Revelation Of Truth Research Articles

Awareness of Disease Status Among Patients With Cancer: An Integrative Review.

As the quality of cancer care improves, oncology patients face a rapidly increasing number of treatment options. Thus, it is vital that they are full and active partners in the treatment decision-making process. Awareness of disease status has been investigated in the literature; it has been inconsistently conceptualized and operationalized. The aim of this integrative review was to develop a conceptual definition and model of the awareness of disease status among patients with cancer. Whittemore and Knafl's integrative review methodology guided this article. We obtained data through a systematic search of 8 databases. Key terms utilized were awareness, perception, truth disclosure, diagnosis, prognosis, terminal illness, status, neoplasm, and metastasis. Dates through January 2020 were searched to capture all relevant articles. Sixty-nine articles met inclusion criteria. The integrative review methodology guided the development of a conceptual definition and model. The concept of "awareness of disease status" was defined as the individual patient's understanding of being diagnosed and treated for cancer based on the multifactorial components of individual patient characteristics and contextually driven communication practices of healthcare providers. This understanding is dynamic and changes throughout the disease trajectory. These findings will inform consistency in the literature. Such consistency may improve person-centered clinical communication, care planning practices, and, ultimately, cancer-related outcomes. With a greater understanding of the complexity of patients' awareness of disease status, nurses will be able to guide their patients to make informed decisions throughout their disease trajectory.

LYMPHATIC DRAINAGE SYSTEM OF THE BRAIN: A NEW PLAYER IN NEUROSCIENCE

The lymphatic system not only plays an important role as a drainage eliminating metabolic wastes and toxins from tissues, but also represents an arena for the unfolding of immune response scenarios aimed at protecting the organism from bacteria and viruses. In the central nervous system (CNS), drainage processes proceed with the same intensity as in peripheral tissues. The brain actively exchanges nutrients with the blood and excretes metabolic waste products through the drainage paths closely related to the peripheral lymphatic system. The same routes allow the traffic of immune cells and antibodies to the CNS, thus providing a communication between the peripheral and central immune systems. Over the two-century history of brain drainage studies, a lot of facts have been accumulated to suggest indirectly the presence of lymphatic vessels in the CNS. However, even with the advent of high-tech imaging of brain structures and a rediscovery of the meningeal lymphatic vessels (MLVs), which was a watershed in neuroscience, scientists have not advanced beyond4 confirming the already existing dogma that the lymphatic network is present exclusively in the brain meninges, but not in brain tissues. In fact, however, the rediscovery of MLVs by American scientists was not a “true revelation”, as they were first described by the Italian anatomist Mascagni two centuries earlier, and his results were confirmed later on in many other studies performed on the meninges in humans, macaques, rodents, dogs, rabbits and zebrafish. As a result, the scientific community did not recognize the “forgotten” MLVs as a new discovery. This review highlights the turning points that occurred in neuroscience, when a new player has entered the game and set in order bicentennial efforts of scientists to explain how unnecessary molecules and toxins are removed from the brain, as well as how drainage and immunity are implemented in the CNS. This is an important informational and creative platform both for new fundamental knowledge about the lymphatic system in the brain, as well as for the development of innovative neurorehabilitation technologies based on the management of lymphatic drainage processes.

Գեորգի Տիգրանովը «Նամուս» օպերայի մասին

The opera was written based on Shirvanzade's novel of the same name. According to G. Tigranov, the high humanistic pathos of the novel, the truthful disclosure of human characters, and the dramatic development of the action motivated L. Khoja-Einatov to write an opera. With its genre features and musical dramaturgy methods "Namous" is a lyrical-psychological opera closely related to the operatic traditions of Tchaikovsky and Rachmaninoff. "Namus" is a lyrical-psychological opera, closely related to the operatic traditions of Tchaikovsky and Rachmaninoff with its genre features and musical dramaturgy methods. A stranger to external effects, Khoja-Einatov strives for the dramatic and psychological justification of every element of the musical texture. The simple and expressive language of the opera is associated with Armenian folk music. Тhe composer does not resort to quoting folk music. Instead, the basis of the folk song is felt in the modal-intonational and metro-rhythmic features of the opera music, giving the latter a national flavor. Folk song forms in opera are enriched with compositional techniques adopted from European and Russian operatic classics. According to G. Tigranov, "Namous" is L. Khoja-Einatov's creative success, his best, artistically most complete, and mature work, and deserves its place in the history of Armenian musical theatre.

