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Çocuklarda Topikal Kortikosteroid Kullanımı Hakkında Ailelerin Bilgi ve Endişe Düzeyleri

Year 2014, Volume: 8 Issue: 3, 113 - 116, 01.06.2014

Abstract

Amaç: Steroid fobisi günlük pratikte tedaviye uyumu olumsuz yönde etkileyebilen önemli bir faktördür. Ülkemizde yapılmış, genel popülasyon ve sağlık çalışanlarının bu konudaki tutumlarını inceleyen bir çalışma bulunmamaktadır. Bizim amacımız ebeveynlerin kortikosteroid içeren topikal ilaçlar hakkındaki bilgi ve endişe düzeylerini ve bunun tedaviye etkilerini incelemektir.Gereç ve Yöntemler: Çocuk sağlığı ve hastalıkları polikliniğine çeşitli sebeplerle başvuran hasta yakınları ve hastanemiz sağlık çalışanlarından oluşan toplam 300 kişiye konuyla ilgili anket uygulanmıştır. Ankette ebeveynlerin çocuklarına daha önceden kortizon içeren bir krem kullanıp kullanmadıkları, bu konu ile ilgili endişelerinin olup olmadığı ve bu ilacın ciltten uygulanması durumunda hangi yan etkileri yapabileceğine dair bilgi düzeyleri ile ilgili sorular yer almıştır.Bulgular: Hasta yakını grubunda steroid kullanımı ile ilgili endişe % 20.5 (n=41), sağlık çalışanı grubunda % 54 (n=54) bulunmuştur. Hasta yakını grubunun % 40’ı tedaviyi endişesi nedeniyle hiç uygulamamış, % 24’ü tedaviyi erken bırakmıştır. Steroidler hakkındaki endişesi olanlara bunun sebebinin sorulduğu açık uçlu soruya yanıt olarak hasta grubunun % 79’u yan etkileri olabileceğini, % 8.32’si hormon bozukluğuna, % 4.16’sı diyabete, % 4.16’sı kilo artışına, % 4.16’sı da ciltte lekelenmeye yol açabileceğini düşündüklerini belirtmişlerdir.Sonuç: Eğitim seviyesi arttıkça, sağlık çalışanı bile olsa ebeveynlerde yersiz bir steroid fobisinin bulunduğu ve bunun tedavi sürecini olumsuz etkilediğini saptadık. Hekimlerin bu durumu göz önünde bulundurarak tedaviye başlamadan önce ebeveynlere tedavi hakkında yeterli bilgilendirmeyi yapmalarının tedavi sonuçlarını olumlu etkileyeceğini düşünmekteyiz.

References

  • Morleya KW, Dinulosb JG. Update on topical glucocorticoid use in children. Curr Opin Pediatr 2012;24:121-8.
  • Fraser R, Gower D, Honour J, et al. Analysis of corticosteroids. In: Makin H and Gower D (eds). Steroid analysis. 2nd ed. New York: Springer, 2010: 329-455.
  • Nieman L. Consequences of systemic absorption of topical glucocorticoids. J Am Acad Dermatol 2011;65:250–2.
  • Tempark T, Phatarakijnirund V, Chatproedprai S, Watcharasindhu S, Supornsilchai V, Wananukul S. Exogenous Cushing’s syndrome due to topical corticosteroid application: Case report and review of literature. Endocrine 2010;38:328–34.
  • Hepburn D, Yohn J, Weston W. Topical steroid treatment in infants, children and adolescents. Adv Dermatol 1994;9:225–54.
  • Fischer G. Compliance problems in paediatric atopic eczema. Australas J Dermatol 1996;37:10-13.
  • David TJ. Steroid scare. Arch Dis Child 1987;62:876–8.
  • Patterson R, Walker CL, Greenberger PA, Sheridan EP.
  • Prednisone- phobia. Allergy Proc 1989;10:423–8.
  • Kojima R, Fujiwara T, Matsuda A, Narita M, Matsubara O, Nonoyama S, et al. Factors associated with steroid phobia in caregivers of children with atopic dermatitis. Pediatr Dermatol 2013;30:29-35.
  • Hon KL, Kam WY, Leung TF, Lam MC, Wong KY, Lee KC, et al. Steroid fears in children with eczema. Acta Paediatr 2006;95: 1451–55.
  • Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol 2000;142: 931–6.
  • Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: A study of its nature, origins and frequency. Br J Dermatol 2011; 165:808-14.
  • Bewley A. Expert consensus: Time for a change in the way we advise our patients to use topical corticosteroids. Br J Dermatol 2008;158:917–20.
  • Beattie PE, Lewis-Jones MS. Parental knowledge of topical therapies in the treatment of childhood atopic dermatitis. Clin Exp Dermatol 2003;28:549–53.

