The Caregiver Thoughts Scale: An Instrument to Assess Functional and Dysfunctional Thoughts about Caregiving

ABSTRACT

Objectives

Caregivers’ care-related thoughts critically effect their well-being. Currently, there is a lack of validated measures to systematically assess caregivers’ functional and dysfunctional thoughts. We therefore aimed to develop a measure of caregivers’ thoughts that assesses not only their dysfunctional but also their functional thoughts in multiple domains.

Methods

A pool of potential questionnaire items was generated from therapy sessions with caregivers and was rated by experts. A sample of 322 main family caregivers (M_age = 63.9 years) of a person with dementia then completed a set of 28 items about their care-related thoughts and a number of related measures at three measurement points. Items were then aggregated via a formative measurement approach based on theoretical considerations. Correlational analyses were used to examine the construct validity of the subscale scores.

Results

The final 28-item scale assesses caregiving thoughts in four distinct domains: dysfunctional caregiving standards, self-care, dysfunctional assumptions about dementia, and acceptance. The correlational analyses demonstrated the subscales’ construct validity, by showing that scale scores are meaningfully related to theoretically relevant constructs.

Conclusions

The Caregiving Thoughts Scale is a promising measure of caregivers’ thoughts in four important domains.

Clinical Implications

The scale can be applied in clinical research settings.

KEYWORDS:

• Caregiver health
• dysfunctional thoughts
• psychological assessment
• dementia

Clinical implications

• The CTS is a promising measure of caregivers dysfunctional and, at first, functional thoughts, related to “Dysfunctional Caregiving standards”, “Dysfunctional Assumptions of Dementia, “Acceptance” and “Self-care”.

• The CTS correlates with established measures of psychological and physiological health.

• The CTS may be helpful for uncovering and assessing care-related thoughts that some caregivers may conceal due to shame or guilt.

Acknowledgments

The authors wish to thank all family caregivers who participated in the study. We are also grateful to our colleagues Kathi Albrecht, Psy.D., Tanja Kalytta, Psy.D., Denise Schinköthe, Ph.D., Franziska Meichsner, Ph.D., and Karen A. Sullivan, Ph.D. for expert ratings, to Ph.D. Marlena Louise Itz for proofreading. The trial on which this work is based was conducted in collaboration with Renate Soellner, Maren Reder, and Anna Machmer of the University of Hildesheim. Renate Soellner contributed to conceiving the study and its design and applying for funding. Renate Soellner, Maren Reder, and Anna Machmer served as advisors for data management and data analysis in the trial and contributed to or conducted data analyses reported in previous articles presenting findings from the trial.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, AKR, upon reasonable request.

Additional information

Funding

This work was supported by the German Federal Ministry of Health [Grant number IIA5-2512FSB555]. The funding source was neither involved in study design nor the collection, analysis, or interpretation of data. The authors report there are no competing interests to declare; Bundesministerium für GesundheitBundesministerium für Gesundheit [IIA5-2512FSB555].