Chaney - Developmental Area

Question 1

aim

Answer 1

to test whether an asthma spacer device known as a “Funhaler” could provide positive reinforcement to improve adherence in child asthmatics compared to derived in current use

Question 2

method

Answer 2

• field experiment
• repeated measure design
• IV: type of device used: standard spacer device (breath-a-tech or AeroChamber) or a novel device known as the “funhaler”
• DV: the compliance level to the prescribed medical regime
• Sample: consisted of 23 children who were instructed tp use a funhaler instead of their normal pMDI )pressurised metered dose inhaler) and spacer inhaler to administer their medication. The funhaler used a number of features to distract the attention of children from the drug delivery and to reinforce correct use of device. Parents of participants then completed questionnaires after use of the standard inhaler and the funhaler.

Question 3

sample/participants

Answer 3

• study involved 32 children, 22 males and 10 female
• the age range was 1.5-6 years
• mean age of 3.2 years and average duration of asthma of 2.2 years
• sampling technique was a random sample of asthmatic children who has been prescribed drugs delivered by pMDI and spacer (pressurised metered dose inhaler) and were recruited from clinics across a large geographical area

Question 4

procedure

Answer 4

• Firstly, 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. The comparison was therefore complementary, indicating that the use of a Funhaler rather than a standard inhaler does not compromise drug delivery. This is an important control measure implemented by the researchers as differences in the amount of air output from the different inhalers could have caused any differences in adherence. As this control measure was implemented, we can be sure that the differences found were not due to differences in aerosol output.
• As part of this process, participants were approached by the researcher at home initially before the Funhaler was mentioned and were interviewed with a questionnaire on their existing use of the inhaler.
• Then they were give 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.
• Matched questionnaires were competed (by parents) after sequential use of the Breath-a-Tech inhaler and the Funhaler.
• 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.
• Data collected from the self-report related to how easy each device was to use, compliance of parents and children, and treatment attitudes. Furthermore, 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.
• The Funhaler incorporates a number of 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. The Funhaler makes spacers appealing to children in the following ways:
  1. It isolates incentive toys, such as the 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.
  2. The design of the toys themselves ensures sufficient inspiratory resistance to minimise entrainment of inspired air through the toy circuit.
  3. The design attempts to link the optimal function of the toys to deep breathing pattern conducive to effective medication.
  4. 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.

Question 5

results

Answer 5

Compliance was higher when using the funhaler, with children showing greater satisfaction and willingness to use the funhaler compared to the standard inhaler. Parents attitudes towards medicating their children were also more positive when using the novel device

Question 6

conclusions

Answer 6

The funhaler may be useful as a functional incentive device that could improve compliance to medical regimes in young asthmatics

Question 7

The strengths and weaknesses of the different research methods and techniques

Answer 7

• field experiment: positive - less chance of demand characteristics,
• high ecological validity, questionnaire - easy to replicate
• repeated measure design: positive - quicker and more efficient
• field experiment - high chance of extraneous variables
  repeated measures - order effects

Question 8

The strengths and weaknesses of different types of data

Answer 8

• quantitative data: easy to analyse and to compare
• no qualitative data - no context e.g funhaler situation

Question 9

ethical considerations

Answer 9

• parents or guardians are able to consent
• able to withdraw but might not be aware
• no physical, mental or psychological harm
• no debrief
• was confidential
• children couldn’t be debriefed (can’t understand)

Question 10

validity

Answer 10

• no demand characteristics because its a field experiment (children wouldn’t think about demand characteristics)
• low internal validity - responses may be socially desirable (child may have not used the funhaler - lied)
• extraneous variables when using funhaler at home
• high ecological validity

Question 11

reliability

Answer 11

• standardised procedure: over the same time period, every child had to use the funhaler for 2 weeks
• low internal reliability - field experiment, lack control so there are extraneous variables
• high levels of replicability

Question 12

sampling bias

Answer 12

• more boys than girls (androcentric)
• children were all between 2-6 years old
• only used young children - cant generalise and compared to adults
• random sampling

Question 13

ethnocentrism

Answer 13

• medical conditions - should be the same conditions everywhere
• only done on one culture (australia)