Health-related Hardiness Research Articles

Factors influencing resilience in patients with advanced cancer: A cross-sectional study.

Advanced cancer and its treatments lead to various detrimental impacts on patients. Resilience is an important ability to adapt to such adversity, but there is limited information about its influencing factors, specifically in patients with advanced cancer. This study aimed to examine the influence of social support, depression, anxiety, hope, optimism, spiritual well-being, religious belief, and hardiness on resilience among adults with advanced cancer. This cross-sectional research used multi-stage sampling to select 288 participants from a university hospital and three tertiary hospitals in northern Thailand. Data were collected using a demographic data collection form, the Hospital Anxiety and Depression Scale (HADS), the Thai version of the Social Support Questionnaire (SSQ), the Herth Hope Index (HHI), Life Orientation Test-Revised (LOT-R), Buddhist Belief Questionnaire, Health-Related Hardiness Scale (HRHS), and Connor-Davidson Resilience Scale (CD-RISC), from February 2021 to February 2022. Data were analyzed using descriptive statistics, Pearson correlation, and regression analysis. Depression (r = -0.47, p <0.01) and anxiety (r = -0.39, p <0.01) had a significant negative relationship with resilience. Spiritual well-being (r = 0.74, p <0.01), hope (r = 0.67, p <0.01), religious belief (r = 0.53, p <0.01), optimism (r = 0.40, p <0.01), social support (r = 0.33, p <0.01), and hardiness (r = 0.21, p <0.01) had significant positive relationships with resilience. Only hope (β = 0.29, p <0.01) and spiritual well-being (β = 0.59, p <0.01) together influenced resilience by 64.70%. Spiritual well-being and hope are crucial to resilience in patients with advanced cancer. Nurses should provide spiritual support to strengthen patients' ability to adapt successfully to life with advanced cancer.

The Effectiveness of Health-promoting Lifestyle Training on Health-related Hardiness and Hope in Patients With Cardiovascular Diseases

Background: In addition to physical problems, patients with cardiovascular diseases face psychological problems that reduce their control over the disease. The present study aimed to investigate the effectiveness of health-promoting lifestyle (HPL) training on health-related hardiness and hope of patients with cardiovascular diseases in Ahvaz, Iran. Methods: This was a quasi-experiment study with a pre-test-post-test control group design. The statistical population included all patients with cardiovascular disease who were referred to Golestan Educational and Therapeutic Hospital affiliated with the Ahvaz Jundishapur University of Medical Sciences, Iran, in the winter of 2021-2022. The research sample included 40 participants who were selected after examining the inclusion criteria of the research through convenience sampling. The subjects were randomly assigned into the experimental and control groups (n=20). The experimental group underwent eight 90-minute sessions of HPL training. During this time, the control group received no training. The research instruments included the demographic information form, the Revised Health Hardiness Inventory (RHHI-24), and the Adult Hope Scale (AHS). The data were analyzed using the multivariable analysis of covariance (MANCOVA) by SPSS software, version 19 at a significance level of 0.05. Results: The Mean±SD of the post-test scores of health-related hardiness and hope in the experimental group were 54.45±6.68 and 23.40±3.63, respectively, which was significantly different from the pre-test scores (P&lt;0.001). The experimental and control group had a significant difference regarding health-related hardiness and hope (P&lt;0.001). Conclusion: Health specialists are recommended to utilize HPL training together with other training methods to improve health-related hardiness and hope of patients with cardiovascular diseases.

