Development and preliminary testing of the Schizophrenia Hope Scale, a brief scale to measure hope in people with schizophrenia

Abstract

Background: Hope has received attention as a central component of recovery from mental illness; however, most instruments measuring hope were developed outside the mental health field. To measure the effects of mental health programs on hope in people with schizophrenia, a specialized scale is needed. Objective: This study examined the psychometric properties of the newly developed 9-item Schizophrenia Hope Scale (SHS-9) designed to measure hope in individuals with schizophrenia. Design: A descriptive survey design. Setting: Participants were recruited from three psychiatric hospitals and two community mental health centers in South Korea. Participants: A total of 347 individuals over age 18 with a DSM-IV diagnosis of schizophrenia, schizoaffective, or schizophrenia spectrum disorders (competent to provide written informed consent) participated in this study; 149 (94 men, 55 women) completed a preliminary scale consisting of 40 revised items, and 198 (110 men, 88 women) completed the second scale of 17 items. Methods: Scale items were first selected from extensive literature reviews and a qualitative study on hope in people with schizophrenia; the validity and reliability of a preliminary scale was then evaluated by an expert panel and exploratory factor analysis. The remaining 9 items forming the Schizophrenia Hope Scale (SHS-9) were evaluated through confirmatory factor analysis. Results: The SHS-9 demonstrates promising psychometric integrity. The internal consistency alpha coefficient was 0.92 with a score range of 0-18 and a mean total score of 12.06 (SD=4.96), with higher scores indicating higher levels of hope. Convergent validity was established by correlating the SHS-9 to the State-Trait Hope Inventory, r=0.61 (p<0.01). Divergent validity with the Beck Hopelessness Scale was also established, r=-0.55 (p<0.01). Exploratory and confirmatory factor analysis resulted in a 1-factor solution, with the essential meaning of hope accounting for 61.77% of the total item variance. Conclusion: As hope has been shown to facilitate recovery from mental illness, the accurate assessment of hope provided by the short, easy-to-use Schizophrenia Hope Scale (SHS-9) may aid clinicians in improving the quality of life of individuals with schizophrenia. (C) 2013 Elsevier Ltd. All rights reserved.