•k Original Article•l Jpn J Health & Human Ecology 2007;73(1):31-42

The Herth Hope Index (HHI) and related factors in the

Japanese general urban population
Yuko HIRANO, Mayumi SAKITA, Yoshihiko YAMAZAKI, Kaoru KAWAI, Miho SATO

In this study we sought to demonstrate the reliability and validity of the Japanese Herth Hope
Index (HHI) 12, a psychometric instrument for measuring hope, in a general urban population,and to
investigate factors correlated with the HHI score. Anonymous written surveys were collected from
255 male and female residents livingin Tokyo "N" ward and Saitama "T" township aged 20-69. The
Cronbach a coefficientwas 0.89, and confirmatory factor analysis showed three-dimensionality. We
also observed hope to strongly correlate with having reasons for living and benefit-finding, confirm-
ing the reliabilityand validity of the Japanese HHI scale. Mean HHI score was 35.5. Stratified multi
ple linear regression analysis on factors which correlated with the HHI score showed HHI scores to
correlate positive with age, the presence of a spouse, and sufficient psychosocial support. We also
found that younger subjects receiving sufficient social support enjoyed HHI scores equivalent to
older subjects, while women's higher HHI scores appeared attributable to extensive social support
networks. No correlation was observed with adverse experiences or history of illness. This study
shows that HHI scores in the general urban populationare not unexpectedly high compared with pre
viously studied subjects with serious disease, that advanced age correlates with higher HHI scores,
and that receipt of social support may mediate positive influences on the HHI score.

Key words : Herth Hope Index (HHI) score, general urban population, demographic attribute, stressful
experience, social support

ment and in the number of so-called "NEET" indi

‡T Introduction
viduals ("Not in Employment, Education, or Train-
In the early 1990s, the industrial structures of ing"), crimes by minors, and violent crime. The
developed countries around the world underwent a incidence of suicide climbed to 30,000 cases yearly
profound transformation as the result of burgeon- (National Police Agency, 2006). As a result, mod
ing globalization and advances in information ern Japanese society has been described as involv-
technologies. In Japan, the "bubble economy" that ing "Kibou kakusa syakai" ("social disparities in
was the pinnacle of unprecedented post-war eco- hope") and "Kibou soushitu jidai" ("loss of hope")
nomic growth collapsed. These socioeconomic (Yamada,2005).
changes were accompanied by the destabilization Meanwhile, the concept of "hope" has been gar-
of existing social norms such as a decline in long- nering interest on a worldwide scale in the fields
term stable employment, an increase in unemploy of psychology,nursing, and social sciences (Yama-

