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    The co-design of a chat telepsychotherapy manual for Indonesians with minor depression : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Auckland, New Zealand
    (Massey University, 2024-04-08) Endro, Wisnu Tri Widodo
    The primary aim of this study was to address a gap found in the discipline of Psychology and mental health treatment in the Indonesian setting. Advances in technology and the changing lifestyle of Indonesians made distance mental health treatment a common practice. This study focuses on one of the few options for distance mental health treatment, Chat Telepsychotherapy, which has gained popularity among Indonesians, especially the Millennials and Gen Z in Indonesia. The main issue with the phenomenon was the unavailability of comprehensive, evidence-based guidelines on how to best execute such a therapy. Thus, this study aimed to create a manual that could help the community of Indonesian Clinical Psychologists to deliver Chat Telepsychotherapy to Indonesians. The study limits the scope to Indonesian Millennials and Gen Z who suffer from Minor Depression. This is because these generations are the primary users of such a service, and depression itself is found to be one of the most common mental health issues in Indonesia. To achieve the goal of this study, I used a qualitative method that used Collaborative Design with the help of online-focused group discussion. I collaborated with Indonesian clinical psychologists, Indonesian millennials, and Gen Z with minor depression to design the manual. Thematic analysis was used to analyse the participants' answers. The result of the study is a comprehensive manual that consists of nine chapters: 1) Introduction; 2) The Concept of Chat Telepsychotherapy; 3) Starting CT Practice; 4) General Guidelines for Conducting CT; 5) Specific Guidelines for Conducting CT; 6) Characteristics of Indonesian Millennials and Gen Z; 7) Minor Depressive Disorder; 8) Self-Harm; 9) CT Stages for Indonesian Millennial and Gen Z with Minor Depression. The main suggestion for future studies is to test the manual to assess its usability and effectiveness.
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    Babies and Babble : parents’ experiences of the neonatal unit and the role of the Babble app : a thesis presented in partial fulfilment of the requirements for the degree Doctor of Clinical Psychology at Massey University, Auckland, New Zealand
    (Massey University, 2020) Gibson, Charlotte
    Neonatal unit admission is commonly a highly distressing and difficult time for new parents, impacting their confidence in their parenting abilities and predisposing them to significant mental health difficulties (Ballantyne et al., 2017; Holditch-Davis & Miles, 2000). In response to admission, parents commonly report a need for clear, concise information and inclusion in neonatal care (Cleveland, 2008). Alongside the rise of technology and the prevalence of smartphones across the world, mobile health applications have been theorised as an effective method of delivering rapid, consistent and accessible information to health consumer populations. Within the neonatal sphere, such approaches have been growing in popularity, however, little research has focused on the development and efficacy of mobile health applications dedicated to needs of parents with an infant admitted to a neonatal unit. In response, MidCentral District Health Board has developed an informational mobile health application, Babble, for use in conjunction with traditional care formats and with the hopes of providing greater support to parents in neonatal units (Spargo & de Vries, 2018). Although utilised by parents, the Babble app is yet to be empirically evaluated and the impacts of its use are not well understood. In this thesis, an exploration as to parents’ experiences of the neonatal unit and the role of the Babble app is conducted in two parts. Study One explores the experiences of 449 parents with an infant admitted to a neonatal unit in New Zealand, across measures of distress, self-efficacy, how informed they felt during their infant’s admission, and their Babble app use. Study Two involved in-depth qualitative interviews with eight mothers from the Palmerston North neonatal unit, (where the Babble app originated), exploring their perspectives of their infant’s hospitalisation, and the Babble app itself. Study One showed that parents experienced moderate distress, felt reasonably informed and considered themselves to be somewhat confident in their parental role during their infant’s neonatal admission. The Babble app did not demonstrate any significant effect on any of the variables of interest. However, results indicated that the more informed parents felt, the less distress they experienced. This relationship was partially mediated by enhanced self-efficacy, suggesting the importance of information in supporting parental self-efficacy and reducing distress. Study Two expanded on these findings, identifying several key themes present in the experiences of mothers with infants admitted to a Level II+ neonatal unit. Firstly, findings indicated there were various ways in which mothers struggled with their parental role within a neonatal context, experiencing challenges related to managing their own expectations of the experience and asserting their role within the unit. Consistent and supportive relationships with staff, family, friends, and their partners, were seen as influential in the maternal experience. Most significantly, good communication and strong relationships with staff were seen to improve maternal confidence. Information was highly valued by mothers, with some variation in their interactions with information, depending on individual needs and styles. The Babble app was considered a useful adjunct to traditional care formats by mothers who identified that they were able to adapt and integrate its use in alignment with their individual preferences and needs. Taken together, these findings suggest that for families, neonatal admission is a challenging and diverse experience. Staff are essential, not only as sources of information, but as part of a supportive relationship with families. The importance of informational support cannot be understated and its value in building parental self-efficacy and reducing parental distress was evidenced across both studies. Ultimately, the findings presented here suggest that informational resources, such as Babble, can act supportively for parents and therefore, are worthy of further development and exploration.
