title: A caregiver educational program improves quality of life and burden for cancer patients and their caregivers: a randomised clinical trial.
abstract: OBJECTIVE
  The French setting, including laws and guidelines, advocates greater involvement of informal caregivers in the care of cancer patients to protect the caregivers from depression, distress, and a decrease in their quality of life. This study aimed to assess the efficacy of a caregiver educational programme by measuring two outcomes: patients' and caregivers' quality of life and caregivers' burden.
  
  
  METHODS
  A multicentre randomised controlled trial was performed in six oncology wards in French hospitals. Eligible patients had a cancer, a main caregiver, allowed their caregivers' involvement, and received an inclusion agreement by a doctor/psychologist dyad. The experimental group participated in an educational programme performed by nurses to improve their skills in meal support, nursing care, welfare care, or symptom management. The SF36 and the Zarit burden scales were used to measure quality of life and caregivers' burden at the beginning and at the end of the study.
  
  
  RESULTS
  67 patients were randomised and 33 were included in the experimental group. Evolution scores, which measured the difference between baseline and final scores, showed an improvement in patients' and caregivers' quality of life and an alleviated burden for experimental group caregivers.
  
  
  CONCLUSIONS
  An educational programme for caregivers encourages the involvement of patients, informal caregivers and health-care providers in a triangular relationship which enhances the quality of life of patients and caregivers alike and decreases caregivers' burden. Care organisation should therefore be rethought as a triangular relationship between patients, caregivers and health-care providers, with nurses as the mainstay.
authors.affiliation: CHU Clermont-Ferrand, Service de Santé Publique, F-63003 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 4681, PEPRADE, F-63000 Clermont-Ferrand, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Belgacem
authors.forename: Candy
authors.initials: C
authors.lastname: Auclair
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Fedor
authors.forename: David
authors.initials: D
authors.lastname: Brugnon
authors.forename: Marie
authors.initials: M
authors.lastname: Blanquet
authors.forename: Olivier
authors.initials: O
authors.lastname: Tournilhac
authors.forename: Laurent
authors.initials: L
authors.lastname: Gerbaud
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000193:education* / Q000523:psychology; D017281:Cost of Illness; D003479:Curriculum; D005260:Female; D005602:France; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000628:therapy*; D015397:Program Evaluation; D011788:Quality of Life; D012016:Reference Values; D012944:Social Support; D018709:Statistics, Nonparametric
keywords: Burden; Cancer; Caregivers; Educational programme; Quality of life