An Examination of Modifiable Risk Factors in Stroke Survivors, with a view to recurrent stroke prevention

BackgroundStroke is a major public health problem worldwide, as more people survive their initial stroke event and subsequently live with chronic disability. While extensive research has focused upon preventing primary strokes comparatively little research has examined secondary stroke prevention. MethodsWe analysed data collected from a survey of 576 participants from the 45 and Up Study who had a clinical diagnosis of stroke. Health status was assessed using a variety of validated instruments. Demographics and modifiable risk factors, including health behaviours and diagnosed conditions, were also measured. Logistic regression model building was used to examine the relationship between each modifiable risk factor and the independent variables of demographics and health status measures. ResultsThe average time since the most recent stroke for study participants was 10.4 (SD = 8.9) years, with the majority of participants (73.2%) having had only one stroke in total. Regression modelling revealed that health-related hardiness, quality of life, depression and fatigue scores were all statistically significantly associated with heart disease, anxiety, depression and physical activity. For stroke characteristics, years since the most recent stroke was associated with heart disease and the number of strokes was associated with anxiety/nervous disorder, diabetes and alcohol consumption. ConclusionAmong other identified targets for secondary stroke prevention, fatigue and depressive symptoms appear to be common factors affecting several modifiable stroke risk factors. Addressing fatigue and depressive symptoms may therefore have a positive effect on secondary stroke prevention strategies in post stroke adults. All practitioners providing care for post-stroke adults can work towards improving these health factors thereby enhancing and prioritising secondary stroke prevention strategies.

Associations Between Fatigue and Disability, Depression, Health-Related Hardiness and Quality of Life in People with Stroke

BackgroundStroke is a common cause of mortality and morbidity which affects approximately 17 million people globally each year. Common symptoms associated with stroke are physical disabilities, impaired cognitive functions, depression, and fatigue, all of which can significantly impact health-related quality of life (HRQoL). To date, no research has explored the inter-relationship among fatigue, disability, depression, health-related hardiness, and quality of life in stroke survivors. MethodsData was obtained from a sub-study of the 45 and Up Study; including 576 Australian adults who had been diagnosed with a stroke. The cross-sectional questionnaire obtained demographic and health status information, as well as clinical measures and stroke-related measures. Associations among fatigue and disability, depression, health-related hardiness and quality of life were analysed using a linear regression model. ResultsIn comparison to those participants with no stroke-related disability, those with slight (β = 1.141; p = 0.008), moderate (β = 3.250; p < 0.001) or severe (β = 3.526; p < 0.001) disability had significantly higher fatigue scores. For every one unit increase in the depression score, the fatigue score increased by 1.502 points (p < 0.001). For every one unit increase in the health-related hardiness score, the fatigue score decreased by 0.054 points (p = 0.044). For every one unit increase in the quality of life score, the fatigue score decreased by 0.068 points (p < 0.001). ConclusionThis study found significant associations among fatigue and disability, depression, health-related hardiness, and quality of life in stroke survivors. Accurate detection and management of fatigue may help improve the rehabilitation of stroke survivors.

Fear of COVID-19 and Life Satisfaction: The Role of the Health-Related Hardiness and Sense of Coherence.

Introduction: The COVID-19 pandemic is contributing to increased fear and anxiety throughout society, which may affect life satisfaction. Health-related hardiness and sense of coherence (SOC) are personal resources that help people adapt to difficult circumstances. The purpose of this study was to investigate the relationship between fear of COVID-19, SOC, health-related hardiness, and life satisfaction.Methods: A total of 907 Polish people (522 women and 385 men) participated in this study. The Fear of COVID-19 Scale (FOC-6), the Health-Related Hardiness Scale, the Sense of Coherence Scale (SOC-29), and the Satisfaction with Life Scale were used.Results: Correlation showed that fear of COVID-19 was negatively related to health-related hardiness, SOC, and life satisfaction. Health-related hardiness and SOC were positively related to life satisfaction. Both SOC and hardiness were mediators between fear of COVID-19 and life satisfaction during the current pandemic.Conclusion: SOC and health-related hardiness are personal resources that are important for dealing with the effects of the COVID-19 pandemic. According to our study, SOC and hardiness can mediate between fear of COVID-19 and life satisfaction. Presented cross-sectional results have to be verified in future longitudinal studies in order to strengthen the conclusions presented in this manuscript. This study verified the role of only two personal resources, so more research is needed on the role of other personal resources during COVID-19 pandemic.

