Research ArticleOriginal Article
Open Access

Validity and reliability of the Arabic version of topical corticosteroid phobia (TOPICOP©) questionnaire

Hashem M. Al-Dujaily, Huda A. Hussein, Bahaa Abdelrahim, Mohammad Shawer, Ahmad Mehyar, Baha’ Aljeradat, Dima Batarseh, Sarah Khraim, Amjad Abdeen and Noor Almaani
Saudi Medical Journal March 2025, 46 (3) 307-315; DOI: https://doi.org/10.15537/smj.2025.46.3.20240506

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  • Table 1

    - Socio-demographic data.

    VariablesAll patients (N=145)Parents (n=99)Adult patients (n=46)
    Age (years), mean±SD35.6±12.040.4±7.525.2±13.3
    Child’s age (years), mean±SD 8.2±3.8 
    Gender
    Male79 (54.5)61 (61.6)18 (39.1)
    Female66 (45.5)38 (38.4)28 (60.9)
    Area of residence
    Amman94 (64.8)61 (61.6)33 (71.7)
    Balqa25 (17.2)19 (19.2)6 (13.0)
    Zarqa15 (10.3)13 (13.1)2 (4.3)
    Other5 (3.5)4 (4.0)1 (2.2)
    Madaba4 (2.8)1 (1.0)3 (6.5)
    Irbid2 (1.4)1 (1.0)1 (2.2)
    Educational level
    Elementary school2 (1.4)2 (2.0)0 (0.0)
    Middle school8 (5.5)6 (6.1)2 (4.3)
    High school34 (23.4)12 (12.1)22 (47.8)
    Diploma17 (11.7)13 (13.1)4 (8.7)
    Bachelor58 (40.0)43 (43.4)15 (32.6)
    Master16 (11.0)15 (15.2)1 (2.2)
    Doctorate10 (6.9)8 (8.1)2 (4.3)
    Family income
    Less than 200 JOD7 (4.8)5 (5.0)2 (4.3)
    200-2000 JOD130 (89.7)92 (92.9)38 (82.6)
    More than 2000 JOD8 (5.5)2 (2.0)6 (13.0)

    Values are presented as numbers and percentages (%). JOD: Jordanian dinar, SD: standard deviation

    • Table 2

      - Specific data regarding atopic dermatitis and disease characteristics (N=145).

      Disease related datan (%)
      Family history of atopic dermatitis
      Yes55 (37.9)
      No90 (62.1)
      Comorbidities related to atopic dermatitis†
      Allergic rhinitis27 (17.5)
      Asthma20 (13.0)
      Food allergies20 (13.0)
      None87 (56.5)
      Recent or past use of TCS
      Yes121 (83.4)
      No24 (16.6)
      Duration of topical corticosteroids use
      Less than 2 weeks25 (17.2)
      2 weeks to 3 months39 (26.9)
      3 months to a year20 (13.8)
      More than a year37 (25.5)
      I have never used topical corticosteroids before24 (16.6)
      Do you have fears regarding the use of TCS? 
      Yes
      No80 (55.2)
      Reasons for having fears towards the use of TCS?†65 (44.8)
      Fear of side effects
      Previous negative experience with TCS72 (47.7)
      Doctor did not tell me regarding its advantages & disadvantages8 (5.3)
      I am not afraid of using TCS6 (4.0)
      Source of information on TCS65 (43.0)
      Dermatologists
      Other doctors81 (55.9)
      Nurses13 (9.0)
      Pharmacists2 (1.4)
      Family and friends8 (5.5)
      Social media19 (13.1)
       22 (15.2)

      Values are presented as numbers and percentages (%).

      TCS: topical corticosteroids

      • ↵† Multiple responses were allowed for these questions.

    • Table 3

      - Responses and scores for the Arabic version of topical corticosteroid phobia (TOPICOP©) scale items.

