Chaney et al - Developmental area

Question 1

What are behaviour therapy and behaviour modification based on?

Answer 1

• Based on classical conditioning

- Based on operant conditioning

Question 2

What doesn’t necessarily improve with rising severity of illness?

Answer 2

Adherence

Question 3

What did Watt et al propose would improve medical adherence in young asthmatics?

Answer 3

That a positive interplay of adherence considerations with aerosol output factors would improve medication adherence in young asthmatics

Question 4

What is operant conditioning?

Answer 4

• It is a form of associative learning
• Whereby, associations and connections are formed between stimuli and responses that didn’t exist before learning occurs

Question 5

What does operant conditioning involve?

Answer 5

It involves learning through the consequences of behavioural responses

Question 6

Who first investigated the principles of operant conditioning?

Answer 6

Thorndike

Question 7

What did he find?

Answer 7

• 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

Question 8

What was the aim of this study?

Answer 8

• 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

Question 9

What experimental method was used?

Answer 9

Field experiment

Question 10

What was the experimental design that was used?

Answer 10

Repeated measures design

Question 11

What was the IV? (2)

Answer 11

• Whether the child used a standard/small volume spacer device - The breath-A-Tech
• Whether the child used a Funhaler

Question 12

What was the DV?

Answer 12

The amount of adherence to the prescribed medical regime

Question 13

How many children were in the study? (gender)

Answer 13

• 32 children

- 22 male, 10 female

Question 14

Where was the study conducted?

Answer 14

Conducted in the P’s home setting in Australia

Question 15

On average, how long had the children had asthma?

Answer 15

2.2 years

Question 16

How did the children’s parents get involved?

Answer 16

• Helped (where necessary) in the use of the inhalers

- Completed questionnaires and took part in a phone interview

Question 17

What did the parents provide?

Answer 17

Provided informed consent

Question 18

What was the sampling technique?

Answer 18

Random sampling

Question 19

How were P’s recruited?

Answer 19

Recruited from clinics across a large area

Question 20

What happened first? (inhalers)

Answer 20

• Firstly, a comparison was made between the aerosol output of the standard/small volume spacer device
• 235ml Breath-A-Tech
• 225ml Funhaler

Question 21

Was there any differences observed?

Answer 21

There was no significant differences observed

Question 22

What did that mean for the comparison?

Answer 22

• The comparison was therefore complementary

- It indicated that the use of a Funhaler rather than a standard inhaler does not compromise drug delivery

Question 23

How were participants approached by the researcher?

Answer 23

• 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

Question 24

How long were they given the funhaler?

Answer 24

Two weeks

Question 25

What happened in the 2 weeks

Answer 25

They reported over the phone on an ad hoc basic to take snapshots of whether they had used the Funhaler the previous day

Question 26

What were completed by the parents?

Answer 26

Matched questionaires

Question 27

When were the matched questionnaires completed?

Answer 27

After sequential use of the Breath-A-Tech inhaler and the Funhaler

Question 28

After sequential use of both inhalers, who visited them again?

Answer 28

Researchers

Question 29

What happened when they were visited?

Answer 29

The parents were interviewed and they completed the matched questionnaires

Question 30

What data was collected from the self-report?

Answer 30

- How easy each device was to use - Compliance of parents and children - Treatment attitudes

Question 31

During the course of the study, when were the parents called?

Answer 31

- At random | - To find out whether they had attempted to medicate their child the day before

Question 32

Why does the Fuhaler include features to the inhaler?

Answer 32

- To distract the attention of the child from the drug delivery event - Provide a means of self-reinforcing the use of effective technique

Question 33

How was the funhaler made appealing?

Answer 33

- 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.

Question 34

Did the use of the Funhaler associate with improved parental and child compliance?

Answer 34

Yes

Question 35

When surveyed at random, how many children were found to have been medicated the previous day (FUNHALER)

Answer 35

81% (22/27)

Question 36

What was this in comparison to?

Answer 36

- 59% of children (16/27) | - using the existing small volume spacer device

Question 37

How many children took the recommended 4 or more cycles per aerosol delivery when using the funhaler?

Answer 37

- 80% - 24/30 - compared with 15/30 - 50% Standard/ Small volume spacer - 30% more

Question 38

How many parents were always successful in medicating their child with the funhaler?

Answer 38

22/30

Question 39

How many parents were always successful in medicating their child with the B-A-T?

Answer 39

3/30

Question 40

What was the Funhaler associated with?

Answer 40

Fewer problems than when using the existing device

Question 41

Is the Funhaler useful for management of young asthmatics?

Answer 41

Improved adherence combined with satisfactory delivery characteristics, suggest that the Funhaler may be useful for management of young asthmatics

Question 42

What could the use of the Funhaler be translated to?

Answer 42

The use of the Funhaler could possibly be translated to improved measures of clinical outcome

Question 43

How can the Funhaler improve health?

Answer 43

The use of functional incentive devices such as the Funhaler may improve the health of children

Question 44

Is more research needed?

Answer 44

More research is recommended in the long term efficiency of this treatment