Spinoza’s Defense of Democracy and the Emergence of Secularism

Prof. Stephen Strehle’s recent study suggests that modern politics is informed by secularism, which tends to promote hostility toward religion and the desire to purge religion from the public sphere. This essay considers one of the founding documents of secularism and modern political thought, Spinoza’s Theologico-Political Treatise. Spinoza’s account is ambiguous: his theology raises doubts about the truth of revelation even as he argues that salvation, as taught by the Bible, requires the practice of caritas. Spinoza also attempts to separate religion and politics. He grounds political life on universal natural rights and directs it toward the pursuit of comfort and security rather than salvation. This teaching appears to neglect the extraordinary possibilities and peaks of human life, both intellectual and spiritual. Spinoza’s account appears to support Prof. Stehle’s concern that such a single-minded focus on material comfort will lead ultimately to a debasement of humanity, and a confusion or denial of the distinction between high and the low.

Do privacy assurances work? a study of truthfulness in healthcare history data collection.

Patients often provide untruthful information about their health to avoid embarrassment, evade treatment, or prevent financial loss. Privacy disclosures (e.g. HIPAA) intended to dissuade privacy concerns may actually increase patient lying. We used new mouse tracking-based technology to detect lies through mouse movement (distance and time to response) and patient answer adjustment in an online controlled study of 611 potential patients, randomly assigned to one of six treatments. Treatments differed in the notices patients received before health information was requested, including notices about privacy, benefits of truthful disclosure, and risks of inaccurate disclosure. Increased time or distance of device mouse movement and greater adjustment of answers indicate less truthfulness. Mouse tracking revealed a significant overall effect (p<0.001) by treatment on the time to reach their final choice. The control took the least time indicating greater truthfulness and the privacy + risk group took the longest indicating least truthfulness. Privacy, risk, and benefit disclosure statements led to greater lying. These differences were moderated by gender. Mouse tracking results largely confirmed the answer adjustment lie detection method with an overall treatment effect (p < .0001) and gender differences (p < .0001) on truthfulness. Privacy notices led to decreased patient honesty. Privacy notices should perhaps be administered well before personal health disclosure is requested to minimize patient untruthfulness. Mouse tracking and answer adjustment appear to be health care lie-detection methods to enhance optimal diagnosis and treatment.

Disclosure Of Final Stadium Patients' Diagnosis Review From Law And Bioethics In Indonesia

The relationship between doctor-patient rights and obligations, especially in hospitals, cannot be separated from conflicts or disagreements. These conflicts usually occur in special conditions that cause dilemmas in decision-making by doctors. Disclosure of the truth of the diagnosis in terminal patients or those suffering from end-stage disease is an ethical and legal issue that often occurs in health services. Problems occur, where on the one hand if the doctor tells the truth (reveals the truth) regarding the diagnosis/disease and on the other hand the doctor is worried that revealing the truth will have an impact that can worsen the patient's condition such as making the patient more depressed so that the patient can refuse further treatment. . But on the other hand, patients have the right to know information related to their illness. This research was conducted with a normative review approach. The results of this study found that disclosure of the truth about the end-stage disease can cause disturbances in psychological aspects and can potentially affect the patient's quality of life. The legal approach in disclosing the truth of end-stage disease through Law Number 36 of 2009 concerning health, Law Number 44 of 2009 concerning hospitals, and Law Number 29 of 2004 concerning medical practice is not fully the basis for the implementation of doctors in conveying the truth. Therefore, the bioethical aspect approach in this case through the principles of non-maleficence and respect for autonomy, truth disclosure can be done ethically and can minimize the negative impact of truth disclosure.

Розвиток змісту поняття «свобода» в іудаїзмі

Against the background of quite frequent historical periods of physical imprisonment of the Jewish people, this people became the bearer of the Revelation of Truth, which led to the conscious use of freedom of choice in favor of preserving divine gnosis with further ethical direction of freedom. At this stage of the design of the Torah as a collection of sacred books, and the subsequent management of its commandments, the freedom of the individual was sacrificed to the general religious goals of the community. The sacred fear of the greatness of God led to the realization of almost total predestination. The Talmudic and rabbinical currents, which initially continued to cultivate the content of freedom that began in the Torah period, later adopted the anthropocentric ideas of medieval Europe and gradually transformed their religious and cultic positions under the influence of civil liberties. so-called "modern Judaism". The common general orientation of the freedom of the Jewish people has been divided into the political and social freedoms of each individual Jew, where each is responsible for the ethical consequences of his own existence.

