Discussion
anxiety, cancer, dementia, depression, Cancer
CANCER, DISEASE, CANCER
The present analysis of 179 caregivers showed no clinically relevant changes in QoL summary scores (SF-36-PCS and -MCS), nor in HADS anxiety and ZBI burden scores, regardless of the allocation group. HADS depression scores significantly increased at M12 and M24 exclusively in the control group, and the mixed models confirmed the mean change results in the control group at M24 (adjusted mean change: 3.4 [0.6–2.5]). No direct comparisons between groups were allowed based on the current sample size.The deterioration in QoL physical sub-dimensions reported by caregivers in the first 2 years of the ICE study is consistent with previously reported results [In the SIG, no significant changes in depression, and less QoL sub-dimensions with significant deterioration were reported, indirectly reflecting a benefit from social worker intervention. Previous studies investigating intervention in caregivers of patients with dementia also reported quite limited but significant decrease in caregiver depression and burden [Caregivers play a critical role and assume in turn several tasks in disease management of patients with cancer [Clinicians underlined difficulties to appropriately identify the primary caregiver [To date, no specific assessment of living conditions, including accurate identification of caregiving is performed at the initiation of patient management, and conducting research on caregivers remains a challenging issue [The innovative and ambitious ICE program received funding from the National research agency and the French National Institute of Cancer and aimed to raise awareness and recognition of the role caregiver, improve self-recognition and support, and consider caregivers as part of the unit of care. Along with large public information campaigns in the last years, incentives to strengthen the relationship between health and humanities and social sciences structures are encouraged. The ICE study focused on the support to be delivered to the still difficult to reach population of caregivers, on an individual level. The study provided useful insights into caregiver characterization. While caregiver depression increased over time in this population, social worker intervention proved promising. These results underlined the critical need to better support caregivers of older patients and urge support to be adjusted with adequate methods, resources, and timing elements. Indeed, social workers reported that they mainly had a role of listening and returned that caregivers had not taken advantage of the full scope of opportunities they may provide. Several assumptions may explain such missed opportunities. The protocol scheduled semester visits that did not correspond to the current social worker practice, usually proposing more closely spaced visits. This may have contributed to limiting the ability of social workers to provide appropriate timely support. More frequent visits, organized at the request of caregivers, would have encouraged the emergence of needs; therefore, caregiver needs could have been more appropriately and efficiently addressed.The term “informal” is largely used worldwide to qualify unpaid caregiving. However, this term may still lack conceptual clarity, and controversial views have been reported highlighting the negative connotation that “Informal” may include, faced with the substantial efforts in supporting and directly caring for patients over a long period of time that the caregivers, identified or not, supported or not, currently provide.Health policy developments and local regulation have already evolved in recent years and have been recognized as essential to provide adequate support to this vulnerable population and new institutional structures have been created to alleviate caregiver burden in France [