Women living with HIV in Nigeria: Predictive influence of hardiness on perceived stress

Background: Women living with HIV experience severe HIV-related stress in sub-Saharan Africa. But evidence shows that individuals with high levels of the psychological hardiness characteristic who accept stressful situations as meaningful experience may withstand psychological stress. However, the literature on associations between hardiness and HIV-related stress among women living with HIV is scarce. The objective of this study was to investigate the relationship between hardiness and HIV-related stress among women living with HIV in Niger State, Nigeria. Methods: This study used a cross-sectional design. A systematic sampling technique was used to recruit 748 participants from three selected hospitals in Niger State. The perceived stress scale and the health-related hardiness scale were used for data collection. A total of 676 questionnaires were returned in usable form and were analysed using hierarchical regression analysis. Results: Pearson’s correlation analysis showed that there is a statistically significant association between perceived stress and subscales of hardiness (p < 0.001). Hierarchical regression analysis results showed that hardiness significantly predicted perceived stress among the study sample with R2 = 0.286, F(3, 669) = 90, p < 0.001. Conclusion: The finding of this study that higher hardiness is associated with lower perceived stress suggests the potential helpfulness to women living with HIV of this personality for coping. The finding also suggests that nurses and other health care workers may facilitate the development and/or improvement of hardiness characteristics through cognitive behavioural interventions among women living with HIV to ameliorate HIV-related stress.

Selected psychometric aspects of the Polish version of the Liverpool Self-efficacy Scale

BackgroundSelf-efficacy expresses the individual’s belief in their ability to take up and continue actions in order to achieve a particular result and cope with various life events. For people with multiple sclerosis (MS), self-efficacy is an im-portant resource because it affects how they adapt to the disease, and influences their motivation, health-related behavior and physical activity. It also has a great impact on their quality of life. Because of the lack of tools for meas-uring self-efficacy in Polish patients with multiple sclerosis, the goal of the current study was to develop a Polish language version of the Liverpool Self-efficacy Scale (LSES) and assess its validity and reliability.Participants and procedureA total of 175 people diagnosed with MS took part in the study. A Polish version of the LSES, the Sense of Coherence Questionnaire (SOC-29), the Resiliency Assessment Scale (SPP-25), the Health-Related Hardiness Scale (HRHS), the Acceptance of Illness Scale (AIS) and the Multiple Sclerosis Impact Scale were applied.ResultsConfirmatory factor analysis, reliability analysis using α and ω coefficients, and two measures of validity (content and criterion validity) were used in order to validate psychometric properties of the Polish version of the LSES. Our analyses confirmed a good fit of the one-factor and two-factor models.ConclusionsThe results indicate that the Polish version of the LSES is a useful and valuable tool for assessing levels of self-efficacy in Polish patients with multiple sclerosis. The scale can be used for both clinical and research purposes.

Validity and reliability of the Polish adaptation of the Health-Related Hardiness Scale – the first confirmatory factor analysis results for a commonly used scale

BackgroundThe Health-Related Hardiness Scale (HRHS) developed by Pollock is one of the most widely used measures to assess the construct of hardiness in chronic diseases. However, the original structure of the scale has been investigated only with exploratory factor analysis, and there have been no studies investigating the structure of the scale using a confirmatory approach, so significant doubts about the validity of the scale could be raised.Participants and procedureA total of 450 participants took part in the study, with the majority suffering from chronic diseases. A Polish ver-sion of the HRHS, the Sense of Coherence questionnaire (SOC-29), the Resiliency Assessment Scale (SPP-25), the Liverpool Scale of Sense of Self Efficacy (LSES), and the Acceptance of Illness Scale (AIS) were used. Confirmatory factor analyses (CFA) to assess factor structure of the HRHS and correlational analyses to inves-tigate criterion validity were conducted. Since the original structure did not fit the data adequately, a modified structure of the short version of the scale was investigated and a good fit to the data was obtained.ResultsThe modified version consisted of two subscales of Control (6 items) and Challenge/Commitment (6 items) which had good Cronbach’s α reliability, .75 and .75 respectively, and .83 for the overall score. The HRHS showed expected correlation patterns with criterion variables. Separate sten norm were provided for female and male patients with chronic illnesses.ConclusionsThe Polish version of the HRHS is a useful and valuable tool for assessing levels of health-related psychologi-cal hardiness. The scale can be used for both clinical and research purposes.