A Gadamerian-Hermeneutic Reflection on T. S. Eliot and W. B. Yeats’s Poetics

ABSTRACTThis article investigates the hermeneutical dimension of T. S. Eliot and W. B. Yeats’s poetics vis-à-vis H.-G. Gadamer’s philosophical hermeneutics. The study stems from a remarkable observation that Eliot and Yeats not only anticipate what Gadamer has systematically explained in his philosophical project, but they also present a new kind of poetry that can easily yield itself to a Gadamerian reading—one that is primarily based on the principle of hermeneutical situation and dialogue. The article strives for a critical study that focuses on the relevance of Gadamer’s hermeneutics to reading and interpreting the poetry of Eliot and Yeats, as well as uncovering the underlying kinship between their hermeneutic reflection on the nature of poetry, truth, history, and understanding. The analysis undertaken has yielded interesting results, bestowing Eliot and Yeats as poets-philosophers who are genuinely aware of what Gadamer has advanced in his philosophy. This hermeneutic consciousness ingrained in Eliot and Yeats’s thoughts is the main motive that drives them to experiment with tradition, myth, symbolism, and musicality, in order to provide the reader with dialogic poetry, which Gadamer himself highly admires for its ability to facilitate the disclosure of truth.

EMPATIA: A Guide for Communicating the Diagnosis of Neuromuscular Diseases.

Introduction: Neuromuscular diseases comprise a heterogeneous group of genetic syndromes that lead to progressive muscle weakness, resulting in functional limitation. There is a gap in the literature regarding the communication of the diagnosis of such diseases, compromising the autonomy of patients and families, besides causing stress on the assistant physician. Objectives: Developing a guide to reduce communication barriers in the diagnosis of neuromuscular diseases. Methodology: Systematic review, after searching the descriptors (“Muscular Diseases” OR “Neuromuscular Diseases”) AND (“Truth Disclosure” OR “Bad news communication” OR “Breaking bad News”) in the Pubmed, Bireme, and Scopus websites, and these results were analyzed through narrative textual synthesis. Results: 16 articles were submitted to the final analysis, giving rise to seven steps to support the communication process. These are Empathy, Message, Prognosis, Reception, Time, Individualization, and Autonomy. Discussion and conclusion: The empathic transmission of the message and the prognosis must accommodate the feelings of the interlocutors with different information needs. In this way, communication planning optimizes the time and individualizes each context, respecting the autonomy of those involved. EMPATIA reflects the bioethical and interdisciplinary analysis of the literature and comes to fill the gap related to the communication of bad news in neuromuscular diseases.

Evaluating Methods to Protect Sex Crime Victims’ Privacy: A Legal Analysis of States’ Attempts to Protect Victims’ Identities

Disclosing sex crime victims’ identities without their consent can harm their autonomy, dignity, equality, and intimacy. This article analyzed how state statutes in the United States may protect sex-crime victims’ privacy interests. Several states have allowed punishing printing, publishing, or broadcasting sex crime victims’ identifying information in instruments of mass communication. Such laws have conflicted with constitutional rights when applied to punish truthful disclosures of matters of public significance lawfully obtained from public records. States, at times, may punish government employees for knowingly or intentionally disclosing victims’ identifying information stored in government records. Fewer constitutional concerns arise when states shield victims’ identities with pseudonyms or confidentiality provisions than when states use swords to punish disclosures in instruments of mass communication. Methods to shield victims’ privacy interests may recognize victims’ privacy rights without unduly limiting constitutionally protected expression rights.

The role of rapport in eliciting children’s truthful reports

Children (N = 114, ages 7–13) witnessed a transgressor steal money from a wallet and then asked them to lie about the theft when interviewed by a novel interviewer. During the interview, children were asked to either describe various experienced events (Narrative Practice Rapport-building condition) or participate in an interactive activity designed to focus on the relational aspects of rapport-building including mutual attentiveness, positivity, and coordination between child and interviewer (Interactional Rapport-building condition). Children also completed a measure of rapport to indicate their subjective level of rapport with the interviewer. Older children in the Interactional Rapport-building condition were significantly more likely to be truthful, disclose the transgression earlier, and give more details. Findings provide an initial, exploratory understanding of how the rapport-building phase in eyewitness interviews may play an important role in children’s disclosure decision-making and may be another area to study to promote more truthful disclosures.

