Chaney et al - Developmental area Flashcards
What are behaviour therapy and behaviour modification based on?
- Based on classical conditioning
- Based on operant conditioning
What doesn’t necessarily improve with rising severity of illness?
Adherence
What did Watt et al propose would improve medical adherence in young asthmatics?
That a positive interplay of adherence considerations with aerosol output factors would improve medication adherence in young asthmatics
What is operant conditioning?
- It is a form of associative learning
- Whereby, associations and connections are formed between stimuli and responses that didn’t exist before learning occurs
What does operant conditioning involve?
It involves learning through the consequences of behavioural responses
Who first investigated the principles of operant conditioning?
Thorndike
What did he find?
- Found that any response that led to desirable consequences was more likely to be repeated
- Any response that led to undersirable consequences was less likely to be repeated - a principle which became known as the Law of Effect
What was the aim of this study?
- The aim of this study was to show that the use of a novel asthma spacer device, the ‘Funhaler’, which incorporated 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 experimental method was used?
Field experiment
What was the experimental design that was used?
Repeated measures design
What was the IV? (2)
- Whether the child used a standard/small volume spacer device - The breath-A-Tech
- Whether the child used a Funhaler
What was the DV?
The amount of adherence to the prescribed medical regime
How many children were in the study? (gender)
- 32 children
- 22 male, 10 female
Where was the study conducted?
Conducted in the P’s home setting in Australia
On average, how long had the children had asthma?
2.2 years
How did the children’s parents get involved?
- Helped (where necessary) in the use of the inhalers
- Completed questionnaires and took part in a phone interview
What did the parents provide?
Provided informed consent
What was the sampling technique?
Random sampling
How were P’s recruited?
Recruited from clinics across a large area
What happened first? (inhalers)
- Firstly, a comparison was made between the aerosol output of the standard/small volume spacer device
- 235ml Breath-A-Tech
- 225ml Funhaler
Was there any differences observed?
There was no significant differences observed
What did that mean for the comparison?
- The comparison was therefore complementary
- It indicated that the use of a Funhaler rather than a standard inhaler does not compromise drug delivery
How were participants approached by the researcher?
- Approached by the researcher at home
- Before the Funhaler was even mentioned
- They were interviewed with a questionnaire on their existing use of the inhaler
How long were they given the funhaler?
Two weeks
What happened in the 2 weeks
They reported over the phone on an ad hoc basic to take snapshots of whether they had used the Funhaler the previous day
What were completed by the parents?
Matched questionaires
When were the matched questionnaires completed?
After sequential use of the Breath-A-Tech inhaler and the Funhaler
After sequential use of both inhalers, who visited them again?
Researchers
What happened when they were visited?
The parents were interviewed and they completed the matched questionnaires
What data was collected from the self-report?
- How easy each device was to use
- Compliance of parents and children
- Treatment attitudes
During the course of the study, when were the parents called?
- At random
- To find out whether they had attempted to medicate their child the day before
Why does the Fuhaler include features to the inhaler?
- To distract the attention of the child from the drug delivery event
- Provide a means of self-reinforcing the use of effective technique
How was the funhaler made appealing?
- Isolates Incentive toys (spinner + whistle)
- Design of the toys ensures sufficient inspiratory resistance to minimise entrainment of inspired air through the circuit toy
- Design attempts to link optimal function of the toys deep breathing pattern conductive to effective medication
- Design anticipates the potential for boredom - its modular arrangement would allow for the replacement of the incentive toy module with a range of other toys.
Did the use of the Funhaler associate with improved parental and child compliance?
Yes
When surveyed at random, how many children were found to have been medicated the previous day (FUNHALER)
81% (22/27)
What was this in comparison to?
- 59% of children (16/27)
- using the existing small volume spacer device
How many children took the recommended 4 or more cycles per aerosol delivery when using the funhaler?
- 80%
- 24/30
- compared with 15/30 - 50% Standard/ Small volume spacer
- 30% more
How many parents were always successful in medicating their child with the funhaler?
22/30
How many parents were always successful in medicating their child with the B-A-T?
3/30
What was the Funhaler associated with?
Fewer problems than when using the existing device
Is the Funhaler useful for management of young asthmatics?
Improved adherence combined with satisfactory delivery characteristics, suggest that the Funhaler may be useful for management of young asthmatics
What could the use of the Funhaler be translated to?
The use of the Funhaler could possibly be translated to improved measures of clinical outcome
How can the Funhaler improve health?
The use of functional incentive devices such as the Funhaler may improve the health of children
Is more research needed?
More research is recommended in the long term efficiency of this treatment
