The goal of this clinical trial is to learn whether an artificial intelligence (AI)-supported communication tool can help improve communication between people receiving palliative care and their healthcare providers. The study will also evaluate a new questionnaire designed to measure the quality of healthcare communication.
The main questions this study aims to answer are:
1. Can the new questionnaire accurately measure the quality of communication between participants and healthcare providers? 2. Does using the AI-supported communication tool, called NurseChat+, help participants feel more confident and prepared before meeting with their healthcare team? 3. Does NurseChat+ improve the quality of communication during palliative care visits?
Researchers will compare participants who use NurseChat+ together with their usual care to participants who receive usual care alone to see whether the tool improves communication outcomes.
The study will be conducted in three stages. First, researchers will develop and test a questionnaire that measures healthcare communication. Next, they will develop and refine the NurseChat+ tool. Finally, they will test the tool in adults receiving palliative care at National Taiwan University Hospital.
Participants in the final stage of the study will be randomly assigned to one of two groups. One group will use NurseChat+ before their scheduled medical visits in addition to receiving usual care, while the other group will receive usual care only. Participants will complete questionnaires about their communication experiences during the study.
Age 18 years or older.
Diagnosed with an advanced disease requiring consultation with outpatient palliative care clinics or home care services.
Able to self-complete the study questionnaires.
Age 18 years or older.
Identified as the primary family caregiver of a patient with an advanced disease requiring palliative care.
Professional or paid caregivers.
Unable to complete the study questionnaires.
Parallel
NurseChat+
BehavioralParticipants will use NurseChat+, a generative AI-supported communication tool, before scheduled palliative care visits to help prepare questions and concerns for discussion with healthcare providers. The intervention is provided in addition to usual care.
Change from Baseline in Communication Self-Efficacy via the 5-item Perceived Efficacy in Patient-Physician Interaction Scale (PEPPI-5)
【Randomized Control Trial \& Pilot study】The PEPPI-5 is a 5-item self-report instrument used to measure a patient's perceived self-efficacy in communicating with their physician. Each item is scored on a 5-point Likert scale from 1 (not at all confident) to 5 (very confident). The total score ranges from 5 to 25, with higher scores indicating higher levels of communication self-efficacy. Outcome will be assessed as the change in scores from T0 to T1.
Quality of Health Communication via the Phase-One Developed Instrument
Evaluated using a newly developed and validated communication-quality instrument generated in Phase One of the study. This instrument is designed to comprehensively assess the specific communication quality, patterns, and clinical encounter effectiveness between healthcare providers and palliative care patients/families when aided by GenAI communication aid. The instrument is currently undergoing development and psychometric validation. The finalized total score will be structured such that higher scores will mathematically indicate a superior quality of health communication and better communication patterns.
System Usability Scale (SUS) Score of NurseChat+
【Pilot study】The UEQ contains 26 pairs of contrasting adjectives used to evaluate the user experience of NurseChat+ across 6 scales (Attractiveness, Perspicuity, Efficiency, Dependability, Stimulation, and Novelty). Each item is scored on a 7-point scale ranging from -3 (horrible/extremely bad) to +3 (excellent/extremely good). Scores above 0.8 represent a positive evaluation.
Inventory of Technology Acceptance Model (ITAM) Score
【Pilot study】The ITAM assesses user acceptance, perceived usefulness, and perceived ease of use regarding the NurseChat+ GenAI system. Items are scored on a 7-point Likert scale, ranging from 1(strongly disagree) to 7 (strongly agre), with higher total scores indicating a higher intention to adopt and greater acceptance of the technology.
Evaluation of User Experience via the User Experience Questionnaire (UEQ)
【Pilot study】The UEQ is a 26-item semantic differential scale used to provide a holistic assessment of the user experience of NurseChat+. It measures both pragmatic qualities (efficiency, perspicuity, dependability) and hedonic qualities (stimulation, novelty), along with overall attractiveness. Each item consists of a pair of contrasting adjectives rated on a 7-point scale ranging from 1 to 7. For analysis, responses are transformed to range from -3 (horribly bad) to +3 (extremely good), where 0 represents a neutral evaluation. Higher positive values reflect a superior user experience, and scale scores above 0.8 generally indicate a positive evaluation.
Improvement in Symptom Burden via the Edmonton Symptom Assessment System (ESAS)
【Randomized Control Trial】The ESAS is a validated tool designed to assess 9 common symptoms in palliative care patients (pain, tiredness, drowsiness, nausea, appetite, shortness of breath, depression, anxiety, and wellbeing). Each symptom is rated on a visual analogue scale from 0 (no symptom) to 10 (worst possible symptom). The total distress score ranges from 0 to 90, with higher scores indicating a higher symptom burden.
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National Taiwan University Hospital
Lead sponsor
National Science and Technology Council, Taiwan
Collaborator
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