Department of Health Sociology,Division of Health and Nursing Sciences, TokyoUniversity Graduate School of
Medicine
 32 Jpn J Health & Human Ecology
da, 2005). Hope can be conceived of as a coping
strategy or the psychosocial internal resources nec-
essary to maintain a positive outlook in the face of
adversity and stress (Farran et al., 1995 ; Herth,
1992 ; Snyder et al.,1991) . Dufault and Martocchio
(1985) define hope as "a multi-dimensional
dynamic life force characterized by a confident yet
uncertain expectation of achieving good, which to
the hoping person, is realistically possible and per
sonally significant." Academic research on the the
ory of hope has occurred mostly outside of Japan
since the concept was first proposed and codified
in early 1990 (Farran et al.,1995) .
Several scales have been developed to measure
hope, of which the simplest is the Herth Hope
Index (HHI). Chinese, Japanese, Thai, and other
versions of the scale have been developed based
on the original English version. There are two apa-
nese versions as well, developed by Koizumi et al.
(1999) and Yamakiand Yamazaki (2003). The HHI
is a 12 question version of the longer 30 item
Herth Hope Scale (HHS), developed by Herth to
measure hope based on Dufault and Martocchio's
model of hope (Dufault and Martocchio, 1985).
Dufault and Martocchio's model of hope postulates
two spheres within which to measure hope, ener-
alized and particularized, and six dimensions, con-
textual, affective, cognitive, behavioral, affiliative,
and temporal. In Herth's version, these six dimen
sions are combined into three subscales each
involving two concepts "inner sense of temporal
ity and future," "inner positive readiness and
expectancy," and "interconnectedness with self and
others." The validity and reliability of these
subscales have been verified (Herth, 1992).
HHI-related research has focused on individuals
which chronic disease such as HIV/AIDS (Herth,
1990), cancer (Chen, 2003 ; Herth, 1990 ; Herth,
2000 ; Lin et al., 2003 ; Wonghongkul,2000), my-
otrophic lateral sclerosis (ALS) (Hirano et al.,
2007;73 (1)
2006), as well as other individuals suffering
chronic difficulties such as the elderly (Koizumi et
al., 1999), certain categories of workers (Konishi
and Esaki, 2004), and family members providing
palliative home care (Chapman and Pepler, 1998).
Factors found to contribute to the HHI score
include sex, income, marital status, length of illness
(Herth, 1992 ; Konishi and Esaki, 2004), specific
illness diagnosis (Herth, 1990), pain and other
forms of physical suffering (Chen, 2003 ; Herth,
1992 ; Hirano et al., 2006 ; Lin et al., 2003), uncer
tainty (Wonghongkul,2000), illness-related wor
ries and frustrations, social difficulties, psychoso
cial support, and happiness (Hirano et al., 2006).
Meanwhile, high HHI scores have been found to
correlate with high quality of life (Herth, 2000) and
low despair, somatization, and loss of control (Chap-
man and Pepler, 1998). It is expected that results
such as these will impact/influence/contribute to
clinical patient care.
These examples illustrate how research on hope
and HHI has been limited to minority populations
such as individuals confronted with severe illness
or other stressful situations. No study of hope in a
general population has yet been undertaken. We
feel that evaluating hope in a general population is
particularly important in Japan today given the
endemic "loss of hope" that is often felt to currently
exist in Japan, which has underscored the impor
tance of hope for the population at large (Yamada,
2005).
For these reasons, we first sought to verify the
reliability and validity of the Japanese version of
the Herth Hope Index 12 scale, then used this psy
chometric instrument to investigate HHIs score as
well as correlated factors in a general urban
population.
 Jpn J Health & Human Ecology
II Subjects and Methods
1. Subjects and Data Collection Techniques
In May 2004, a two-stage random sampling tech-
nique was used to obtain addresses from the resi
dential registers of "N" ward in Tokyo and "T" town-
ship in Saitama, in order to send anonymous writ-
ten surveys to 300 men and 300 women ages 20-
69 years. Responses were received from 277 sub
jects (response rate 46.2%), 22 of which were
excluded due to failure to report gender or age, or
failure to answer three or more HHI items 12. Of
the 255 respondents included in this study, 122
were men and 133 were women, with a mean age
of 48.9±13.0 years.
2. Survey Items and Measurements
(1) Herth Hope Index (HHI) : The HHI is a 12
item abbreviated version of the Herth Hope Scale
developed by Herth to measure hope. The validity
and reliability of these instruments have been veri-
fied (Herth, 1992). HHI items, such as "I have a
positive outlook on life" and "I have short and/or
long range goals" are rated on a 4-point Likert
scale ranging from 1 (strongly disagree) to 4
(strongly agree), with higher total scores indicat
ing higher levels of hope (total score range 12-
48). We used the version by Yamaki and Yamazaki
(2003), who evaluated the reliability of the index.
The Cronbach a coefficient for the HHI in this
study was 0.89.
(2) Perceived Health Competence Scale
(PHCS) : The PHCS is an 8-item, 5-point scale
(total score range 8-40) that is "a domain-specific
measure of the degree to which an individual feels
capable of effectively managing his or her health
outcomes (Smith et al.,1995) ." PHCS items, such
as "I handle myself well with respect to my health"
and "I succeed in the projects I undertake to
improve my health" were rated on a Likert scale