The current status and influencing factors of health-related hardiness among maintenance hemodialysis patients

The current status and influencing factors of health-related hardiness among maintenance hemodialysis patients

The mediating effect of health-related hardiness on the degree of physical disability and perceived stress in Chinese female patients with neuromyelitis optica spectrum disorder

BackgroundNeuromyelitis optica spectrum disorder (NMOSD) is a rare and chronic disease of the central nervous system. The characteristics and main symptoms of recurrent NMOSD lead to an increase in psychological stress and accelerate a decline in the patients’ quality of life. The incidence of NMOSD in the Chinese population is much higher than that for other countries and the majority of NMOSD patients are female. In general, there are sex differences in the perception and management of stress, with females experiencing higher levels of perceived stress than males. Thus, we should be concerned about the psychological issues experienced by Chinese female NMOSD patients. Health-related hardness is a psychological adjustment factor that could affect perceptions of illness that impact on NMOSD patients. The objective of this study was to evaluate the mediating role of health-related hardiness on physical disability and perceived stress in Chinese NMOSD female patients. MethodsParticipants were 68 females patients with NMOSD treated at the Department of Neurology, Huashan Hospital, Fudan University, China, between March and September 2018. Patients were evaluated for their degree of physical disability, perceived stress, and health-related hardiness. Measures included the Expanded Disability Status Scale (EDSS), Perceived Stress Scale (PSS), and Health-related Hardiness Scale (HRHS). Pearson's correlation analyses and stepwise multiple linear regression analysis were used. ResultsFindings indicated a positive correlation between the PSS and EDSS (r = 0.735, P < 0.001) and a negative correlation between the PSS and HRHS total score (r = −0.441, P < 0.001). After adjusting for the confounding factors, the EDSS was found to have a positive predictive effect on the PSS (β = 2.743, P = 0.000), and the HRHS was found to have a negative predictive effect on the PSS (β = −0.152, P = 0.04). Mediation analysis showed a direct effect of the EDSS on the PSS, and as a mediating variable for health-related hardiness (α = −1.928, b = −0.152, c = 2.743, c’ = 2.481), which was statistically significant (P < 0.05). The mediating effect of health-related hardiness accounted for 10.68% of the total effect. ConclusionsAs a mediating variable, health-related hardiness indirectly affected perceived stress caused by physical disability and improved health-related hardiness. This was beneficial in reducing psychological stress and promoting mental health in NMOSD female patients.

Physical activity and depression symptoms in women with chronic illness and the mediating role of health-related quality of life

BackgroundThe aim of this study was to determine the impact of physical activity on depression symptom severity in women 45 years and older with a chronic illness diagnosis, and explore relations between physical activity and psychological and health-related characteristics predicting depression symptoms. Methods1932 women diagnosed with one of five chronic illnesses: asthma, depression, diabetes, osteoarthritis, or osteoporosis participated in a sub-study of the 45 and Up Study—a cross-sectional study of people aged 45 years and older. The survey included items measuring demographics, depression symptoms, health-related quality of life (HRQoL), health-related hardiness, sleep quality, and health behaviours, such as physical activity. ResultsA multiple regression model explained 43% of the variance in depression symptoms (R2 = 0.43, F (18) = 61.72, p < .001); intensity of physical activity was a significant predictor of depression symptoms (p < .001), and HRQoL was found to explain the most variance (B = −10.00) in depression symptoms. Mediation analysis confirmed that HRQoL partially mediated the relation between physical activity and depression symptoms; however, the effect was very small. LimitationsCross-sectional data and self-report measures limit the implications of the findings. ConclusionWomen with chronic illness engaging in more vigorous physical activity had less severe depression symptoms. Findings suggest that improving HRQoL is critical to the prevention and management of depression symptoms in women with chronic illness. Psychological and health-related factors that influence HRQoL, such as sleep quality and health-related hardiness, are important clinical considerations for health practitioners.

