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

NCT07463443 | Recruiting

• 1 other identifier: 2025-12-005AC
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Pneumonia; Family Caregivers; Knowledge, Attitudes, Practice; Chatbot; Geriatric Patient

Keywords

Pneumonia; Family Caregivers; Knowledge, Attitudes, Practice; Chatbot; Geriatric patient

Outcome Measures

Primary Outcomes (3)

• 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.

Study Arms (2)

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.

Behavioral: Chatbot with Educational Videos

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.

Behavioral: Traditional Paper-based Education

Interventions

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.

Chatbot and Educational Videos Group

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.

Traditional Paper-based Education Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• (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.

You may not qualify if:

• (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.

Sponsors & Collaborators

• Taipei Veterans General Hospital, Taiwan: lead

Study Sites (1)

Taipei Veterans General Hospital

Taipei, Taiwan, 112201, Taiwan

RECRUITING

Related Publications (10)

• 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.

  PMID: 36383760 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.

  PMID: 35302946 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.

  PMID: 36142971 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.

  PMID: 39104027 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.

  PMID: 37862072 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.

  PMID: 30420506 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.

  PMID: 33634144 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.

  PMID: 27935019 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.

  PMID: 33414597 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.

  PMID: 34087609 RESULT

MeSH Terms

Conditions

Pneumonia; Behavior

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Ming-Shan Jan, Doctor of Philosophy

  Taipei Veterans General Hospital, Taiwan

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Yu-Xuan Peng, Bachelor of Science in Nursing

CONTACT

+886 905569880; ulysse0831@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 5, 2026
• First Posted: March 11, 2026
• Study Start: March 13, 2026
• Primary Completion (Estimated): February 24, 2027
• Study Completion (Estimated): February 24, 2027
• Last Updated: July 15, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)