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Hopelessness can affect any patient population and be more detrimental to the patient than the disease process itseíf. Literature supports the idea that prolonged hopelessness can lead to death (Kubler-Ross, 1969; Sobel, 1979). By being knowledgeable about the diagnosis of hopelessness and its defining characteristics, nurses may make the diagnosis before hopelessness becomes irreversible. Nursing interventions can then be developed to increase the client's hope.
The North American Nursing Diagnosis Association (NANDA) recently (1987) accepted hopelessness for further study and validation. Due to the possible serious effects of this diagnosis upon any patient population and the relative recency of its introduction by NANDA, hopelessness was chosen for study. This article describes a study in which Fehring's (1986) Model of Content Validity was used to validate the diagnosis of hopelessness using the defining characteristics developed by NANDA. Diagnostic content validity (DCV) was established and the appropriate calculations were done. Depending upon the scores, defining characteristics were either labeled as critical, important but not critical, or were recommended to be discarded. Further recommendations are made for the diagnosis and its characteristics on the basis of this study.
Literature Review
Hopelessness has been defined in many ways. Schneider (1985) defined it as "An emotional state displaying the sense of impossibility, the feeling that life is too much to handle, and apathy." Limandri and Boyle (1978) referred to it as "Giving up the will to live." P1JANDA (1987) defined it as a "Subjective state in which an individual sees limited or no alternatives or personal choices available and is unabfe to mobilize energy on own behal f . " As these definitions illustrate, there is a vagueness and a broadness to the concept of hopelessness.
Observable characteristics of hopelessness can also be vague. In three studies (Lange, 1978; Limandri, 1978; Miller, 1985), several characteristics were found in patients with the diagnosis of hopelessness. They appeared depressed, passive, and apathetic about their care. They were quiet, withdrawn, and offered little resistance or help with their care. However, as Limandri and Boyle clarified, patients may feel depressed but not necessarily hopeless. Lange also found a sense of incompetence in these patients which he described as feeling unable to accomplish anything or feeling overwhelmed by life. The defining characteristics according to NANDA...