A comparative investigation of clients' attitudes toward breaking bad news to patients with cancer

Background: Truth disclosure is one of the major challenges for physicians with cancer patients. The attitude toward breaking news adopted by individuals depends on their cultural background. The present study was conducted at Ardabil University of Medical sciences, Ardabil, Iran, to investigate the attitudes of Turkish-speaking patients with cancer and their families to the disclosure of bad news. Materials and Methods: The present descriptive cross-sectional study used convenience sampling to select 62 patients, 76 family members of young and 58 children. The mean age of the patients was 37.29 years, and their majorities were 32-42 years old. The data were collected using the questionnaire proposed by Managheb et al., which included six dimensions, i.e., suitability of the person, suitability of the time, the place, factors affecting the delivery of bad news, amount of disclosed information, and acceptance. Results: Despite the insignificant differences in the total score of attitude between the groups (P=0.23), significant differences were found in terms of suitability of the time (P=0.017) and affecting factors (P=0.007) between children's families. Also, in parents of children, employment made truth acceptance better (p=0.04). The acuteness of the disease increased the total attitude score in all the participants (P=0.047). Significant relationships were also observed between age and accepting truth (P=0.045), male gender and place of disclosing the truth (P=0.004), male gender and amount of disclosed information (P=0.043), as well as owning a house and accepting truth (P=0.002). Moreover, education was negatively related to the person for truth disclosing (P=0.036) and factors affecting the truth disclosing (P=0.015). Conclusion: There are different circumstances and economic impacts in children's families on their tolerance. Given the difficulty of disclosing the truth to the employee and highly-educated individuals, it is recommended that health workers consider individual conditions in these circumstances.

Exiles by James Joyce

Reviewed by: Exiles by James Joyce Valérie Bénéjam (bio) EXILES, by James Joyce, edited by Keri Walsh. Oxford: Oxford University Press, 2021. lii + 128 pp. $49.90 cloth, $11.95 paper. From the first page of her introduction, it is clear that Keri Walsh does not believe spoilers can truly impair the reading experience. This is probably a healthy approach to Joyce's work in general, and to Exiles in particular. The opening of her presentation seems to unveil too much, and yet it raises a series of questions, which Walsh will deftly return to with more information as she guides us through biographical elements and through the many critical debates that have been raised by this hermeneutic quandary of a play. For of course, Walsh tells us all, tells us now, and cannot tell us anything really, since the core of the matter—the consummation of adultery between Bertha and Robert, which may, or may not, have taken place in the ellipsis between the second and the third act—has to remain a topic for "restless living wounding doubt" (97). As Joyce remarked in the Notes he wrote when composing the play, "[t]he doubt which clouds the end of the play must be conveyed to the audience not only through Richard's questions to both but also from the dialogue between Robert and Bertha."1 Indeed, the short exchange between the two potential lovers is rendered almost absurd due to their apparent incapacity to know themselves what they have done: robert [Catching her hands.] Bertha! What happened last night? What is the truth that I am to tell? [He gazes earnestly into her eyes.] Were you mine in that sacred night of love? Or have I dreamed it? bertha [Smiles faintly.] Remember your dream of me. You dreamed that I was yours last night. robert. And that is the truth—a dream? That is what I am to tell? bertha Yes. (91) We get a good sample here of the serious, irony-free tone of the play, and of the reason why it has so many Joyceans cringe in embarrassment. That "Yes" is a long way from Molly's powerful combination of affirmation and abandonment. Two earlier plays written by Joyce have both been lost, but we know they were entitled A Brilliant Career and Dream Stuff,2 perhaps a sign that Joyce's own "brilliant career" as a dramatist was to remain "such stuff/As dreams are made on."3 In truth, the quality of Joyce's only extant play is debatable, and has been much debated. Exiles, however, is not just a pale imitation of Henrik Ibsen: it is much more modern, particularly in its playing with audience expectations of revelations, [End Page 349] and in its replacing the theme of the inevitable disclosure of truth with an ethics—a theology almost—of eternal doubt.4 However, for all the brilliant analyses of Exiles so many Joyceans have put forward—and Keri Walsh has done an equally brilliant synthesis and provided an excellent selected bibliography—the text itself remains as infuriating as it has always been. Its main character's sadistic confessor's tones are insufferable from beginning to end,5 and the submission of everyone else to his superior intellect smacks of Prospero's controlling obsessions without William Shakespeare's richness of plot or verbal inventiveness. Indeed, part of the problem with Exiles might be the reserved behavior and noble language of its main characters, and the lack of an equivalent to Caliban's rebellious "[y]ou taught me language, and my profit on't/Is, I know how to curse. The red-plague rid you/For learning me your language!" (I.ii.363-64). Similarly, Richard's "[t]he isle is full of voices" (84) gives but a poor summary of Caliban's poetic flight: "the isle is full of noises,/Sounds, and sweet airs, that give delight and hurt not./Sometimes a thousand twangling instruments/Will hum about mine ears; and sometimes voices" (III.ii.135-38). In fact, the play's language might be the problem in the problem play that is Exiles. For all its autobiographical content and...