33
from 1 (strongly disagree) to 5 (strongly agree),
with higher scores indicating higher levels of per
ceived health competence. We used the Japanese
version by Togari et al. (2004), the reliability and
validity of which have been verified, The Crohn-
bach a coefficient for the PHCS in this study was
0.88, with a mean score of 25.3± 6.5.
(3) Benefit-finding : Drawing on the results of
previous research (Siegel and Schrimshaw, 2000),
we developed a 4-item, 4-point scale (range4-16)
to measure the ability to find positive meaning in
experiences of adversity, that is, a "silver lining" to
the clouds of adversity. Benefit-finding related
items, such as "I grew mentally stronger" and "I
learned a lot," were rated on a Likert scale from 1
(strongly disagree) to 4 (strongly agree), with
higher scores indicating higher degrees of benefit-
finding. The a coefficient for our scale was 0.81,
with a mean score of 12.0±2.4.
(4) Reasons for living : We queried whether
subjects felt they had a "reason to live," using a 5-
point response scale ranging from 1 (strongly
agree) to 5 (strongly disagree), with higher scores
indicating a greater sense of having a reason to
live. The mean score was 2.5 ± 1.1.
(5) Comfort levels : We queried whether sub
jects were comfortable in the three domains of
time, psychological resources, and financial
resources. The question was rated on a Likert
scale ranging from 1(very little comfort) to 5 (suffi
cient comfort), with higher scores indicating
higher comfort levels. Mean scores were 3.1±1.1,
3.2±1.0, and 3.0±0.8 respectively.
(6) Satisfaction with social role (s) : We que
ried whether subjects felt satisfied with their role
in society using a 5-point scale ranging from 1
(strongly dissatisfied) to 5 (strongly satisfied), with
higher scores indicating greater satisfaction. Mean
score was 2.9± 1.0.
(7) Dreams : We queried whether subjects
 34 Jpn J Health & Human Ecology
embraced any dreams for their future using
point scale.
(8) Social support : We queried subjects on their
social support networks, specifically,the number of
people who gave them psychosocial support, the
number of people to whom they gave psychosocial
support, and the number of people whom they
trusted. We asked subjects about "People who lis-
ten to your troubles and give you help," "People to
whom you listen and give help," and "People with
whom you share a trusting relationship." All three
questions were scored on a 3-point scale.
Response options for the first question were
"N
one," "Yes, but not enough," and "Yes, enough
such people,"while responses to the final two ques
tions were None, Just 1, and 2 or more.
(9) Stressful experiences We queried subjects
about experiences of adversity or illness. The two
questions "In the past three years, have you experi
enced significant emotional stress" and "Have you
experienced significantinjury or illness" were both
scored on a 2-point scale.
(10) Demographic attributes : We collected infor
mation about subject age, sex, marital status, chil
dren, academic background, employment, and
physical limitations. The four possible responses
for marital status were "Married/Divorced/Widow-
ed/Never married." Regarding academic back-
ground, subjects described their highest level of
education ever attained or currently undergoing,
with answers divided for the purpose of analysis
into "high school or below" and "undergraduate or
higher." Seven possible answers for employment
status were "Full time/Part time/Self-employed/
Retired/Housewife/Unemployed/Student."
physical limitations, subjects were asked a 2-point
question about whether they suffered from an ill-
ness or other physical impairment that restricted
their daily activities.
2007;73 (1)
a 2- 3. Statistical Analysis
(1) We computed Crohnbach's a coefficients
to study the reliability of the HHI. To study valid-
ity, we first performed exploratory and confirma
tory factor analyses on HHI scores, then used par
tial correlation analysis between HHI and factors
considered correlated to it while controlling for
gender and age.
(2) To study the relationship between HHI
scores and subjects' gender and age, we performed
a two-way analysis of variance (ANOVA) with the
HHI score as the dependent variable and gender
and age as two independent variables.
(3) To study factors affecting the HHI score,
we performed a preliminary analysis of covariance
(ANCOVA) with the HHI score as the dependent
variable and patient attributes, stressful experi
ences, and social support networks as independent
variables, while adjusting for gender and age. Next,
we performed a stratified multiple linear regres
sion analysis first with subject demographic attrib-
utes and stressful experiences as independent vari
ables (Model 1), then including social support net-
works as an independent variable as well (Model
2). Statistical analyses were performed using both
SPSS 11.5 and Amos 4.0 for Windows.A p value of
equal to or less than 0.05 was considered statisti-
cally significant.
4. Ethical considerations
To ensure appropriate ethical standards, we
informed subjects regarding the purpose and meth
ods of the survey, as well as the data storage and
privacy protection methods that would be employ-
For ed, and the fact that non-participation would result
in no disadvantage. Personal information and other
data were handled and analyzed with appropriate
precautions, and personal data were destroyed fol
lowing completion of the analysis. The return of
the survey instrument, which was optional, was
 Jpn J Health & Human Ecology 35

