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.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
150
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.
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.
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.
Time frame: 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.
Time frame: 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.
Time frame: Baseline (Day 0) and 5 days after the initiation of the intervention.
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