Chaney Et Al Flashcards
Theory.
Operant conditioning.
= form of associative learning, connections are formed between stimuli and responses that didn’t exist before learning occurs.
Learn through consequences of behavioural responses.
Law effect.
Developed by Skinner.
Background to study.
Behaviour therapy and modification to improve adherence to prescribed medical regimes.
Poor adherence to medical regimes is a problem for young asthmatics on inhaled medication.
Compliance rates for regime of inhalers 39%-67%.
Aim.
To show 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.
Research method.
Field experiment.
Repeated measured design.
Conducted in P’s homes.
IV:
- Whether the child used a small volume spacer device.
2. For child used a Funhaler.
DV:
Amount of adherence to the prescribed medical regime.
Sample:
32 children (22 male,10 female; age range was 1.5 - 6 years, mean age 3.2 years). The children's parents provided informed consent and also participated in the study through completing questionnaires and taking part in a phone interview. They also helped (where necessary) in the use of inhalers.
Procedure.
No differences observed between aerosol output of both inhalers.
P’s were approached by researcher at home before funhaler was mentioned and were interviewed with a questionnaire about their current inhaler.
Given funhaler for two weeks and reported over phone to take snapshots of whether they had used the funhaler the previous day.
Matched questionnaires completed by parents then interview after sequential use of both inhalers.
During this study each parent was called random to find out whether they had attempted to medicate the child the day before.
Why was self report used ??
To see how easy each device was, compliance of parents and children and treatment attitudes.
The funhaler incorporates features to distract the attention of the children from the drug delivery itself to provide means of self reinforcing the use of effective technique.
The features were:
- It has incentive toys in a separate branch to the standard inhalation circuit to avoid interference of drug delivery.
- Design attempts to link the optimal function of the toys to deep breathing pattern so it’s more likely to be effective medication.
- Design stops boredom and toys can be replaced due to its modular arrangement.
Key findings.
The use of the funhaler was associated with improved parental and child compliance.
When survey at random 38% more parents were found to have medicated the children the previous day when using the funhaler compared to their existing small spacer device.
60% more children took the recommended four or more cycles per aerosol delivery when using the funhaler compared to the small spacer device.
More parents reported they were always successful in medicating their children using the funhaler compared to the existing small spacer device.
Conclusions.
Improved adherence, combined with satisfactory delivery characteristics, suggest that the funhaler may be more useful for management of young asthmatics.
Use of funhaler could possibly be translated to improved measures of clinical outcome.
Use of functional incentive devices such as the funhaler may improve the health of children.
More research is recommended into the long-term efficacy of this treatment.