Fig. 1 Confirmatory factor analysis of HHI score

*Hopel : I have a positive outlook toward life .
Hope2 : I have short and/or long range goals.
Hope3 : I feel all alone.
Hope4 : I can see possibilities in the midst of difficulties,
Hope5 : I have a faith that gives me comfort.
Hope6 : I feel scared about my future.
Hope7 : I can recall happy/joyful times.
Hope8 : I have deep inner strength.
Hope9 : I am able to give and receive caring/love.
Hope10 : I have a sense of direction.
Hopell : I believe that each day has potential.
Hopel2 : I feel my life has value and worth.
* *el -e15 : error variable

considered to indicate informed consent to partici- Index (GFI) : 0.928 ; comparative fit index (CFI)
pate in the study. 0.937 ; and root mean square error of approxima
tion (RMSEA) : 0.073 (results shown in Fig. 1).
‡V Results
GFI and CFI are used to assess model fitness,
1, HHI Factor Structure and Concurrent while RMSEA is used to assess stability (Yama
Validity moto and Onodera, 2002).
The a coefficient for the HHI was 0.89. One fac- To study concurrent validity,we performed a par
tor with an eigenvalue of 1 or above was obtained tial correlation analysis between the HHI score
from exploratory factor analysis (principal factor and several potentially analogous concepts, while
analysis, promax solution) of the 12 HHI questions. controlling for gender and age (results shown in
Eigenvalue contribution was 45.1%. Next, we per- Table 1). Survey items found to have a strong sig
formed a confirmatory factor analysis on a model nificant correlation with HHI score (p<0.001)
consisting of the three factors proposed by Herth. were, in descending order, reasons for living (r=
The results of this analysis were goodness of fit 0.729), benefit-finding (r=0.507), dreams (r=
 36 Jpn J Health & Human Ecology 2007;73 (1)

Table 1 Correlation between HHI and related factors

Notes
1) Excluding invalid responses
2) Adjusted for age and gender
3) * : p<0.05, * * * :p<0.001

Table 2 HHI score gender and age distributions 3. Factors Related to HHI

Next we evaluated factors that correlated with

0.477), psychological comfort (r=0.446), PHCS
(r=0.422), and satisfaction with social roles (r=
0.339). A significant correlation was observed with
economic comfort (r=0.145, p=0.014), and no cor-
relation was observed with time-related comfort.
2, HHI Scores and Gender/Age Distribu
tions
The mean HHI score for the 255 valid responses
received was 35.5±5.6.
Table 2 shows the gender and age distribution
of HHI scores. We performed a two-way ANOVA
with HHI as the dependent variable and gender/
age as independent variables. This revealed a sig-
nificant main effect for gender alone, with higher
HHI scores for women than for men (p<0.05).
the HHI score. Table 3 shows the ANCOVAand
multiple comparison of Bonferroni results when
controlling for gender and age. In descending
order, higher HHI scores were correlated with the
marital status of "Married" as opposed to "Never
married" (p<0.001) ; "Yes, enough such people"
as opposed to "None" and "Yes,but not enough"
with regard to individuals offering psychosocial sup-
port to subjects (p<0.001) ; "2 or more" or "Just
1" as opposed to "None" regarding people with
whom subjects shared a trusting relationship (p<
0.001) ; "2 or more" as opposed to "None" for
those receiving psychosocial support from subjects
(p<0.001) ; "Yes" as opposed to "None" for chil-
dren (p=0.001) ; and the absence of physical
impairments (p0.001). No correlation with HHI
score was observed for academic background, expe
rience of adversity, experience of illness, or
employment status.
The results of stratified multiple linear regres
sion analysis are shown in Table 4. Although not
discussed here, in previous analyses similar results
were obtained when marital status and job status
were treated bimodally-dividing groups into "Mar
ried" or not and "fully employed" or not-hence,
 37
Jpn J Health & Human Ecology

Table 3 ANCOVA of HHI scores for patient attributes, stressful experiences, and social support