Tarihsel ve Çağdaş Yönleriyle Heterodoks Dinî Bir Kimlik Olarak Deizm

Deism from the beginning has positioned itself as a heterodox religious identity contrary to orthodoxy. In this regard, it is the review of established classical theological presuppositions regarding the following headings: conception of God; God-world relationship; religion-science relationship; ethical considerations regarding the problem of evil, etc. In these contexts, deism could be seen as a sort of religious self-criticism. As arose in British philosophical-theological circles, deism sounds to have resisted some conventional Christian presuppositions as put forward by E. Herbert of Cherbury, the father of English deism, in the forthcoming articles: “There is a supreme God. This sovereign deity should be worshipped. Virtue arises from the piety created by this worship. As the man is filled with wickedness, he needs repentance, which means communication with this sovereign Being. There is reward or punishment in the life to come.” In the course of time, different kinds of deisms turned up, ranging from accepting God as a sublime creator alone and rejecting revelation, i.e., institutional religion, to those accepting religion on the condition that it should be compatible with reason. Samuel Clarke mentions the arguments of different kinds of deists and skillfully criticizes them. Historical and contemporary deism have the following in common: “The compromise between truth of revelation and truth of reason; saving knowledge versus saving faith; rejection of institutional structures; glorification of reason and human nature; ethical rationality.” With this doctrinal backdrop, hot debates on deism in Turkey have recently gotten new dimensions. Figures showing the rise of deism in recent years under an Islamist political rule makes the case all the more thought-provoking. The visibility of religion in the public sphere has increased, and the rate of religiosity would also be expected to increase. However, the result is quite the opposite. There is a widespread and remarkable secularization in conservative circles. After they got the political power and economic welfare, which enabled them to attain worldly glory, they have gradually left religious glory behind and glorified profanity. In this case, deism seems to take the form of secularized orthodoxy. Deists in Turkey, rather than rejecting revealed religion they want it to be compatible with reason, to demythologize it from supernatural narratives, and to find a way of getting rid of fanatical elements in the religion. They want to replace religious institutional authority with the authority of reason, which rests itself on innate ideas and a priori truths. They claim ethical rationality, which means ethical truths are accessible through reasoning. My study tackles some statistical data specifically signifying why youngsters tend to claim to be deists. Some surveys among high school students have been included in the study and due evaluations have been made. It seems sectarian identities, radical voices, authoritative religious language, blockades to freedom of speech, a dichotomy between religious and scientific facts in the curricula and mythological religious language are among the reasons counted by the youngster to reject conventional religion and embrace deism. The mainstream theological tradition of Islam is quite familiar with deistic claims. The discussions on deism will finally bring the enlightened minds together with the reasonable religious line.

Truth Disclosure at the End of Life: A Qualitative Study of Internal Medicine Residents in the United Arab Emirates.

Respect for patient autonomy has become the guiding biomedical ethical tenet in the West; yet, moral values are contextual and culturally relevant. In the collectivist society of the Middle East, families and physicians have historically believed that concealing truth about a terminal illness is more ethical and compassionate. Recent studies reveal a trend toward truth disclosure. To gain insight into resident experiences with, and barriers to, truth disclosure in terminally ill patients in the United Arab Emirates (UAE). Focus group interviews were conducted with first through fourth year internal medicine residents and recent graduates at two large academic medical centers in the UAE. Qualitative thematic content analysis was used to identify themes related to communication and truth telling in end-of-life care. Residents revealed that non-disclosure of medical information in serious illness is a common practice in UAE hospitals. Barriers to truth telling include family objection, deficits in medical training, and inconsistently implemented institutional guidelines. Educational and policy interventions are needed to improve physician-patient communication, decrease patient-family-physician tension, and alleviate trainee moral distress.

