title: TOPICOP©: a new scale evaluating topical corticosteroid phobia among atopic dermatitis outpatients and their parents.
abstract: BACKGROUND
  The fear of using topical corticosteroids, usually called topical corticophobia, is a frequent concern for atopic dermatitis patients and/or their parents. Assessing patients' atopic dermatitis and their parents' topical corticosteroid phobia is an essential step to improving adherence to treatment. Because topical corticophobia appears to be a complex phenomenon, its evaluation by binary responses (yes/no) is too simplistic. Thus, a scale is needed, which is capable of identifying the subtleties of topical corticosteroid phobia.
  
  
  OBJECTIVE
  To develop and validate a scale, TOPICOP©, measuring worries and beliefs about topical corticosteroids among atopic dermatitis outpatients and their parents.
  
  
  METHODS
  An initial statistical validation of TOPICOP was carried out, collecting qualitative data about patients' topical corticophobia behaviors and beliefs using focus-group methodology. Then, 208 outpatients or their parents from five French centers completed a self-administered questionnaire built from focus-group results. The scale-development process comprised an explanatory principal component analysis, Cronbach's α-coefficients and structural equation modeling.
  
  
  RESULTS
  The validated questionnaire comprised 12 items, covering two important dimensions relative to "worries" (6 items) and "beliefs" (6 items). Psychometric properties showed that items had very good communality (>0.60) within their own dimension. The final two-factor solution accounted for 47.3% of the variance. Cronbach's α-coefficients were, respectively, 0.79 and 0.78. Structural equation modeling strongly supported the possibility of calculating a global score.
  
  
  CONCLUSIONS
  TOPICOP© is the first scale aimed at assessing topical corticophobia in adult patients and parents of children with eczema. TOPICOP® has excellent psychometric properties and should be easy to use in everyday clinical practice for clinicians and researchers. Further studies are needed to confirm our results and validate TOPICOP© in other cultures.
authors.affiliation: Public Health Department, University Hospital of Nantes, Nantes, France ; EA 4275, Biostatistics, Clinical Research and Subjective Measures in Health Sciences, Faculty of Pharmaceutical Sciences, University of Nantes, Nantes, France.
authors.forename: Leïla
authors.initials: L
authors.lastname: Moret
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Anthoine
authors.forename: Hélène
authors.initials: H
authors.lastname: Aubert-Wastiaux
authors.forename: Anne
authors.initials: A
authors.lastname: Le Rhun
authors.forename: Christophe
authors.initials: C
authors.lastname: Leux
authors.forename: Juliette
authors.initials: J
authors.lastname: Mazereeuw-Hautier
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Stalder
authors.forename: Sébastien
authors.initials: S
authors.lastname: Barbarot
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D002648:Child; D003469:Culture; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D006801:Humans; D016014:Linear Models; D010045:Outpatients / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010698:Phobic Disorders / Q000523:psychology*; D025341:Principal Component Analysis; D011594:Psychometrics
chemical_list: D000305:Adrenal Cortex Hormones