Notes
1) SE : Standard Error
2) Adjusted for age and gender
3) * * : p<0.01, * * ; p<O.001

these factors were treated as binary variables in In Model 2, we included social support networks
multiple linear regression. Also, presence of chil- in the analysis in addition to factors used in Model
dren was highly correlated with marital status and 1. We found a correlation between higher HHI
was potentially multicolinear, so this factor was scores and increasing subject age (/3 =0.134, p=
excluded from analysis. 0.043). HHI scores were also extremely high in
In Model 1, the independent variables employed subjects reporting sufficient sources of support
were demographic attributes and a history of compared to those with no such sources of support
stressful experiences. Female sex (,6=-0.162, p= (3 = 0.442, p<0.001). Incorporating the number
0.020) and the presence of a spouse (/3 =0.285, p of sources of support into the model was sufficient
<0.001) were correlated with significantly higher to eliminate the significant correlation of the other
HHI scores. two social support variables. HHI scores were con-
38 Jpn J Health & Human Ecology 2007;73(1)Table 4 A stratified
 Jpn J Health & Human Ecology 39

sistently high for those married regardless of Herth's three factors and proved goodness of fit.
social support variables (a =0.237, p<0.001). The Japanese version of the HHI 12 is composed
Finally,correlations between HHI scores and gen- of the same three factors as the original instru-
der disappeared in Model 2. ment and demonstrates factorial validity.
In evaluating concurrent validity, we found that
‡W Discussion
the HHI has corellates strongly with the presence

1, Reliability and Validity of the Japanese of reasons for living, with r value at 0.729, followed

HHI in a General Urban Population next in significance by benefit-finding, dreams,

The HHI a coefficient was 0.89, demonstrating psychological comfort, PHCS, and satisfaction with
high internal consistency. social roles. This demonstrates concurrent validity

To study validity we performed exploratory fac- in this study of the HHI, which consists of the

tor analysis on the 12 HHI questions, which dem three factors described above, and suggests that

onstrated unidimensionality. Previous HHI the HHI is a measure of coping strategies or the

research has used exploratory analysis to elucidate internal psychosocial resources necessary to main

factor structure In 1992 Herth identified the tain a positive outlook in the face of adversity and

three HHI-related factors of "inner sense of tempo stress.

rality and future," "inner positive readiness and
expectancy," and "interconnectedness with self and
others" in a study of adult men and women with
chronic disease (n=172) ; Koizumi et al. (1999)
identified the two factors of "emotion and human
interaction accompanying the process of hope" and
"confidence in hope
, assertive preparations and
expectations" in a study of the elderly in Japan (n=
87) ; and Konishi and Esaki (2004) identified the
Drawing upon previous research into the con
cept of reasons for living, Nomura (2005) identified
component factors of "meaning and value found in
living" and"introspective, positive feelings about liv-
ing" in an elderly populace. That these factors are
in turn reminiscent of hope as defined here lends
support to the conclusions of our study.
2, HHI Scores and Related Factors

three factors of "positive awareness," "give and
take between self and others," and "pessimistic
awareness" in a study involving adult laborers (n=
1,909). As has been previously observed (Koizumi
et al., 1999 ; Konishi and Esaki, 2004), differences
in the number and nature of factors influencing the
HHI may be attributable to differences in culture,
subject background, and even translational nuance.
In this study we used confirmatory instead of
exploratory factor analysis because of this
method's ability to prove theoretical hypotheses
(Yamamoto and Onodera, 2002). GFI, CFI, and
RMSEA were greater than 0.9, greater than 0.9,
and lower than 0.08 respectively, demonstrating
good fitness characteristics. We used a model with
The mean HHI score for the 255 valid responses
received was 35.5± 5.6. In previous research study-
ing persons with serious illness (Chen, 2003 ; Her
th, 1992 ; Hirano et al., 2006 ; Lin et al., 2003;
Wonghongkul, 2000), physical and psychological
discomfort or suffering resulting from illness has
been found to negatively influence HHI scores.
Therefore, it would be anticipated that our sample,
which involved a more general population sample,
including healthy individuals, would tend to demon
strate higher HHI scores than those found in stud
ies of persons with serious illness. Accordingly,the
scores reported in this study are not unexpectedly
high when evaluated in light of the previously
reported mean scores of 34.3±1.6 for US cancer
 40 Jpn J Health & Human Ecology 2007;73 (1)

