Development of Questionnaires on Coping with Disease and Itching Cognitions for Children and Adolescents with Atopic Eczema

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Abstract
Background: There are numerous questionnaires for adults to assess coping with disease and quality of life in patients with atopic eczema, but there are hardly any for children and adolescents. This is surprising because the prevalence of atopic eczema is higher in these age groups than in adults. Moreover, the patients in this age range are in a sensitive phase of emotional development with many new demands (e.g. puberty, first partnership, choice of profession). Objective: Adaptation or development of questionnaires on coping with disease and itching cognitions for children and adolescents with atopic eczema. Methods: Based on existing questionnaires for adults, questionnaires on coping with disease and itching cognitions were designed for two age groups (7–12 years, 13–18 years). After several preliminary studies the final versions were tested in a group of 204 children and 168 adolescents. In addition to the questionnaires, the SCORAD (severity scoring of atopic dermatitis) was used. Results: Two-factor scale solutions resulted for both questionnaires for children. With respect to coping with disease (COPEKI), the scales ‘depressive mood/social anxiety’ and ‘itching-scratching circle/stress from the disease’ resulted. With respect to itching cognitions (JUCKKI), the scales ‘catastrophizing’ and ‘coping’ resulted. The internal consistency can be rated satisfactory to good (α = 0.72–0.91). Similar scales resulted for the adolescents (COPEJU, JUCKJU). With respect to coping with disease the following scales resulted: ‘depressive mood/itching-scratching circle’, ‘social anxiety’ and ‘stress from the disease’. Satisfactory to good values for Cronbach´s α (0.66–0.89) were found for these scales. High scale intercorrelations and moderate correlations with the SCORAD were observed both in children and adolescents. Comparing two severity groups (SCORAD Conclusion: The questionnaires on coping with disease and itching cognitions provide two age-appropriate assessment tools to reliably measure different aspects of these constructs in children and adolescents. Sensitivity to change of the questionnaires is currently being examined.

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