homelessness, hope, Miller's Model, theory-based intervention



  1. Tollett, Jane H. PhD, RN
  2. Thomas, Sandra P. PhD, RN


This quasi-experimental study sought to determine if a specific nursing intervention to instill hope would positively influence levels of hope, self-efficacy, self-esteem, and depression in homeless veterans. Miller's Model of Patient Power Resources served as the conceptual framework from which a middle-range theory of homelessness-hopelessness was derived to guide the study. Homeless veterans completed pretests on admission to a Veterans Affairs Medical Center, were randomly assigned to treatment or waiting control group, and completed posttests at the end of 4 weeks. There was support for the homelessness-hopelessness theory as evidenced by a high level of depression and low levels of hope, self-efficacy, and self-esteem among these homeless veterans. Further support for the theory was seen in the increased levels of hope and self-esteem and decreased depression in veterans who received the nursing intervention. Treatment and control groups differed significantly with regard to hope at posttest.