Structuring the meaning of hope in health and illness.

The purpose of this paper is to describe a conceptual model for hope that captures 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 approach for quantifying personal or connotative meaning. This tool was distributed in the form of a questionnaire to a voluntary sample (n = 550), consisting of three primary subsamples: a healthy adult subsample (n = 146), a chronic and life-threatening illness subsample (n = 159) and a nursing subsample (n = 206). A multidimensional structure for the concept, Hope, was identified, using principal components analysis. Three primary factors defined this structure: personal spirit (personal dimension), risk (situational dimension) and authentic caring (interpersonal dimension). Personal spirit, a dominant factor, is characterized by a holistic configuration of hope elements, revolving around a core theme of meaning. Risk is primarily a predictability factor, targeted with an underlying component of boldness. The authentic caring factor has a substantial credibility component, linked with the theme of comfort. Three distinctive features characterize this model: (a) its ability to capture the dynamic qualitative experience of hope within a holistic multidimensional quantitative framework, (b) its representation of hope as a location in three-dimensional space and (c) its sensitivity to individual and group variability. This integrative model deepens our understanding of the experience of hope within health and illness at the theoretical, clinical and methodological levels.