Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Pneumonia is a leading cause of death and hospitalization among the elderly in Taiwan. High-quality home care is essential to recovery and reducing readmission, yet primary caregivers often lack the specific skills needed, such as airway clearance and safe feeding techniques. Traditional education, consisting of one-time verbal instructions and paper brochures, often lacks interactivity and real-time support.
This study introduces "Pneumonia Care Helper," an interactive LINE chatbot designed to provide digital health education. The goal is to evaluate whether this digital tool is more effective than traditional paper-based education in improving the knowledge, attitudes, and caregiving practices of primary caregivers of elderly pneumonia patients. The study will compare the outcomes of caregivers using the chatbot versus those receiving standard paper-based instructions over a 5-day intervention period.
This study employs a quasi-experimental research design to evaluate the effectiveness of a chatbot intervention, "Pneumonia Care Helper," in improving the caregiving capabilities of primary caregivers of elderly patients with pneumonia at Taipei Veterans General Hospital. Pneumonia remains a leading cause of mortality among the elderly in Taiwan, placing a significant burden on family caregivers who often lack professional medical training in essential tasks such as symptom recognition, airway clearance techniques, safe feeding practices, and oral hygiene. To address the limitations of traditional one-time verbal instructions and static paper-based materials, which often fail to provide interactive or real-time support, this research implements a digital health education framework via a mobile application. A total of 150 primary caregivers will be recruited from four specialized medical wards, including Hospital Medicine, Geriatrics, General Medicine, and Infectious Diseases. Participants are assigned to either the experimental or control group based on their respective hospital wards to minimize potential intervention crossover between participants in the same unit. Caregivers in the experimental group receive a five-day digital intervention featuring four specialized educational videos and an interactive, AI-driven chatbot for 24/7 on-demand inquiries. The control group receives a standardized 20-minute one-on-one verbal education session accompanied by a printed brochure containing identical content. The evaluation is guided by the Knowledge, Attitude, and Practice (KAP) theory, with assessments conducted at enrollment (Day 0) and upon completion of the five-day intervention (Day 5) using a validated KAP scale. This study aims to demonstrate the feasibility and efficacy of using mobile chatbot technology as a modern pedagogical tool to bridge the gap in clinical nursing education and enhance the overall quality of home-based pneumonia care for the elderly population.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Chatbot and Educational Videos Group | Experimental | Participants in the intervention wards will receive pneumonia health education via a dedicated chatbot. In addition to interactive text and FAQ modules, the chatbot provides four specialized educational videos covering pneumonia caregiving techniques. Caregivers can watch these videos repeatedly and access all digital materials anytime during the patient's hospitalization. |
|
| Traditional Paper-based Education Group | Active Comparator | Participants in the control wards will receive traditional health education through printed brochures and standard verbal instructions from nursing staff. The content of the paper-based materials is identical to the information provided in the chatbot group, but without interactive or digital features. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Chatbot with Educational Videos | Behavioral | Participants will receive access to a dedicated chatbot named "Pneumonia Care Helper." The intervention lasts for 5 days. It includes: (1) Initial orientation on chatbot operation. (2) Unlimited on-demand access to four educational videos: Introduction to Pneumonia, Airway Clearance Techniques, Feeding and Tube Feeding Skills, and Oral Hygiene. (3) An interactive text-based AI response system for real-time Q&A. Caregivers are encouraged to engage with the chatbot and watch the videos as many times as needed, 24/7, throughout the 5-day study period. |
| Measure | Description | Time Frame |
|---|---|---|
| Caregiver Knowledge of Elderly Pneumonia Care | Measured using the "Pneumonia Care Knowledge subscale" (13 items). This multiple-choice subscale covers the causes, symptoms, prevention, emergency recognition, chest physiotherapy, feeding safety, and oral hygiene of pneumonia. Each correct answer scores 1 point and incorrect answers score 0. Total scores range from 0 to 15, with higher scores indicating a better level of knowledge regarding elderly pneumonia care. The scale has been validated by experts with an S-CVI/Ave of 0.99. | Baseline (Day 0) and 5 days after the initiation of the intervention. |