      DomainsTotally disagreeNot really agreeAlmost agreeTotally agreeI do not understand the statementDomain subscores (mean±SD)
      Knowledge and beliefs
      Q1: TCS can be absorbed into the bloodstream4 (2.8)53 (36.6)51 (35.2)17 (11.7)20 (13.8)49.4±17.5
      Q2: TCS can lead to infections25 (17.2)72 (49.7)38 (26.2)7 (4.8)3 (2.1)
      Q3: TCS can make you fat24 (16.6)43 (29.7)39 (26.9)37 (25.5)2 (1.4)
      Q4: TCS damage your skin8 (5.5)41 (28.3)60 (41.4)32 (22.1)4 (2.8)
      Q5: TCS will affect your future health negatively10 (6.9)43 (29.7)58 (40.0)31 (21.4)3 (2.1)
      Q6: Using TCS can lead to asthma35 (24.1)89 (61.4)14 (9.7)4 (2.8)3 (2.1)
      Fears
      Q7: I’m afraid of putting TCS on certain skin areas such as eyelids†15 (10.3)20 (13.8)49 (33.8)58 (40.0)3 (2.1)63.4±22.1
      Q8: I do not know of any side effects, but I am still afraid of using TCS27 (18.6)17 (11.7)65 (44.8)33 (22.8)3 (2.1)
      Q9: I’m afraid of applying too much TCS†14 (9.7)33 (22.8)48 (33.1)50 (34.5)0 (0.0)
      Behaviors
      Q10: I wait as long as I can before treating myself or my child with TCS†27 (18.6)45 (31.0)35 (24.1)33 (22.8)5 (3.4)62.6±25.9
      Q11: I stop TCS treatment as soon as I can†18 (12.4)32 (22.1)44 (30.3)45 (31.0)6 (4.1)
      Q12: I need reassurance on TCS†12 (8.3)24 (16.6)23 (15.9)84 (57.9)2 (1.4)
      Global TOPICOP score, mean±SD
      All participants56.4±16.5
      Parents of pediatric patients59.1±16.1
      Adult patients50.4±16.1
      Participants who declared not to have TCS phobia46.0±14.6

      Values are presented as numbers and percentages (%).

      TCS: topical corticosteroids, SD: standard deviation

      • ↵† Options include never, sometimes, often, and always.

    • Table 4

      - Difficulty in answering each item of the Arabic version of topical corticosteroid phobia (TOPICOP©) questionnaire.

      DomainsNot at all difficultA little difficultQuite difficultExtremely difficult
      Knowledge and beliefs
      Q1: TCS can be absorbed into the bloodstream69 (47.6)27 (18.6)38 (26.2)11 (7.6)
      Q2: TCS can lead to infections76 (52.4)31 (21.4)29 (20.0)9 (6.2)
      Q3: TCS can make you fat104 (71.7)21 (14.5)12 (8.3)8 (5.5)
      Q4: TCS damage your skin101 (69.7)23 (15.9)16 (11.0)5 (3.4)
      Q5: TCS will affect your future health negatively87 (60.0)33 (22.8)18 (12.4)7 (4.8)
      Q6: Using TCS can lead to asthma88 (60.7)22 (15.2)23 (15.9)12 (8.3)
      Fears
      Q7: I’m afraid of putting TCS on certain skin areas such as eyelids99 (68.3)16 (11.0)21 (14.5)9 (6.2)
      Q8: I do not know of any side effects, but I am still afraid of using TCS90 (62.1)32 (22.1)16 (11.0)7 (4.8)
      Q9: I’m afraid of applying too much TCS101 (69.7)22 (15.2)19 (13.1)3 (2.1)
      Behaviors
      Q10: I wait as long as I can before treating myself or my child with TCS109 (75.2)20 (13.8)13 (9.0)3 (2.1)
      Q11: I stop TCS treatment as soon as I can106 (73.1)21 (14.5)11 (7.6)7 (4.8)
      Q12: I need reassurance on TCS112 (77.2)24 (16.6)7 (4.8)2 (1.4)

      Values are presented as numbers and percentages (%). TCS: topical corticosteroids

      • Table 5

        - Clarity and feasibility of the Arabic version of topical corticosteroid phobia (TOPICOP©) questionnaire (N=145).

        Topicsn (%)
        Overall clarity of the questionnaire
        Extremely clear65 (44.8)
        Clear75 (51.7)
        Not clear5 (3.4)
        Time to complete the questionnaire
        Less than 5 minutes106 (73.1)
        5-10 minutes37 (25.5)
        More than 10 minutes2 (1.4)
        I found difficulty in completing TOPICOP questionnaire
        Totally disagree52 (35.9)
        Disagree67 (46.2)
        Somewhat agree16 (11.0)
        Totally agree10 (6.9)
        TOPICOP questionnaire covered all aspects that might stop me from using TCS
        Totally disagree2 (1.4)
        Disagree15 (10.3)
        Somewhat agree72 (49.7)
        Totally agree56 (38.6)
        I would like to use this questionnaire in the future for follow up
        Totally disagree9 (6.2)
        Disagree12 (8.3)
        Somewhat agree46 (31.7)
        Totally agree78 (53.8)

        Values are presented as numbers and percentages (%). TCS: topical corticosteroids

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