Document Type

Thesis - Open Access

Award Date


Degree Name

Doctor of Philosophy (PhD)


Graduate Nursing

First Advisor

Kay Foland


factor analysis, health-promoting behaviors, health-related quality of life, hope, Parkinson's disease


Objective: The purpose of the study was to determine the relationship between hope, health-promoting behaviors, and health-related quality of life (HRQOL) in persons with Parkinson’s disease.
Background: The incidence of Parkinson’s disease is high in Midwest and Northeast regions of the United States. Parkinson’s disease affects motor and non-motor symptoms and has a variety of complications. Parkinson’s disease is related to genetic and environmental factors. HRQOL decreases in Parkinson’s disease; thus, the effect of hope and health-promoting behaviors on health is crucial as the disease advances.
Methods: A descriptive correlational design was used to guide the study. A convenience sample of persons with Parkinson’s disease who completed three questionnaires was used to measure health-promoting behaviors and HRQOL while modifying for disease severity.
Results: Exploratory factor analysis was used to examine dimensions of hope, healthpromoting behaviors (HPLP), and HRQOL. Confirmatory factor analysis determined goodness of fit for the structure of the study data. The construct reliability of the confirmed factor structure model showed an adequate inter-item consistency (Cronbach’s alpha 0.70, QOL = .792, HPLP = .857, and hope = .844). After meeting the assessment of the reliability test, convergent validity, discriminant validity and confirmation of model fit of the factor model, a summated scale or a composite variable was created. The summated scale variables met five assumptions of the multivariate regression method to assess for appropriateness of method used. Finally, a path analysis was constructed where together hope and HPLP explained about 62% of the variation of scores within the dependent measure in HRQOL. Hope became non-significant statistically, with the inclusion of HPLP. Effects of varying stages of disease severity and its relation to the direct effects of hope and HPLP to the dependent measure in HRQOL was contemplated.
Conclusions: This study advances knowledge regarding the relationship between hope, HPLP, and HRQOL in persons with Parkinson’s disease. The increased knowledge raises awareness of the importance of hope and health-promoting behaviors despite various stages of disease severity.

Library of Congress Subject Headings

Parkinson's disease.
Health behavior.
Quality of life.
Health promotion.
Factor analysis.


Includes bibliographical references (pages 116-136)



Number of Pages



South Dakota State University


Copyright © 2017 Amy K. Forbes

Included in

Nursing Commons