patients (n115) (Herth, 2000), 39.0•¬4.3 for US women has the provision of social support been
terminal patients (n=20) (Herth,1990), 37.3±5.3 shown to result in higher life satisfaction (Kin et
(n=226) (Chen, 2003) and 32.5±4.2 (n=233) (Lin al., 1999). This previous work suggests that clear
et al., 2003) in studies of Taiwanese cancer positive benefits of social support may exist
patients, 41.6 •¬ 5.4 for Thai breast cancer patients
women that may not exist for men, a conclusion
(n=71) (Wonghongkul, 2000), 37.8±7.0 for eld- supported by our study as well.
erly Japanese (n=87) (Koizumi et al., 1999), 33.9± Model 1 showed no correlation between HHI
5.1 for adult laborers (n=1,909) (Konishi and score and age, but a significant correlation did
Esaki, 2004), and 32.16•¬7.68 for ALS patients on appear in Model 2. Previous research has shown
invasive mechanical ventilation (n=157) (Hirano et no consistent pattern of correlation between age
al., 2006). While we did not investigate the cause and hope (Herth,1992 ; Konishi and Esaki, 2004
of this finding, we can postulate that it may demon Wonghongkul,2000) ; this study showed a signifi
strate the ability of individuals in adverse situa cant correlation only when social support was fac
tions to adapt to and cope with illness-related diffi tored in. In our sample of the general urban popula
culty through the maintenance of hope. tion, younger subjects showed a tendency towards
•@In order to investigate factors correlated with lower HHI scores except when they enjoyed suffi
the HHI score, we first performed a preliminary cient social networks-in these cases their HHI
bivariate analysis of factors thought to affect the scores were as high as older subjects. Reasons
HHI score-demographic attributes, stress, and that advanced age was associated with higher HHI
social support-with the HHI score, after which are thought to include freedom from the burdens
we performed a stratified multiple linear regres- of work and childcare and increased latitude in
sion analysis. The final model showed that higher terms of finances and time.
HHI scores were significantly correlated with Marital status showed a strongly significant cor-
higher age, presence of a spouse, and sufficient relation with HHI score regardless of age or
psychosocial support. gender. This result is in agreement with previous
•@In Model 1, women were found to have signifi research (Herth,1992 ; Konishi and Esaki, 2004).
cantly higher HHI scores than men. However, in We also found no significant correlations
Model 2 (which incorporated social support) we between HHI score and illness or adversity. Previ-
observed a significant score correlation with the ous research involving patients with severe dis
number of people offering social support, while the ease has shown that lower levels of HHI are corre-
correlation with gender disappeared. This result lated with illness-related experiences and distress
explains the higher HHI scores seen in women, (Chen, 2003 ; Herth, 1992 ; Hirano et al., 2006;
who receive greater support, than men. Higher Lin et al., 2003 ; Wonghongkul, 2000). This is
HHI scores have been previously reported in likely because severe illnesses create suffering
women (Konishi and Esaki, 2004), and our data that may persist intermittently up until the time of
suggest this outcome may be mediated by social the HHI survey itself. In contrast, the survey ques
support parameters. Other research has shown tion asked whether such adversity had been experi
that women enjoy superior social support net- enced in the past three years, a relatively long
works because for women these networks are period that allowed for the suffering associated
broader (Yoshii et al., 2005) and because only for with the experience to dissipate. This may explain
 Jpn J Health & Human Ecology 41

the lack of a correlation found
adversity, and physical limitations
score in the current study.
We investigated the relationship between social
support and HHIs score through the ANCOVA
test. While a significant correlation was found
between the HHI score and the number of people
to whom subjects gave psychosocial support, and
the number of people whom they trusted, these
correlations disappeared in stratified multiple lin-
ear regression analysis when the number of people
offering psychosocial support was factored in. This
suggests that subjects who gave abundant support
to others and who maintained more than two trust-
ing relationships enjoyed networks which gave
them plentiful support as well, resulting in higher
HHI scores. Hope is cultivated through relation-
ships with others (Farran et al., 1995 ; Herth,
between illness, future by studying a more diverse subject sample
and the HHI which also includes individuals in rural areas.
V Conclusion
Our results confirm the reliability and validity of
the Japanese version of the Herth Hope Index
(HHI) 12 scale by demonstrating a satisfactory
Cronbach a coefficient and strong positive correla
tions of HHI scores with both reasons for living
and benefit-finding. We have shown that HHI
scores in the general urban population are not
unexpectedly high compared to the subjects of pre
vious research with serious diseases. We have also
shown that higher age correlates with higher HHI
scores, and that the receipt of social support
appears to have a mediating effect on HHI scores.
Acknowledgments

