# Validity and reliability of the Turkish version of the topical corticosteroid phobia (TOPICOP) scale

## TL;DR

This study validates a Turkish version of a scale to measure fear of using topical corticosteroids, showing it is reliable and useful for dermatology patients.

## Contribution

The study provides a culturally adapted and validated Turkish version of the TOPICOP scale for assessing corticophobia.

## Key findings

- The Turkish TOPICOP scale demonstrated strong validity and reliability with Cronbach’s alpha of 0.861 for the total scale.
- Factor analysis confirmed two subdomains (beliefs and worries) explaining 67.61% of the variance.
- Test-retest reliability showed a strong correlation coefficient of 0.746 (p < 0.001).

## Abstract

Concerns about the use of topical corticosteroids (TCSs), commonly referred to as corticophobia, are widespread among dermatology patients and often lead to nonadherence to TCS treatment. This study aimed to evaluate the validity and reliability of the Turkish version of the topical corticosteroid phobia (TOPICOP) scale.

The TOPICOP scale comprises 12 items grouped into 2 dimensions: beliefs (6 items) and worries (6 items). For cultural adaptation, the scale was forward and backward translated. The final Turkish version was administered to 123 patients with chronic dermatoses who rated their perceptions of TCSs using a 4-point Likert scale. Test-retest reliability was assessed in 30 patients over a 2-week interval. In the validity analysis of the scale, content, construct (exploratory factor analysis (EFA), confirmatory factor analysis (CFA)) and criterion validity were tested. Internal consistency (Cronbach’s alpha coefficient) and test-retest analyses were performed in the reliability analysis.

EFA yielded 2 subdomains explaining 67.61% of the total variance and factor loadings ranging between 0.81 and 0.42. In CFA, χ2/df, SRMR, RMSEA, CFI, and TLI were in the excellent/acceptable range. Internal consistency had Cronbach’s alpha coefficients of 0.788 for the beliefs dimension, 0.815 for the worries dimension, and 0.861 for the total scale. A moderate-to-strong positive correlation was observed in test–retest reliability, with a correlation coefficient of 0.746 (p < 0.001). The mean (SD) global score of the Turkish TOPICOP scale was 50.74% (21.06%). Patients with higher educational levels had higher mean scores (p ≤ 0.05).

The Turkish version of the TOPICOP scale is a valid and reliable tool for assessing topical corticophobia among Turkish patients. Physicians should dedicate sufficient time to patient education to enhance TCS adherence.