Information and Anxiety Levels of the Parents about Using Topical Corticosteroids on Children

Year 2014, Volume: 8 Issue: 3, 113 - 116, 01.06.2014

Abstract

Objective: Corticosteroid phobia is an important factor affecting therapy compliance negatively in daily practice. There is no study on the attitudes of the general population and health care workers on this issue in our country. Our objective was to investigate the information and anxiety levels of parents about topical medications containing corticosteroids, and their effects on treatment.Material and Methods: A total of 300 individuals that consisted of the parents of the patients who were admitted to the pediatric clinics for various health reasons and the health care workers of our hospital were asked to complete a questionnaire on this topic. The items in the questionnaire consisted of questions on whether the parents had previously used cortisone-based ointments on their children, whether they had any concerns regarding the issue, and what side effects, in their opinion, might develop in case the drug was applied on the skin.Results: The anxiety rates were found to be 20.5% (n=41) in the patient’s parents group, and 54% (n=54) in the health care workers group. Due to anxiety, 40% of the patient’s parents group never applied the treatment, and 24 % of them discontinued the treatment early. As regards the open-ended question on why people felt anxiety about steroids, 79% reported possible side effects, 8.32% hormonal disorder, 4.16% diabetes, 4.16% gaining weight, and 4.16% blemishing of skin.Conclusion: We detected an unnecessary phobia regarding steroids in the general population and even in health care workers with increasing education level and the anxiety affected the treatment process negatively. Thus, we suggest that physicians consider this fact and provide suffi cient information to parents prior to treatment to affect the results of the treatment positively

References

  • Morleya KW, Dinulosb JG. Update on topical glucocorticoid use in children. Curr Opin Pediatr 2012;24:121-8.
  • Fraser R, Gower D, Honour J, et al. Analysis of corticosteroids. In: Makin H and Gower D (eds). Steroid analysis. 2nd ed. New York: Springer, 2010: 329-455.
  • Nieman L. Consequences of systemic absorption of topical glucocorticoids. J Am Acad Dermatol 2011;65:250–2.
  • Tempark T, Phatarakijnirund V, Chatproedprai S, Watcharasindhu S, Supornsilchai V, Wananukul S. Exogenous Cushing’s syndrome due to topical corticosteroid application: Case report and review of literature. Endocrine 2010;38:328–34.
  • Hepburn D, Yohn J, Weston W. Topical steroid treatment in infants, children and adolescents. Adv Dermatol 1994;9:225–54.
  • Fischer G. Compliance problems in paediatric atopic eczema. Australas J Dermatol 1996;37:10-13.
  • David TJ. Steroid scare. Arch Dis Child 1987;62:876–8.
  • Patterson R, Walker CL, Greenberger PA, Sheridan EP.
  • Prednisone- phobia. Allergy Proc 1989;10:423–8.
  • Kojima R, Fujiwara T, Matsuda A, Narita M, Matsubara O, Nonoyama S, et al. Factors associated with steroid phobia in caregivers of children with atopic dermatitis. Pediatr Dermatol 2013;30:29-35.
  • Hon KL, Kam WY, Leung TF, Lam MC, Wong KY, Lee KC, et al. Steroid fears in children with eczema. Acta Paediatr 2006;95: 1451–55.
  • Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol 2000;142: 931–6.
  • Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, et al. Topical corticosteroid phobia in atopic dermatitis: A study of its nature, origins and frequency. Br J Dermatol 2011; 165:808-14.
  • Bewley A. Expert consensus: Time for a change in the way we advise our patients to use topical corticosteroids. Br J Dermatol 2008;158:917–20.
  • Beattie PE, Lewis-Jones MS. Parental knowledge of topical therapies in the treatment of childhood atopic dermatitis. Clin Exp Dermatol 2003;28:549–53.
There are 15 citations in total.

Details

Other ID JA96TA32JT
Journal Section Research Article
Authors

Sevil Bilir Göksügür This is me

Nadir Göksügür This is me

Mervan Bekdaş This is me

Fatih Demircioğlu This is me

Publication Date June 1, 2014
Submission Date June 1, 2014
Published in Issue Year 2014 Volume: 8 Issue: 3

Cite

Vancouver Göksügür SB, Göksügür N, Bekdaş M, Demircioğlu F. Information and Anxiety Levels of the Parents about Using Topical Corticosteroids on Children. Türkiye Çocuk Hast Derg. 2014;8(3):113-6.


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