1992), and the positive correlation between social We would like to express our gratitude to the

support and hope has been well established (Herth, respondents who took the time to participate in

1990 ; Herth, 2000 ; Hirano et al., 2006). This our survey, as well as to our fellow graduate stu-

study supports this conclusion and is the first dents and other individuals whose invaluable assis

research to elucidate a mediating effect between tance made this study possible.

the receipt of social support and hope, thus under-

lining the importance of such support as a echa-
References
nism for improving hope in the general population.
Chapman KJ and Pepler C (1998) : Coping, hope, and
anticipatory grief in family members in palliative
3. Limitations of the Study and Future
home care, Cancer Nurs, 21(4), 226-234
Directions Chen ML (2003) : Pain and hope in patients with can
There are several limitations to the current -cer, Cancer Nurs, 26(1), 61-67
Dufault K and Martocchio BC (1985) Hope : Its
study. First, the cross-sectional nature of the
spheres and dimentions, Nurs Clin North Am, 20(2),
study prevented us from establishing causal rela 379-391
tionships between the various factors identified Farran CJ, Herth KA and Popovich JM (1995) Hope
and Hopelessness Critical Clinical Constructs, Sage
and HHI scores. To further elucidate the concept
Publication (London)
of hope in the general urban population, we antici Herth K (1990) : Fostering hope in terminally-ill peo
pate longitudinal studies to carry this research - ple, J Adv Nurs,15(11), 1250-1259
forward. Further, the subjects in this study were Herth K (1992) Abbreviated instrument to measure
hope development and psychometric evaluation, J
all located in urban or suburban areas with large
Adv Nurs.17(10). 1251-1259
population concentrations ; the further generaliz Herth K (2000) : Enhancing hope in people with a first
ability of our results may be investigated in the recurrence of cancer, J Adv Nurs, 32(6), 1431-1441
 42 Jpn J Health & Human Ecology
Hirano YM, YamazakiY,Shimizu J et al. (2006) Venti
-lator dependence and expressions of need : A study
of patients with amyotrophic lateral sclerosis in
Japan, Soc Sci Med, 62(6), 1403-1413
National Police Agency (2006) : Danjobetu, nenreisou
-betu zisatushasuu no jyoukyou (heisei 17 nen),
Heisei 18 nendo keisatu hakusyo toukeisiryou (http://
wwwnpa.go.jp/hakusyo/h18/2shou/2-18.pdf), 2-18
Kin K, Sugisawa H, Okabayashi H et al. (1999) A lon
- gitudinal study of social support and satisfaction level
in daily life in elderly people, Jpn J Public Health, 46
(7), 532-541
Koizumi M, Ito M, Mori Y et al. (1999) : Nihongoban
Herth Hope Index no kaihatu Nihon no koureisya ni
okeru sukelu no sinraisei to datousei no kentou,
Kitakanto Med J, 49(4), 277-282
Konishi R and Esaki F (2004) : The score and effect fac
-tors of hope in workers, Job Stress Res, 11(4), 249-
255
Lin CC, Lai YL and Ward SE (2003) Effect of cancer
pain on performance status, mood states, and level of
hope among taiwanese cancer patients, J Pain Symp
-tom Manage, 25(1), 29-37
Nomura C (2005) : Worth Living of Elderly : A Con
- cept Analysis, J Jpn Acad Nurs Sci, 25(3), 61-66
Siegel K and Schrimshaw EW (2000) : Perceiving bene
-fits in adversity : Stress-related growth in women
living with HIV/AIDS, Soc Sci Med, 51(10), 1543-
2007;73 (1)
1554
Smith MS, Wallston KA and Smith CA (1995) : The
development and validation of the perceived Health
Competence Scale, Health Educ Res,10(1), 51-64
Snyder CR, Harris SC, Anderson SR et al. (1991) The
will and the ways : development and validation of an
individual difference measure of hope, J Pers Soc Psy
-chol, 60(4), 570-585
Togari T, Ikezaki S, Yamazaki Y et al. (2004) : The
development of Perceived Health Competence Scale
Japanese version, Jpn J Health Hum Ecol, 70(5),
184-195
Wonghongkul T (2000) The influence of uncertainty
in illness, stress appraisal, and hope on coping in sur
vivors of breast cancer, Cancer Nurs, 23(6), 422-429
Yamada M (2005) Kibou kakusa syakai, 23-70,
Chikuma Syobou (Tokyo)
Yamaki T and Yamazaki Y (2003) : Herth Hope Index
(HHI) nihongoban sakusei no torikumi, Kanja shou
gaisha koureisha oyobi sono kazoku no raifu ni
kansuru kenkyuukai houkoku siryou
Yamamoto K and Onodera T (2002) : Amos niyoru
kyoubunsankouzoubunseki to kaiseki zirei, 2ed., 36-
42, Nakanisiya Shuppan (Kyoto)
Yoshii K, Kondo K, Kuse J et al. (2005) : Social rela-
tionship factors and risk of care requirement in Japa
nese elderly, Jpn J Public Health, 52(6), 456-467
(Received 4.25,2006 ; Accepted 12.11,2006)
 民族 衛 生 第73巻 第1号2007年1月 43

