Chaney: External Influences on Children's Behaviour (Developmental) Flashcards
What theory is Chaney’s study based on?
Operant conditioning - a form of associative learning where connections are formed between stimuli and responses that didn’t exist before learning occurs. Learning through consequence
What was the background to Chaney’s study?
- Poor adherence to prescribed frequency and technique is a major problem for paediatric asthmatics on inhaled medication
- Adherence does not necessarily improve with rising severity of illness
- Although reasons for poor adherence are varied, it was suggested that the element of fun could be reducing compliance
What was the aim of Chaney’s study?
To show that the use of a novel asthma spacer device, the funhaler, which incorporated toys separate from the main inhaler as to not compromise the drug delivery, can provide positive reinforcement which leads to improved adherence in young asthmatics
What was the research method and design in Chaney’s study?
A field experiment, conducted in the participants’ home settings in Australia, which used a repeated measures design
What were the variables in Chaney’s study?
IV: whether the child used a standard/small volume spacer device or a Funhaler
DV: the amount of adherence to the prescribed medical regime
What was the sample for Chaney’s study?
-32 children (22 male and 10 female), age range 1.5-6 years, average duration of asthma 2.2 years
-Who were prescribed drugs delivered by pMDI
-Parents provided informed consent and also participated in the study through completing questionnaires and taking part in a phone interview
-Random sampling from clinics across a large geographical area
What was done by the researchers before the experiment began in Chaney’s study?
-A comparison between the standard spacer device and the funhaler found that there were no significant differences in the aerosol output. So did not compromise drug delivery
-Participants were approached by the researcher at home before the Funhaler was mentioned and they answered a closed answer questionnaire on their child’s existing use of the inhaler
How was data collected on the use of the Funhaler in Chaney’s study?
-Parents were given the funhaler for 2 weeks and reported over the phone at random times from the research to take snapshots of whether they had used the Funhaler the previous day
-Matched questionnaires were completed after sequential use of the Breath-a-tech inhaler and the funhaler
-They were then visited again by the researcher and interviewed and completed the matched questionnaire
What did the data collected measure in Chaney’s study?
How easy each device was to use, compliance of parents and children, and treatment attitudes
How was the Funhaler designed to maximise its purpose?
-Isolates incentive toys (spinner and whistle) in a separate branch to the inhalation circuit
-Attempts to link the optimal function of the toys to deep breathing pattern conductive to effective medication
-Anticipates boredom so the toys can be removed and altered with other toys
What were the key findings of Chaney’s study?
-Use of the Funhaler was associated with improved parental and child compliance
-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 spacer device
-30% more children took the recommended four or more cycles per aerosol delivery when using the funhaler
-Of the parents who were unsuccessful with the conventional spacer, 17 became successful with time and practice in medicating their children,
leaving 11 who never succeeded. When these 11 were changed to the Funhaler, 7 were immediately successful, 1 became successful with time
and only 3 continued to have problems.
What possible conclusions can be drawn from Chaney’s study?
-Improved adherence, combined with satisfactory delivery characteristics, suggest that the Funhaler may be useful for management of young asthmatics
-The use of the Funhaler could possibly be translated to improved measures of clinical outcome
-The use of functional incentive devices such as the Funhaler may improve the health of children
-More research is recommended in the long term efficacy of this treatment
What are the strengths and weaknesses of the design used in Chaney’s study?
+Participant variables were controlled as all participants were exposed to both conditions of the IV
-Risk of demand characteristics as it is likely that the participants would have been able to figure out the aim of the study
-Counterbalancing not an option as if the Funhaler was given first adherence may have either been increased by the time they used the standard spacer device or the child wouldn’t want to use anything other than the Funhaler
What were the strengths and weaknesses of the type of data collected in Chaney’s study?
-Quantitative: yes/no to using the inhaler the day before
-Easy statistical analysis of difference
-Data doesn’t tell us why there was a difference in attitude and behaviour, Chaney assumed it was reinforcement but this may not be the case
-Questions which asked for qualitative data may have supported conclusions
What ethical considerations are there for Chaney’s study?
-Informed consent from parents
-Briefed of the aims of the study
-Data responses were anonymised, ensuring privacy
-Care was taken to ensure the Funhaler administered a satisfactory level of medication so children were protected from harm
