Purpose/Objectives-The purpose of the study was to examine the patient and family caregiver variables that predicted caregiver burden and depression for family caregivers of patients with cancer at the end-of-life.Design-A prospective, longitudinal study was implemented with an inception cohort of patients and their family caregivers who were followed after the diagnosis and treatment of cancer. Data were analyzed using quantitative methods to determine the effect of caregiver age, sex, education, relationship to the patient, employment status, reports of patients' symptoms, patient cancer type, stage of cancer, and time from the patient's diagnosis to death on caregiver burden and depression at the patient's end-of-life. This report examines the experiences of family caregivers whose patients died during the study. Setting-Patients and caregivers were accrued from community oncology sites in the Midwestern United States.Sample-152 family caregivers of patients with cancer who died during the course of the study.Methods-Telephone interviews with patients were conducted at 6-8 weeks, 12-16 weeks, 24-30 weeks, and 52 weeks following patients' diagnoses. In addition, patient medical records and state death certificates were reviewed.Findings-Caregivers aged 45-54 reported the highest levels of depressive symptoms; caregivers aged 35-44 reported the strongest sense of abandonment. Caregivers who were the adult children of patients with cancer and who were employed reported high levels of depressive symptoms. Feeling abandoned (a portion of caregiver burden) was more prevalent in female, non-spouse, and adult

Cancer patients diagnosed with solid tumors and undergoing a first course of chemotherapy were randomized to either conventional care or a 10 contact 20 week cognitive behavioral intervention designed to reduce emotional distress. Three hypotheses were tested. First, a test for a group effect found that patients in the intervention who entered the trial with higher symptom severity reported significantly lower depression at 10 but not 20 weeks. Patients in the experimental group who entered with higher depression were more depressed at 10 weeks than patients in the control group. The second hypothesis compared the intervention in two sub-indices of symptom severity; one comprised of symptoms with a depressive component, the other of symptoms not associated with depression. The intervention was more effective in lowering depression at 10 weeks through an interaction with the non-depressive symptom sub-index. At 20 weeks, a significant main effect for the intervention on depression was observed. No interaction with either sub-index was observed. The third hypothesis found no main or interaction effect between psychotropic drugs and the intervention. In conclusion, behavioral interventions may influence depression differently over time. Initially, the intervention lowered depression through certain symptoms and only later did it effect depression directly. Symptoms with an affective component are relatively unaffected by the intervention which was independent of the presence of psychotropic medications.

Within an increasingly global marketplace, discussions of intercultural communication are important in business and technical communication classrooms. Although many business and technical communication textbooks integrate discussions of intercultural communication, they do not go far enough in engaging the complicated nature of this issue. This article summarizes recent literature about the importance of paying attention to intercultural communication and analyzes the productive approaches in popular business and technical communication textbooks. It presents five challenges for business and technical communication teachers to consider and includes teaching modules that address these challenges. Although the article focuses on classroom practice, such intercultural explorations are also of value to authors of business and technical communication textbooks, who might consider integrating modules such as these into their textbooks.

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