Structuring the meaning of hope in health and illness

The purpose of this paper is to describe a conceptual model for hope that c aptures the personal meaning of this construct within the context of health and illness. To identify this model, a research tool was created based on the semantic differential technique, a well-validated and often used approa ch for quantifying personal or connotative meaning. This tool was distribut ed in the form of a questionnaire to a voluntary sample (n - 550), consisti ng of three primary subsamples: a healthy adult subsample (n = 146), a chro nic and life-threatening illness subsample (n = 159) and a nursing subsampl e (n = 206). A multidimensional structure for the concept, Hope, was identi fied, using principal components analysis. Three primary factors defined th is structure: personal spirit (personal dimension) risk (situational dimens ion) and authentic caring (interpersonal dimension). Personal spirit, a dom inant factor, is characterized by a holistic configuration of hope elements , revolving around a con theme of meaning. Risk is primarily a predictabili ty factor, targeted with an underlying component of boldness. The authentic caring factor has a substantial credibility component, linked with the the me of comfort. Three distinctive features characterize this model: (a) its ability to capture the dynamic qualitative experience of hope within a holi stic multidimensional quantitative framework, (b) its representation of hop e as a location in three-dimensional space and (c) its sensitivity to indiv idual and group variability. This integrative model deepens our understandi ng of the experience of hope within health and illness at the theoretical, clinical and methodological levels. (C) 1999 Elsevier Science Ltd. All righ ts reserved.