Experience of hope in older people with chronic illness: A meta-synthesis.

BACKGROUND: The increase in life expectancy has contributed to an increase in the number of older people, but this population has to learn to live with at least one chronic illness. Thus, hope has become an important resource for the older adult to face the repercussions of chronic illness. OBJECTIVE: To synthesise qualitative evidence on the experience of hope in older people with chronic illness. METHODS: This meta-synthesis included qualitative studies which present the experiences of hope in older people diagnosed with at least one chronic illness. The searches were made from six databases, guided by the SPIDER tool. The identified articles were then independently screened by two reviewers. The results were analysed according to the thematic synthesis approach. RESULTS: Eighteen articles were included, and four analytical themes were constructed. The results allow us to understand that older people live with long-term conditions and hope for an ordinary life. To react to new changes and to maintain hope, they create goals that motivate them in daily life. The treatment is initially seen as a salvation, but the information acquired with the evolution of the illness modifies this perception. In addition, the uncertainty about the success of the treatment creates conflict in their hope. In the support and care of older people in the new context of illness, meaningful relationships strengthen hope most of the time. There is still the hope of being reconciled with death, but there are times when suffering overcomes the hope of living. CONCLUSIONS: This meta-synthesis highlights that the experience of hope in older people is dynamic and influenced by the context of changes related to illness, treatment, significant relationships and proximity to death. IMPLICATIONS FOR PRACTICE: A better understanding of the role and characteristics of hope in older people with chronic illness may help to develop more effective interventions to promote and maintain hope.