The Herth Hope Index (HHI) and related factors in the

Japanese general urban population

Yuko HIRANO, Mayumi SAKITA, Yoshihiko YAMAZAKI, Kaoru KAWAI, Miho SATO
Jpn J Health & Human Ecology,73(1)31-42, 2007

和文抄録

  本 研 究 の 目的 は,都 市 一 般 住 民 を 対 象 に,ホー プ尺 度 の 口本 語 版Herth Hope Index(HHI)12項 目の 信

頼 性 お よ び 妥 当 性 を 示 した 上 で,HHI得 点 とそ の 関 連 要 因 に つ い て 明 らか に す る こ とで あ る。 東 京 都N区

と埼 玉 県T市 在 住 の20歳 以 上70歳 未 満 の 男 女 各300名 計600名 を対 象 に,無 記名 自記式 質問 紙で の郵

送 配 票 調 査 を 実 施 した.分 析 対 象 者 は255名,有 効 回 収 率 は46.2%で あ っ た.日 本 語 版HHI12項 目 は,

Cronbachα 係 数0.89,確 証 的 因 子 分 析 に よ り3次 元 性 が 示 さ れ,生 きが い 感 とベ ネ フ ィ ッ ト ・フ ァイ ン

デ ィ ン グ と強 い 正 の 相 関 が 認 め られ た こ とか ら,信 頼 性 と構 成 概 念 妥 当 性 は概 ね 示 さ れ た と言 え る.HHI

平 均 得 点 は35.5点 で あ っ た.HHI得 点 の 関 連 要 因 の 検 討 の た め 階 層 的 重 回 帰 分 析 を 行 っ た 結 果,年 齢が

高 い 人 ほ ど,配 偶 者 が い る人 で,ソ ー シ ャ ル サ ポ ー トを提 供 して くれ る人 が 十 分 に い る人 でHHI得 点が 有

意 に 高 か っ た.ま た,年 齢 が 若 い 人 は,ソ ー シ ャル サ ポ ー トの 受 領 が 十 分 に 得 られ る こ とで 年 齢 が 高 い 人

と同 じ レ ベ ル のHHI得 点 を 維 持 して い る可 能 性,女 性 は 男 性 に比 べ て,ソ ー シ ャ ル サ ポー トの 受 領 が よ り

十 分 に得 られ て い る こ とに よ っ てHHI得 点 が 男 性 よ り高 くな っ て い る可 能 性 が 示 され た.逆 境 経 験 と病 い

経 験 とは 有 意 な 関 連 は 見 られ な か っ た.以 上 よ り,重 篤 な 病 い を もつ 人 々 を 対 象 と した 先 行 研 究 と比 べ る
と,本 研 究 で は,一 般 住 民 のHHI得 点 は 決 して 高 い 値 で は な い こ と,HHI得 点 の 特 有 の 関 連 要 因 と して

年 齢 が あ げ られ る こ と,ソ ー シ ャ ル サ ポ ー トの 受 領 はHHI得 点 に 対 して 媒 介 効 果 を も つ こ とが 明 らか に

な っ た.