Self-Care Performance of Middle-Aged Stroke Patients in Korea.

The incidence rate of middle-aged ischemic stroke patients has been increasing. Because of their high risk of recurrence, it is important for them to adhere to their self-care performance. The purpose of this study was to investigate predictors of self-care performance among middle-aged ischemic stroke patients. A descriptive correlational and cross-sectional survey design was used. About 140 participants who had been diagnosed with ischemic stroke within a year and visited neurological outpatients were investigated. Participants answered self-report questionnaires, the Secondary Stroke Prevention Knowledge Scale, the Health-Related Hardiness Scale, and the Subjective Self-Care Performance Scale. Hardiness, secondary-stroke-prevention knowledge, age, and stroke-diagnosis duration had statistically significant influences on self-care performance; hardiness had the largest effect. This study highlighted hardiness as the major predictor of self-care performance. To improve middle-aged ischemic stroke patients' self-care performance, nurses need an integrated approach that considers a patient's age, diagnosis duration, secondary-stroke-prevention knowledge, and, especially, hardiness.

A Conceptual Analysis of Cancer Survivorship

Purpose: The purpose of this study was to identify attributes of the concept of cancer survivorship. Methods: Walker & Avant’s concept analysis framework (2005) was used to review the medical & nursing text books, medical and nursing research articles related to cancer survivorship and published from 1985 to 2011. Results: There were nine aspects of the concept of cancer survivorship: A process, liminality, uncertainty, life-changing experience, complexity, unique experience, duality of positive and negative aspects, partnership, and need for support. Antecedents of cancer survivorship were cancer diagnosis and perception as a cancer survivor. Empirical referents of cancer survivorship were survival rate, quality of life, adaptation to the survivorship experience, and health-related hardiness, social support, spirituality, and health behavior. The consequences of cancer survivorship were effects on the physical, psychosocial, spiritual and socio-economic well-being of the patients. Conclusion: This concept analysis of cancer survivorship is expected to contribute to promotion of survivorship care in the clinical field by removing conceptual ambiguity and confirming the true meaning of survivorship care.

Health-Related Hardiness in Individuals With Chronic Illnesses

The aims of this study were to (a) describe health stressors, health-related hardiness, perception of illness impact, self-perception of health status, and psychosocial adjustment to illness in individuals living with an inherited bleeding disorder; (b) determine relationships between health stressors, health-related hardiness, perception of illness impact, self-perception of health status, and psychosocial adjustment to illness; and (c) determine if perception of illness impact had a direct and/or mediating effect on the relationship between health stressors, health-related hardiness, and self-perception of health status and psychosocial adjustment to illness. A cross-sectional survey design was used. Sixty participants composed the sample. Participants completed five questionnaires. Higher health stressors were associated with higher perception of illness impact, lower perception of health status, and poorer psychosocial adjustment to illness. Individuals with higher perception of illness impact were associated with lower self-perception of health status and poorer psychosocial adjustment to illness.

Optimism, health-related hardiness and well-being among older Australian women.

This article examines whether optimism and health-related hardiness contribute to health and well-being among older women. Positive psychological characteristics, including optimism and health-related hardiness, are correlated with good self-rated health, but these variables are all affected by socioeconomic status, social support, physical illness and access to services. Using data from 9501 Australian women aged 73 to 78, we show that optimism and health-related hardiness explain a significant proportion of variance in all subscales of the SF-36, and in stress, even after these confounders are taken into account. The data, although cross-sectional, suggest that positive personal characteristics may contribute to well-being.

Health-related hardiness and chronic illness: a synthesis of current research.

