The aim of this study was to develop a meta-synthesis of nursing research about hope as perceived by people during sickness and by healthy people. A meta-synthesis does not intend to cover all studies about hope; rather it tries to synthesize qualitative findings from different contexts, cultures and times to provide a global picture of the phenomenon under study. Noblit and Hare's meta-ethnographic approach was used. The approach is a systematic comparison of studies where each study is translated into the other. Data were 15 qualitative studies published in nursing or allied health journals and conducted in USA, Great Britain, Canada, Australia, Norway, Sweden and Finland. The meta-synthesis resulted in six metaphors that illustrate dimensions of hope. These metaphors permeated the experiences of hope regardless of whether the human being was healthy, chronically or terminally ill. They comprise the complexity of hope and were: living in hope, hoping for something, hope as a light on the horizon, hope as a human-to-human relationship, hope vs. hopelessness and fear: two sides of the same coin, and hope as weathering a storm. Knowing the multidimensionality of hope and what hope means from the patient's perspective might help nurses and other healthcare professionals to inspire hope as Florence Nightingale did when she walked with the lamp through the dark corridors and spread hope and light to the patients. We suggest that nurses working with patients with serious conditions such as cancer reflect on the meaning of the metaphors.

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The use of drawings in clinical situations might give cancer nurses new perceptions of hope and other phenomena. Patients might feel threat and despair when diagnosed with cancer; they need gentle truth about reality, and they long for being together with loved ones. Nurses are in a unique position to enable hope in this situation through listening and active engagement. Drawing might be a tool in understanding the hope. Drawings picture where words come short.