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

March 5, 2026 updated by: Yu-Xuan Peng, Taipei Veterans General Hospital, Taiwan

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

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

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
150

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Yu-Xuan Peng, Bachelor of Science in Nursing
  • Phone Number: +886 905569880
  • Email: ulysse0831@gmail.com

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Chatbot and Educational Videos Group
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
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.
Active Comparator: Traditional Paper-based Education Group
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
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.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Caregiver Knowledge of Elderly Pneumonia Care
Time Frame: Baseline (Day 0) and 5 days after the initiation of the intervention.
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
Time Frame: Baseline (Day 0) and 5 days after the initiation of the intervention.
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
Time Frame: Baseline (Day 0) and 5 days after the initiation of the intervention.
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.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Taipei Veterans General Hospital, Taiwan

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Ming-Shan Jan, Doctor of Philosophy, Taipei Veterans General Hospital, Taiwan

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

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Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 10, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 24, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 24, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 5, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 5, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 11, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 5, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025-12-005AC

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

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

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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