A critical analysis of the relationship between health-related hardiness and chronic illnesses based on a review of the literature. To synthesize the current literature in order to provide an understanding of the state of knowledge and the implications for nursing regarding health-related hardiness and chronic illness. Three computerized databases, which yielded 125 articles published from 1966 to 2002. The presence of the health-related hardiness characteristic was significantly related to psychological, psychosocial, and physiologic adaptation. Higher levels of hardiness had positive outcomes in patients with chronic illness. The implications are that the current knowledge base regarding health-related hardiness and chronic illness could be used to assist patients who have to manage not only one but also multiple chronic illnesses.

The relationship of hardiness and depression to disability in institutionalized older adults.

Studies of depression among residents of long term care facilities are a familiar component of the research literature, but the concept of 'hardiness' is less familiar on this side of the Atlantic. Studies have suggested that health-related hardiness predicted the degree of disability experienced by older people subjected to similar levels of stress. In this study, a lecturer at Yale University explored the relationship of hardiness and depression to disability in a sample of 58 older people who were residents in a nursing home. The results indicated that the psychological variables of hardiness and depression contributed more than did health status and length of stay to explaining levels of disability. The author concludes by suggesting therapeutic approaches which may be beneficial. 56 references.

Do Hardiness And Attitude Promote Self-care Adherence To Physical Activity Among Adults With Diabetes

A descriptive correlational study was conducted to determine the relationship between health-related hardiness (HRH), patient attitude toward compliance (PAC), and self-care adherence to physical activity (SCA) among adults (N=155) with diabetes. Data were obtained through individual questionnaires mailed to the subjects identified from local hospital database. Theory of Reasoned Action and Orem's Self-Care Theory were integrated to guide the study. HRH was significantly positively correlated with SCA. The correlation between commitment/challenge part of HRH and SCA was significant and positive, while that between control and SCA was not. The variation in SCA due to control (1.4%), and commitment/challenge (7.7%) together was 9.1% compared to 5.2% due to unified HRH. Separating the HRH into its sub-components of control, and commitment/challenge may explain the individual differences in SCA better than the unified HRH characteristic. Individuals with higher commitment/challenge characteristic may adhere to health professionals' recommendations more than those with higher control characteristic. Those with higher control characteristic may follow self-management strategies other than exercise to control diabetes.

Gender differences in the factors related to physical activity among adults with diabetes

A descriptive correlational study was conducted to determine the gender differences in the relationship between health-related hardiness, patient attitude toward compliance, and self-care adherence to physical activity among 155 adults with diabetes. The two subcomponents of health-related hardiness, control and commitment/challenge, were included as separate variables. The correlations between commitment/challenge and self-care adherence to physical activity, and between total health-related hardiness and self-care adherence to physical activity, were significant among men (n = 52). The correlation between patient attitude toward compliance and self-care adherence to physical activity was significant among women (n = 103). Clinically, when compliance with self-care adherence to physical activity is the goal, a male patient may need hardiness instructions, while a female patient may need interventions to promote attitude toward compliance. Future research may include studying the relationships between other self-care practices such as diet management, medication compliance, and glucose monitoring and the variables of health-related hardiness and patient attitude toward compliance, which may help health-care professionals in appropriate care planning aimed at promoting self-management of diabetes.

Health-related hardiness and the effect of a psycho-educational group on clients' symptoms.

In the health literature, an individual's ability to resist illness when under stress has been referred to as 'hardiness'. Resources, which may be used to sustain a sense of well being, can be categorized by two broad domains, 'control' and 'commitment and challenge'. In this research, a quasi-experimental nonequivalent control group design was used to determine the impact of a specific clinical nursing intervention (the Wellness Program) in terms of its usefulness in fostering the development of health-related hardiness. Findings demonstrated a significant reduction in symptoms related to obsessive compulsiveness, hostility, psychoticism and average level of distress after subjects completed a relatively short psycho-educational health promotion group. Subjectively, the treatment group subjects also described positive changes in thoughts, feelings and behaviours. This research has implications for clinical interventions using small groups to promote health.