Patients’ perceptions of hope-engendering nurse interventions were low, with a mean score of 358.07 for the total scale, and a possible range of scores from 44 to 1100. There was a statistically significant, weak relationship between HENI – PT and HHI (r = .27; p = .008).
Findings suggest a need to understand hospitalized patients’ perceptions about and sources of hope, in order to implement appropriate nursing interventions. Nurses may not be providing hope-engendering nurse interventions in the acute care setting, which suggest a need for nursing education in pre-licensure and practice settings, and establishing expectations for nurse hope-promoting activities in the provision of care.
This study explored the use of the Hope-Engendering Nurse Intervention – Patient Version (HENI – PT) Instrument and the Herth Hope Index (HHI) in a population of patients in an acute medical surgical setting and further developed a new instrument to measure hope-engendering nurse interventions. Further research is needed to determine what other factors influence patients’ perceptions of hope during a health/illness transition, as nurses are in a position to foster those other factors that influence patients’ hope.