Patient Aid for Theory-Driven Health Communication (PATH): Translating Goal-Power Theory Into an Instrument and Generative AI Support for Palliative Care Communication

【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.

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.

【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.

【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.

【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.

【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.

【Randomized Control Trial】The C-PSS is a 27-item instrument validated in Taiwan's outpatient population, assessing 6 dimensions: efficiency, fairness, chin-chieh (kindness), professionalism, responsibility, and respect. Each item is rated on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). With reverse-scored items appropriately adjusted, total scores are aggregated, where higher total scores indicate greater patient communication and overall satisfaction with the clinical encounter.

【Randomized Control Trial】The Chinese version of the SWD is a 6-item questionnaire designed to assess a patient's satisfaction with the healthcare decision-making process and its clinical outcomes. Each item is rated on a 5-point Likert scale. Total scores range from 6 to 30, with higher scores indicating a higher degree of satisfaction and agreement with the decisions made during the medical consultation.