Neustadt a.d. Aisch

The historical reappraisal of the German past is a continuous process. The concept of Vergangenheitsbewältigung is an integral part of the society, especially considering the political climate drifting slowly but steadily toward right-wing belief. However, there is a noticeable difference in approaching the past on the collective level or the individual level. While the collective is constituted and established in the public sphere, the individual is operating within the private realm. The work depicts the process of uncovering unexpected facts within the family. The three-channel audio-visual installation conceptualizes the revelation of an uncomfortable truth inside a family in two separate conversations, held between the wife and granddaughter, and the daughter and granddaughter of the deceased family member. Both conversations are captured in alternating audio tracks over the same visual.

A Simple Model of Corporate Fiduciary Duties: With an Application to Corporate Compliance

Abstract This article models the duty of care as a response to moral hazard where the principal seeks to induce effort that is costly to the agent and unobservable by the principal. The duty of loyalty, by contrast, is modeled as a response to adverse selection where the principal seeks truthful disclosure of private information held by the agent. This model of corporate loyalty differs importantly with standard adverse selection models, however, in that the principal cannot use available contracting variables as a screening mechanism to ensure honest disclosure and must rely upon the use of an external third-party audit technology, such as the court system. This article extends the model to the issue of corporate compliance and argues that the optimal judicial approach would define the duty to monitor as a subset of due care – and not loyalty – but hold that the usual legal protections provided for due care violations no longer apply.

Sejarah Sosial Reformasi Pendidikan Islam

Abstract; This paper will describe the meaning of Islamic education reform, the real condition of Muslims, The outline of Islamic education reform. Along with changes in state configuration and political reforms in several Islamic countries that often occur in Islamic countries or countries with a majority Muslim population also have an impact on changes in educational formation where these changes occur. An inevitability is that where there is a change there are also challenges in the conditions of that change. In this case the Islamic State we mean there are two first terms, the Islamic State in the sense of a State whose principles and laws use Islamic teachings as sources.
 In the Middle Ages, Islam in a period of decline, Western hegemony almost occurred in all Muslim-majority countries. The Muslim community is starting to realize the situation they are facing. Especially the backwardness of Islam in developing outside the truth of revelation. Islamic countries were colonized by Europeans.
 Therefore, Muslims are forced to let go of the shackles and stranglehold of the west. With that, the Islamic community began to overhaul the pattern of thinking through educational institutions. Here, it is hoped that Muslims will start thinking about the independence of the nation, political culture and education

Knowledge, attitudes and preferences of palliative and end-of-life care among patients with cancer in mainland China: a cross-sectional study

ObjectivesThis study aimed to investigate the knowledge and attitudes of patients with cancer of palliative care and their preferences regarding end-of-life care in mainland China.DesignA cross-sectional study.SettingThis study was conducted...

The experiences of health professionals, patients, and families with truth disclosure when breaking bad news in palliative care: A qualitative meta-synthesis.

Disclosing the truth when breaking bad news continues to be difficult for health professionals, yet it is essential for patients when making informed decisions about their treatment and end-of-life care. This literature review aimed to explore and examine how health professionals, patients, and families experience truth disclosure during the delivery of bad news in the inpatient/outpatient palliative care setting. A systemized search for peer-reviewed, published papers between 2013 and 2020 was undertaken in September 2020 using the CINAHL, Medline, and PsycInfo databases. The keywords and MeSH terms ("truth disclosure") AND ("palliative care or end-of-life care or terminal care or dying") were used. The search was repeated using ("bad news") AND ("palliative care or end-of-life care or terminal care or dying") terms. A meta-synthesis was undertaken to synthesize the findings from the eight papers. Eight papers were included in the meta-synthesis and were represented by five Western countries. Following the synthesis process, two concepts were identified: "Enablers in breaking bad news" and "Truth avoidance/disclosure." Several elements formed the concept of Enablers for breaking bad news, such as the therapeutic relationship, reading cues, acknowledgment, language/delivery, time/place, and qualities. A conceptual model was developed to illustrate the findings of the synthesis. The conceptual model demonstrates a unique way to look at communication dynamics around truth disclosure and avoidance when breaking bad news. Informed decision-making requires an understanding of the whole truth, and therefore truth disclosure is an essential part of breaking bad news.