REVIEW PAPER Hope, older adults, and chronic illness: a metasynthesis of qualitative research Wendy Duggleby, Deborah Hicks, Cheryl Nekolaichuk, Lorraine Holtslander, Allison Williams, Thane Chambers & Jeannette Eby Accepted for publication 28 November 2011 Correspondence to W. Duggleby: e-mail: wendy.duggleby@ualberta.ca Wendy Duggleby PhD RN AOCN Nursing Research Chair Aging and Quality of Life Faculty of Nursing, University of Alberta, Edmonton Alberta T6G 2G3, Canada Deborah Hicks MA MLIS Doctoral Student University of Alberta, Edmonton Alberta, Canada Cheryl Nekolaichuk PhD RPsych Associate Professor Department of Oncology, University of Alberta and Psychologist Palliative Care Program, Grey Nuns Community Hospital, Edmonton Alberta, Canada Lorraine Holtslander PhD RN Assistant Professor College of Nursing University of Saskatchewan, Saskatoon Saskatchewan, Canada Allison Williams PhD CIHR OWHC/IGH Mid Career Scientist, Associate Professor School of Geography and Earth Sciences, McMaster University, Hamilton Ontario, Canada DUGGLEBY W., HICKS D., NEKOLAICHUK C., HOLTSLANDER L., WILLIAMS A., DUGGLEBY W., HICKS D., NEKOLAICHUK C., HOLTSLANDER L., WILLIAMS A., CHAMBERS T. & EBY J. (2012) CHAMBERS T. & EBY J. (2012) Hope, older adults, and chronic illness: a metasynthesis of qualitative research. Journal of Advanced Nursing 68(6), 1211– 1223. doi: 10.1111/j.1365-2648.2011.05919.x Abstract Aim. To report a metasynthesis review of qualitative research studies exploring the hope experience of older persons with chronic illness. Background. Hope is a psychosocial resource used by persons to deal with their chronic illness experience. Data sources. A comprehensive search of multiple databases for studies of the hope experience (published 1980–2010) was completed. Inclusion criteria were included qualitative studies of the hope experience of persons (all genders; mean age 60 years and older), with chronic illnesses, and publications in any language and country. Review methods. The metasynthesis followed four procedural steps: (a) compre- hensive search, (b) quality appraisal, (c) classification of studies, and (d) synthesis of findings. Results. Twenty studies were included in the metasynthesis representing research from a variety of different countries and populations with differing medical diagnoses. The characteristics of hope included: (a) dynamic or situational nature, (b) multiple co-existing types, (c) objects that were desirable realistic possibilities, (d) future- focused, and (e) involvement of choice/will. Hope as ‘transcending possibilities’ represented the integration of two processes of transcendence and positive reap- praisal. Reaching inwardly and outwardly and finding meaning and purpose were sub-processes of transcendence, whereas re-evaluating hope in light of illness and finding positive possibilities were sub-processes of positive reappraisal. Conclusions. The concept of hope may differ for older adults vs. younger adults in its interaction with suffering. Resources for hope are both internal and external. Finding meaning and positive reappraisal are important strategies to help older adults with chronic illness maintain their hope. Keywords: chronic illness, hope, metasynthesis, nursing, older adults, nurses, nursing continued on page 2 Ó 2012 Blackwell Publishing Ltd 1211 JAN JOURNAL OF ADVANCED NURSING