| Caregiver Attitude Toward Elderly Pneumonia Care | Measured using the "Pneumonia Care Attitude subscale" (7 items). This subscale assesses the caregiver's perception of disease severity, learning willingness, and caregiving confidence using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Items 5 and 7 are reverse-scored. Total scores range from 7 to 35, with higher scores indicating a more positive attitude toward pneumonia care. The scale has been validated by experts with an S-CVI/Ave of 0.99. | Baseline (Day 0) and 5 days after the initiation of the intervention. |
| Caregiver Practice of Elderly Pneumonia Care | Measured using the "Pneumonia Care Practice subscale" (5 items). This subscale evaluates the frequency or intention of practical caregiving behaviors, including chest physiotherapy, oral hygiene, feeding/tube feeding, symptom monitoring, and preventive actions. It uses a 5-point Likert scale (1 = never to 5 = always). Total scores range from 5 to 25, with higher scores indicating more positive or frequent engagement in correct pneumonia care behaviors. The scale has been validated by experts with an S-CVI/Ave of 0.99. | Baseline (Day 0) and 5 days after the initiation of the intervention. |
Not provided
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yu-Xuan Peng, Bachelor of Science in Nursing | Contact | +886 905569880 | ulysse0831@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ming-Shan Jan, Doctor of Philosophy | Taipei Veterans General Hospital, Taiwan | Principal Investigator |
Not provided
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36383760 | Result | Cao Y, Liu C, Lin J, Ng L, Needleman I, Walsh T, Li C. Oral care measures for preventing nursing home-acquired pneumonia. Cochrane Database Syst Rev. 2022 Nov 16;11(11):CD012416. doi: 10.1002/14651858.CD012416.pub3. | |
| 35302946 | Result | Jenkins CL, Imran S, Mahmood A, Bradbury K, Murray E, Stevenson F, Hamilton FL. Digital Health Intervention Design and Deployment for Engaging Demographic Groups Likely to Be Affected by the Digital Divide: Protocol for a Systematic Scoping Review. JMIR Res Protoc. 2022 Mar 18;11(3):e32538. doi: 10.2196/32538. |
Not provided
Not provided
Individual participant data will not be shared to protect the privacy and confidentiality of the participants. Additionally, the data is being used for a master's degree thesis, and the full research findings will be made available through the university's thesis repository upon completion
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Traditional Paper-based Education | Behavioral | Participants will receive a 20-minute one-on-one verbal health education session conducted by the researcher upon enrollment. A printed pneumonia care brochure will be provided, containing information identical to the content in the chatbot's educational videos (Introduction to Pneumonia, Airway Clearance Techniques, Feeding and Tube Feeding Skills, and Oral Hygiene). The study period lasts for 5 days, during which caregivers have unlimited access to the brochure for review at any time. |
|
| 36142971 | Result | Ebihara T. Comprehensive Approaches to Aspiration Pneumonia and Dysphagia in the Elderly on the Disease Time-Axis. J Clin Med. 2022 Sep 10;11(18):5323. doi: 10.3390/jcm11185323. |
| 39104027 | Result | Choonhawarakorn K, Kasemkhun P, Leelataweewud P. Effectiveness of a message service on child oral health practice via a social media application: A randomized controlled trial. Int J Paediatr Dent. 2025 Mar;35(2):446-455. doi: 10.1111/ipd.13256. Epub 2024 Aug 5. |
| 37862072 | Result | Chen BL, Lien HC, Yang SS, Wu SC, Chiang HH, Lin LC. Impact of Mobile Apps in Conjunction With Percutaneous Endoscopic Gastrostomy on Patients' Complications, Quality of Life, and Health-Related Self-Care Behaviors: Randomized Clinical Trial. JMIR Mhealth Uhealth. 2023 Oct 20;11:e48970. doi: 10.2196/48970. |
| 30420506 | Result | Button B, Goodell HP, Atieh E, Chen YC, Williams R, Shenoy S, Lackey E, Shenkute NT, Cai LH, Dennis RG, Boucher RC, Rubinstein M. Roles of mucus adhesion and cohesion in cough clearance. Proc Natl Acad Sci U S A. 2018 Dec 4;115(49):12501-12506. doi: 10.1073/pnas.1811787115. Epub 2018 Nov 12. |
| 33634144 | Result | Belli S, Prince I, Savio G, Paracchini E, Cattaneo D, Bianchi M, Masocco F, Bellanti MT, Balbi B. Airway Clearance Techniques: The Right Choice for the Right Patient. Front Med (Lausanne). 2021 Feb 4;8:544826. doi: 10.3389/fmed.2021.544826. eCollection 2021. |
| 27935019 | Result | Beach SR, Schulz R. Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults. J Am Geriatr Soc. 2017 Mar;65(3):560-566. doi: 10.1111/jgs.14547. Epub 2016 Dec 9. |
| 33414597 | Result | Andrade C, Menon V, Ameen S, Kumar Praharaj S. Designing and Conducting Knowledge, Attitude, and Practice Surveys in Psychiatry: Practical Guidance. Indian J Psychol Med. 2020 Aug 27;42(5):478-481. doi: 10.1177/0253717620946111. eCollection 2020 Sep. |
| 34087609 | Result | Almirall J, Boixeda R, de la Torre MC, Torres A. Aspiration pneumonia: A renewed perspective and practical approach. Respir Med. 2021 Aug-Sep;185:106485. doi: 10.1016/j.rmed.2021.106485. Epub 2021 May 26. |
| ID | Term |
|---|---|
| D011014 | Pneumonia |
| D001519 | Behavior |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
Not provided
Not provided