Chaney et al Flashcards
What was the background behind chaney’s study?
1) Behaviour therapy and behaviour modification (based on classical and operant conditioning) have been major approaches used by clinical psychologists and health practitioners to adherence to prescribed medical regimes
2) Poor adherence to prescribed frequency and technique remains a major problem for paediatric asthmatics on inhaled medication (Chaney et al, 2004)
3) Rates of compliance for offering medication regularly to asthmatic children range from 30% to 70%, while paediatric compliance rates for the correct pressurised metered dose inhaler (pMDI) technique range from 39% to 67%. Adherence does not necessarily improve with rising severity of illness
4) Although reasons for poor adherence are varied, Watt et al proposed that a positive interplay of adherence considerations with aerosol output factors would improve medication adherence in young asthmatics
What was the aim of this study?
The aim of the study was to show that the use of a novel asthma spacer device, the ‘funhaler’, which incorporates incentive toys isolated from the main inspiratory circuit by a valve, whilst not compromising drug delivery, can provide positive reinforcement which leads to improved adherence in young asthmatics
What three theories is Chaney’s study based on?
1) Operant conditioning is a form of associative learning, whereby associations and connections are formed between stimuli and responses that didn’t exist before learning occurs
2) Operant conditioning involves learning through the consequences of behavioural responses. The principles of operant conditioning were first investigated by Thorndike who found that any response that led to desirable consequences was more likely to be repeated, whereas any responses that led to undesirable consequences was less likely to be repeated- a principle which became known as the Law of Effect
3) The principles of operant conditioning were further developed by Skinner who applied them to explain how many aspects human behaviour are acquired.
What was the experimental method that was used?
A field experiment (conducted in the participants’ home setting in Australia)
What was the experimental design that was used in Chaney’s study?
Repeated measures design
What were the 2 IV’s in Chaney’s study?
1) whether the child used a standard/small volume spacer device - the Breath-a-Tech (Scott-Dibben, Australia)
2) whether the child used a Funhaler (InfMed Ltd, Australia).
What was the DV in Chaney’s study?
1) the amount of adherence to the prescribed medical regime
Describe the sample in Chaney’s study
- 32 children
- 22 male, 10 females
- mean age, 3.2yrs
- average duration of asthma, 2.2years
- prescribed drugs delivered by pMDI and spacer were recruited
- parents provided informed consent and also participated in the study through completing questionnaires and taking part in a phone interview
- parents helped (where necessary) in the use of the inhalers
Describe the procedure of chaney’s study (1)
1) A comparison was made between the aerosol output of the standard/small volume spacer device (235ml Breath-a-Tech) and the 225ml Funhaler.
- overall, no significant differences were observed.
- comparison was complementary, indicating that the use of a Funhaler rather than a standard inhaler does not compromise drug delivery
2) Participants were approached by the researcher at home before the funhaler was mentioned and were interviewed with a questionnaire on their existing us of the inhaler
3) They were given the Funhaler for two weeks and reported over the phone on an ad hoc basis to take snapshots of whether they had used the Funhaler the previous day.
4) Matched questionnaires were completed by parents after sequential use of the Breath-A-Tech inhaler and the Funhaler
Describe the procedure of Chaney’s study (2)
5) After sequential use of the Breath-A-Tech inhaler and the Funhaler they were then visited again by the researcher and parents were interviewed and completed the matched questionnaires
6) Data collected from the self-report related to how easy each device was to use, compliance of parents and children, and treatment attitudes.
7) During the course of the study each parent was called at random to find out whether they had attempted to medicate their child the day before.
How was the Funhaler make spacers appealing to the children?
• The funhaler incorporates several features to distract the attention of children from the drug delivery event itself and to provide a means of self-reinforcing the use of effective technique
- It isolates incentive toys (e.g spinner and whistle) in a separate branch to the standard inhalation circuit, placing them outside the expiratory valve of the spacer to avoid problems of contamination and interference of drug delivery.
- The design of the toys themselves ensures sufficient inspiratory resistance to minimise entrainment of inspired air through the toy circuit
- The design attempts to link the optimal function of the toys to deep breathing pattern conductive to effective medication
- The design anticipates the potential for boredom of children with particular incentive toys in its modular arrangement which would allow the replacement of the incentive toy module with a range of different toys
What were 3 finding that were found in Chaney’s study?
1) The use of the Funhaler was associated with improved parental and child compliance
2) When surveyed at random, 81% of children using the Funhaler were found to have been medicated the previous day compared to 59% of children using the existing small volume spacer device
3) Use of the Funhaler was associated with fewer problems than when using the existing device
Give three possible conclusions that Chaney found in the study
1) Improved adherence, combined with satisfactory delivery characteristics, suggests that the Funhaler may be useful for management of young asthmatics
2) The use of the Funhaler could possibly be translated to improve measures of clinical outcome
3) The use of functional incentive devices such as the Funhaler may improve the health of children
How does this study relate to the developmental area and the behaviourist perspective?
Chaney’s study belongs to the developmental area because it is illustrating another way in which children’s behvaiour can be influenced by external factors - in this case, the presence of positive and negative reinforcers.
It can also be considered to link to the behaviourist perspective because of the way it provides empirical support for operant conditioning ( both negative and positive reinforcement). Results found increased adherence, due to the positive reinforcement provided by the funhaler
What was the sampling method used in Chaney’s study?
Random sampling of asthmatic children - recruited from clinics across a large area
