Cet article propose la traduction et l’adaptation de l’espagnol au français du « Dysfunctional Thoughts about Caregiving Questionnaire - DTCQ ». Ce questionnaire, élaboré par l’équipe de Losada, permet d’évaluer les pensées dysfonctionnelles par rapport au soin. Ces dernières sont des pensées, idées ou attitudes qui vont influencer les aidants dans leur manière de percevoir un problème et de réagir face à une situation difficile ou stressante. Une étude pilote a été réalisée dans notre service auprès de 28 aidants afin d’étudier les pensées dysfonctionnelles par rapport au soin en fonction du lien de parenté avec le malade (conjoint/enfant) et de la pathologie (maladie d’Alzheimer/démence fronto-temporale). De plus, les liens entre pensées dysfonctionnelles et stress perçu, anxiété, dépression et fardeau de l’aidant ont été examinés. Les résultats ont montré premièrement que les conjoints présentaient plus de pensées dysfonctionnelles que les enfants et deuxièmement que les conjoints des patients atteints de maladie d’Alzheimer plus de pensées dysfonctionnelles de type « perfectionnisme » que les conjoints de patients atteints de démence fronto-temporale. En outre, le score total au DTCQ était corrélé positivement à l’âge et au stress perçu. Les résultats sont à interpréter avec précaution du fait du nombre modeste de sujets. La version française du DTCQ apparaît être un outil bien adapté à l’étude des pensées dysfonctionnelles par rapport au soin. Le DTCQ peut être utilisé à la fois pour une activité de recherche et pour une pratique clinique.

Family caregivers play a very important role in the support of people with dementia. Nevertheless, caregiving can have negative consequences on both physical and psychological levels. These repercussions can vary as a function of the relationship with the patient (children/spouses) and the type of pathology (Alzheimer's disease/Frontotemporal Dementia – AD/FTD). Some authors recently focused on the exploration of dysfunctional thoughts regarding caregiving. These are thoughts, ideas or attitudes which will influence the manner in perceiving a problem and reacting towards stressful and/or difficult situations. Dysfunctional thoughts guide behavior in a maladaptive way and also influence the acceptance of assistance. They can affect the amount of help received by caregivers. Losada et al. developed an assessment instrument sensitive to dysfunctional thoughts about caregiving called “The Dysfunctional Thoughts about Caregiving Questionnaire”.

The major objective of the current study is to present the French translation and adaptation of this questionnaire. The DTCQ allows for a straightforward quantitative and qualitative evaluation of specific dysfunctional thoughts. It is composed of 2 factors: “perception of sole responsibility” and “perfectionism”. It is self-rated and it consists of 16 items scored on a 5-point Likert scale; total scores range between 0 and 64. The secondary objective is to study the dysfunctional thoughts about caregiving as a function of the relationship with the patient (children/spouse) and the type of pathology (AD/FTD).

The questionnaire was initially translated following a four-step process. A pilot study was carried out comparing four different caregivers groups (n=28) participating in a psychoeducational program: (1) Alzheimer's disease (AD) patients’ spouses, (2) AD patients’ children caregivers (3) frontotemporal dementia (FTD) patients’ spouses, and (4) FTD patients’ children. In addition to the dysfunctional thoughts about caregiving, the burden, the perceived stress, the anxiety and the depressive symptomatology were evaluated using respectively the Zarit burden interview (Zarit), the Perceived Stress Scale (PSS), the State-Trait-Anxiety Inventory (STAI) and the Montgomery and Asberg Depression Rating Scale (MADRS).

The French version of the DTCQ was both well accepted and well understood by the caregivers in each group. The results showed that the two factors of the questionnaire (“perception of sole responsibility” and “perfectionism”) were strongly correlated to the total score, as in the original validation article. In addition, the results showed the DTCQ was a tool that could differentiate subjects according to the status (spouses/children). Spouses had significantly higher scores on the DTCQ (25.3±6.9) than children (17.3±9.6). Secondly, the DTCQ differentiated the subjects according to the pathology of the relative. The spouses of patients with AD (14.6±2.7) had significantly more “perfectionism” dysfunctional thoughts than spouses of patients with FTD (10.57±3.3). This result does not seem related to the age since in our study; the two groups of spouses were of the same average age. Moreover, the results indicated that the total score on the DTCQ was positively correlated with age and perceived stress and the DTCQ perfectionism score to trait-anxiety.

The French version of the DTCQ is a useful instrument for the evaluation of dysfunctional thoughts about caregiving. The DTCQ can be used both for research and in clinical practice, in particular to detect potentially more “at risk” caregivers. However, the results should be interpreted with caution because of the small number of subjects.