Measuring hopelessness in advanced cancer: a secondary analysis of the Hopelessness Assessment in Illness questionnaire (HAI)

Abstract

Objective Hopelessness, or a sense of despair about the future, has been a growing focus of psychological research among patients with serious medical illnesses. This study evaluated the psychometric properties of the Hopelessness Assessment in Illness (HAI) questionnaire, developed specifically for those facing a life-threatening illness. Participants were 344 advanced cancer patients (e.g. lung, breast, gastrointestinal, etc.) participating in two psychotherapy research trials. Design Descriptive statistics characterised participants in regard to both demographic (age, gender, race, ethnicity, religiosity) and clinical characteristics (cancer type). Scale properties were assessed for internal consistency using Cronbach’s coefficient alpha, item-total correlations, Principle Axis factor analysis, and its correlation to relevant psychological constructs. Nonlinear confirmatory factor analysis (CFA) assessed for latent construct variance by gender. Main Outcome Measures Psychometric properties of the Hopelessness Assessment in Illness questionnaire. Results Results indicated strong internal consistency and temporal stability of the HAI, with significant correlations between the HAI and several theoretically related psychological constructs. CFA suggested the same single underlying factor for males and females. Conclusions The HAI demonstrated strong psychometric properties in the context of advanced cancer. Future research is needed to assess the utility of the HAI in more medically and geographically diverse populations.