Effectiveness of Chatbot for Improving Caregiving Outcomes in Primary Caregivers of Geriatric Pneumonia Patients: A Study on Knowledge, Attitude and Practice.

Effectiveness of Chatbot for Improving Caregiving Outcomes in Primary Caregivers of Geriatric Pneumonia Patients: A Study on Knowledge, Attitude and Practice.

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.

Inclusion Criteria:

• (1)Patients with a primary diagnosis of pneumonia during the current hospitalization.(2)Patients aged 65 years or older.(3)Primary caregivers aged 18 years or older.(4)Primary caregivers who can read and understand Mandarin Chinese.(5)Primary caregivers who own a mobile device (e.g., smartphone or tablet) and can use the chatbot application.

Exclusion Criteria:

• (1)Primary caregivers who do not live with the patient.(2)Primary caregivers who have received formal training as professional nursing assistants or caregivers.(3)Primary caregivers who are currently or were formerly healthcare professionals (e.g., physicians, nurses, therapists).(4)Primary caregivers who do not possess a mobile device or are unable to use chatbot applications.