Evaluation of steroid phobia in patients using topical corticosteroids: Turkish validity-reliability study of TOPICOP scale

Topical steroid phobia has been associated with poor adherence, worsening disease outcomes and use of complementary and altenative medicine, and may also lead to treatment failure with topical corticosteroids,resulting in persistent disease and treatment ascalation to systemic agents (such as methotrexate and cyclosporine) or more costly drugs (dupilumab). In this study, we aimed to evaluate topical corticosteroid phobia in patients using topical corticosteroids by translating the ''TOPICOP'' scale into Turkish, proving its validity and reliability, and using the scale in patients. In this methodological and cross-sectional study, 500 people were included. The study was conducted between October 2024 and March 2025 in Isparta Suleyman Demirel University Faculty of Medicine, Family Medicine Polyclinic by face-to-face interwiev method. Data were evaluated using SPSS 26 package program ans SPSS AMOS 21 programs. Descriptive statistics were given as number, percentage, mean±standart deviation. Normality assumptions of our data were investigated by Kolmogorv-smirnov test. Chi square analysis was used for categorical data, Mann-Whitney U analysis was used for data with two groups and Kruskal-Wallis analysis was used for data with more than two groups when scale scores were analyzed according to categorical data. Spearmen Correlation analysis was used to examine the relationship between the scale scores since their distribution was not normal. For statistical significance, p<0,05 was accepted. It was determined that tho KMO value calculated within tho scope of construct validity of the TOPICOP Scale was 0,864 and the Barlett Sphericity test was significant as χ2= 1518,673, p<0,001. According to the results of the Exploratory Factor Analysis and Conformatory Factor Analysis methods fort he Turkish TOPICOP scale in our study, it was seen that it was parallel with the structure of the original scale, and in addition, according to the literatüre review, ,t was seen that the Turkish TOPICOP scale provided the adequacy of structural validity. In our study, Cronbach's alfa coefficient fort he TOPICOP scale was found to be 0,82, 0,70 for the ''beliefs''sub-dimension and 0,80 for the ''worries'' sub-dimension. In our study, the reliability of the scale was also tested with the test-retest method and the totalscore correlation between two applications wasfound to be r=0,910, p<0,001. All these reliability analysis findings of our study were comparable to the findings of the limited number of linguistic validation and reliability-related literatüre findings, the Turkish TOPICOP scale was found to be acceptable or good reliablity. In the light of all these results, the Turkish adapted TOPICOP scale was found to be valid and reliable for general topical corticosteroid users and could be used in our country. Keywords: Topical Corticosteroid Phobia, TOPICOP Scale, Validity, Reliability