•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 living in Tokyo "N" ward and Saitama "T" township aged 20-69. The

Cronbach a coefficient was 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 reliability and 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 population are 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

‡T Introduction

In the early 1990s, the industrial structures of

developed countries around the world underwent a

profound transformation as the result of burgeon-

ing globalization and advances in information

technologies. In Japan, the "bubble economy" that

was the pinnacle of unprecedented post-war eco-

nomic growth collapsed. These socioeconomic

changes were accompanied by the destabilization

of existing social norms such as a decline in long-

term stable employment, an increase in unemploy

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

viduals ("Not in Employment, Education, or Train-

ing"), crimes by minors, and violent crime. The

incidence of suicide climbed to 30,000 cases yearly

(National Police Agency, 2006). As a result, mod

ern Japanese society has been described as involv-

ing "Kibou kakusa syakai" ("social disparities in

hope") and "Kibou soushitu jidai" ("loss of hope")

(Yamada, 2005).

Meanwhile, the concept of "hope" has been gar-

nering interest on a worldwide scale in the fields

of psychology, nursing, and social sciences (Yama-

Department of Health Sociology, Division of Health and Nursing Sciences, Tokyo University Graduate School of Medicine

32 Jpn J Health & Human Ecology 2007;73 (1)

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 Yamaki and 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.,

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.

33Jpn 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

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 2007;73 (1)

embraced any dreams for their future using a 2-

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 "None," "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 significant injury 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." For

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.

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-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 following completion of the analysis. The return of

the survey instrument, which was optional, was

35Jpn J Health & Human Ecology

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-

pate in the study.

‡V Results

1, HHI Factor Structure and Concurrent

Validity

The a coefficient for the HHI was 0.89. One fac-

tor with an eigenvalue of 1 or above was obtained

from exploratory factor analysis (principal factor

analysis, promax solution) of the 12 HHI questions.

Eigenvalue contribution was 45.1%. Next, we per-

formed a confirmatory factor analysis on a model

consisting of the three factors proposed by Herth.

The results of this analysis were goodness of fit

Index (GFI) : 0.928 ; comparative fit index (CFI)

0.937 ; and root mean square error of approxima

tion (RMSEA) : 0.073 (results shown in Fig. 1).

GFI and CFI are used to assess model fitness,

while RMSEA is used to assess stability (Yama

moto and Onodera, 2002).

To study concurrent validity, we performed a par

tial correlation analysis between the HHI score

and several potentially analogous concepts, while

controlling for gender and age (results shown in

Table 1). Survey items found to have a strong sig

nificant correlation with HHI score (p<0.001)

were, in descending order, reasons for living (r=

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

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).

3. Factors Related to HHI

Next we evaluated factors that correlated with

the HHI score. Table 3 shows the ANCOVA and

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,

37Jpn 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

multiple linear regression. Also, presence of chil-

dren was highly correlated with marital status and

was potentially multicolinear, so this factor was

excluded from analysis.

In Model 1, the independent variables employed

were demographic attributes and a history of

stressful experiences. Female sex (,6 =-0.162, p=

0.020) and the presence of a spouse (/3 =0.285, p

<0.001) were correlated with significantly higher

HHI scores.

In Model 2, we included social support networks

in the analysis in addition to factors used in Model

1. We found a correlation between higher HHI

scores and increasing subject age (/3 =0.134, p=

0.043). HHI scores were also extremely high in

subjects reporting sufficient sources of support

compared to those with no such sources of support

(3 = 0.442, p<0.001). Incorporating the number

of sources of support into the model was sufficient

to eliminate the significant correlation of the other

two social support variables. HHI scores were con-

38 Jpn J Health & Human Ecology 2007;73(1)Table 4 A stratified multiple linear regression analysis of HHI score with patient attributes, stressful experiences, and social supportNotes:*:P<0.0*P<0.05**:P<0.01***:P<0.001

39Jpn J Health & Human Ecology

sistently high for those married regardless of

social support variables (a =0.237, p<0.001).

Finally, correlations between HHI scores and gen-

der disappeared in Model 2.

‡W Discussion

1, Reliability and Validity of the Japanese

HHI in a General Urban Population

The HHI a coefficient was 0.89, demonstrating

high internal consistency.

To study validity we performed exploratory fac-

tor analysis on the 12 HHI questions, which dem

onstrated unidimensionality. Previous HHI

research has used exploratory analysis to elucidate

factor structure In 1992 Herth identified the

three HHI-related factors of "inner sense of tempo

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

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

Herth's three factors and proved goodness of fit.

The Japanese version of the HHI 12 is composed

of the same three factors as the original instru-

ment and demonstrates factorial validity.

In evaluating concurrent validity, we found that

the HHI has corellates strongly with the presence

of reasons for living, with r value at 0.729, followed

next in significance by benefit-finding, dreams,

psychological comfort, PHCS, and satisfaction with

social roles. This demonstrates concurrent validity

in this study of the HHI, which consists of the

three factors described above, and suggests that

the HHI is a measure of coping strategies or the

internal psychosocial resources necessary to main

tain a positive outlook in the face of adversity and

stress.

