'Hope as a lighthouse' A meta-synthesis on hope and hoping in different nursing contexts.

BACKGROUND Hope has a contextual dimension and experiences of hope seem to be an important part of everybody's life irrespective of changing and challenging health conditions. However, less focus has been placed on the similarities and differences in the experiences of hope among patients and family caregivers in different contexts of suffering and health, such as the nursing contexts of acute and critical care, rehabilitation and long-term care and prevention and health promotion. AIM This paper focuses on experiences of hope and hoping in different clinical nursing contexts, based on a meta-synthesis of seventeen empirical studies on hope and hoping. These studies highlight experiences of hope and advance our theoretical and clinical understanding of the phenomenon. METHODOLOGICAL FRAMEWORK This study on hope and hoping from seventeen empirical research studies was based on a meta-synthesis, by clarifying and modifying the essence of hope and hoping, aiming to identify the unique conditions in the different clinical contexts. RESULTS A new understanding of the empirical findings emerged from the text: Hope means transformation and hope is indispensable in the acute and critical nursing context, and hope as an inner flame and hope as a lighthouse related to rehabilitation and long-term care. Hope means pushing limits and expanding hope was experienced in the context of prevention and health promotion. CONCLUSIONS According to the findings, dimensions of hope and hoping were always present but also influenced by contextual suffering and losses. IMPLICATIONS FOR PRACTICE Hope means metaphorically a lighthouse, meaning a bright and shining centre, which must be promoted and protected in patients and their families.