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

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 2007;73 (1)Jpn J Health & Human Ecology

patients (n115) (Herth, 2000), 39.0•¬4.3 for US

terminal patients (n=20) (Herth,1990), 37.3±5.3

(n=226) (Chen, 2003) and 32.5±4.2 (n=233) (Lin

et al., 2003) in studies of Taiwanese cancer

patients, 41.6 •¬ 5.4 for Thai breast cancer patients

(n=71) (Wonghongkul, 2000), 37.8±7.0 for eld-

erly Japanese (n=87) (Koizumi et al., 1999), 33.9±

5.1 for adult laborers (n=1,909) (Konishi and

Esaki, 2004), and 32.16•¬7.68 for ALS patients on

invasive mechanical ventilation (n=157) (Hirano et

al., 2006). While we did not investigate the cause

of this finding, we can postulate that it may demon

strate the ability of individuals in adverse situa

tions to adapt to and cope with illness-related diffi

culty through the maintenance of hope.

•@In order to investigate factors correlated with

the HHI score, we first performed a preliminary

bivariate analysis of factors thought to affect the

HHI score-demographic attributes, stress, and

social support-with the HHI score, after which

we performed a stratified multiple linear regres-

sion analysis. The final model showed that higher

HHI scores were significantly correlated with

higher age, presence of a spouse, and sufficient

psychosocial support.

•@In Model 1, women were found to have signifi

cantly higher HHI scores than men. However, in

Model 2 (which incorporated social support) we

observed a significant score correlation with the

number of people offering social support, while the

correlation with gender disappeared. This result

explains the higher HHI scores seen in women,

who receive greater support, than men. Higher

HHI scores have been previously reported in

women (Konishi and Esaki, 2004), and our data

suggest this outcome may be mediated by social

support parameters. Other research has shown

that women enjoy superior social support net-

works because for women these networks are

broader (Yoshii et al., 2005) and because only for

women has the provision of social support been

shown to result in higher life satisfaction (Kin et

al., 1999). This previous work suggests that clear

positive benefits of social support may exist women that may not exist for men, a conclusion

supported by our study as well.

Model 1 showed no correlation between HHI

score and age, but a significant correlation did

appear in Model 2. Previous research has shown

no consistent pattern of correlation between age

and hope (Herth,1992 ; Konishi and Esaki, 2004

Wonghongkul, 2000) ; this study showed a signifi

cant correlation only when social support was fac

tored in. In our sample of the general urban popula

tion, younger subjects showed a tendency towards

lower HHI scores except when they enjoyed suffi

cient social networks-in these cases their HHI

scores were as high as older subjects. Reasons

that advanced age was associated with higher HHI

are thought to include freedom from the burdens

of work and childcare and increased latitude in

terms of finances and time.

Marital status showed a strongly significant cor-

relation with HHI score regardless of age or

gender. This result is in agreement with previous

research (Herth,1992 ; Konishi and Esaki, 2004).

We also found no significant correlations

between HHI score and illness or adversity. Previ-

ous research involving patients with severe dis

ease has shown that lower levels of HHI are corre-

lated with illness-related experiences and distress

(Chen, 2003 ; Herth, 1992 ; Hirano et al., 2006;

Lin et al., 2003 ; Wonghongkul, 2000). This is

likely because severe illnesses create suffering

that may persist intermittently up until the time of

the HHI survey itself. In contrast, the survey ques

tion asked whether such adversity had been experi

enced in the past three years, a relatively long

period that allowed for the suffering associated

with the experience to dissipate. This may explain

41Jpn J Health & Human Ecology

the lack of a correlation found between illness,

adversity, and physical limitations and the HHI

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,

1992), and the positive correlation between social

support and hope has been well established (Herth,

1990 ; Herth, 2000 ; Hirano et al., 2006). This

study supports this conclusion and is the first

research to elucidate a mediating effect between

the receipt of social support and hope, thus under-

lining the importance of such support as a echa-

nism for improving hope in the general population.

3. Limitations of the Study and Future

Directions

There are several limitations to the current

study. First, the cross-sectional nature of the

study prevented us from establishing causal rela

tionships between the various factors identified

and HHI scores. To further elucidate the concept

of hope in the general urban population, we antici

pate longitudinal studies to carry this research

forward. Further, the subjects in this study were

all located in urban or suburban areas with large

population concentrations ; the further generaliz

ability of our results may be investigated in the

future by studying a more diverse subject sample

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

We would like to express our gratitude to the

respondents who took the time to participate in

our survey, as well as to our fellow graduate stu-

dents and other individuals whose invaluable assis

tance made this study possible.

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(Received 4.25,2006 ; Accepted 12.11,2006)

43民族衛生 第73巻 第1号2007年1月

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.