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    A feasible and effective remote diagnosis system for healthcare : a thesis presented in partial fulfilment of the requirements for the degree of Masters in Engineering, School of Engineering and Advanced Technology, Massey University
    (Massey University, 2018) Rowe, Daniel
    This master thesis documents the research and developmental process in creating a feasible and effective remote diagnosis system for healthcare. The research is within the sector of the rapidly expanding practice that is Telemedicine. Telemedicine is defined as “the remote diagnosis and treatment of patients by means of telecommunications technology” [1]. It has become a reality for delivering high quality healthcare to patients not only in remote locations but also to monitor elderly patients as well as patients living with chronic diseases. In the past decade, advancements in technologies have been fuelling the growth of telemedicine. Numerous healthcare products have appeared on the market and are moving towards smartphone applications (apps), some of which include remote consultation using video calling software. The majority of these products are stand-alone applications with limited monitoring of patient’s vital signs. A number of systems are novel, low cost and specifically designed for monitoring the patients’ vital signs, but few offer a fully integrated system for remote diagnosis. Remote healthcare diagnosis systems, especially affordable small devices that provide reliable data in real-time, still challenge researchers. This research studied the currently available telemedicine systems, cloud database and the features of smartphone apps. The research confirmed the possibility to develop a hand-held system that could obtain remote patient vital signs and transmit the data, effectively in real-time to healthcare professionals for diagnosis via a cloud database and smartphones. A proposed system was designed, and a physical prototype developed. Tests made on the prototype proved the system can capture remote patient’s vital signs and transmit them to a doctor through a cloud database and a smartphone app. The system consists of three major units: • A hand-held device that measures patient vital signs. • A smartphone application with a simple user interface to communicate with health professionals via internet and to the device via Bluetooth. • A cloud database for data transfer and the communication with the smartphone application through an internet connection. The outcome of this research confirms it is feasible to develop small, economic and portable systems for health diagnosis. Such systems could be very useful for remote patients, especially those living with chronic diseases and requiring regular medical checks, without traveling to access health services to obtain professional treatment.
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    Opportunities and barriers for m-health in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Information Science in Software Engineering at Massey University
    (Massey University, 2007) Mirza, Farhaanullah Baig
    This thesis describes a study to determine the opportunities and barriers for mobile health in New Zealand. The world total of mobile phones currently stands at 2.5 billion and is set to reach 3 billion by the end of 2007 [1]. New Zealand has approximately 3.8 million mobile subscribers [2],[3] and this country, along with many others, recognizes the opportunities for using mobile technology in healthcare. Mobile health (m-health) has moved past the hype stage overseas; there is good evidence for improved productivity, and growing evidence for improved patient engagement. Broadband wireless, improved mobile devices and integrated mobile applications will continue this growth. New Zealand health and disability providers can adapt these overseas m-health successes to develop their own mobile health strategies [4]. M-health involves the use of mobile technology to enhance health services. The mobile technology can be either a short-distance or long-distance technology, or be device driven. The health industry is an information intensive industry, and as New Zealand has a public healthcare model, the idea of information integration among and within health sectors is encouraged. The purpose of this study is to identify the barriers and opportunities of m-health in New Zealand. Following an introduction, the literature survey defines the scope of the study. It first discusses wireless and mobile computing technologies, then looks at New Zealand healthcare information strategies and the importance of information in the health industry. Finally, these two topics are investigated by exploring the literature on the use of wireless technology in healthcare - in both clinical and non-clinical applications. M-health is a new area of development in the health industry. Hence the practical part of the research used a qualitative research strategy, determined to be appropriate to obtaining a better understanding of any phenomena about which little is yet known [5]. The two main parts of this research include the questionnaire and the interviews. The questionnaire sample was selected from health users, health planners, health technology suppliers, and academics, and covered areas of patient care, primary care, secondary care, community care, and integrated care. The interview sample consisted of technology strategists, primary healthcare planners, secondary healthcare planners, and community healthcare planners. The main focus of the interview was to find out about the future of m-health in New Zealand, analyze which sectors can benefit from m-health, examine the opportunity for customized software on mobile devices, gather possibilities of mobile assistance toward integrated care, and lastly, find out about the privacy and security issues of using mobile technology in healthcare. The questionnaire results indicate that the patients would appreciate receiving health services on their mobile phones. There is strong agreement that patients will benefit from text reminders, health awareness campaigns, and patient monitoring. The findings indicate that community nurses could use m-health technology to improve integration of information. There are two differing opinions on Electronic Health Records (EHRs) and their mobility across all sectors - the technology strategists think it is very important, but the health planners are divided. The opportunities that have been identified from the interviews include monitoring, health alarms, patient engagement in healthcare, community workers information integration, SMS reminders and alerts, ability of health workers to work offsite, prescription feedback, and using PDAs where necessary to enable electronic data capture. The barriers include legacy systems, disparate systems, lack of standards, lack of integration tools, lack of bandwidth, DHB-led initiatives, older health planners who are resistant to technology, ill population having the least uptake of technology, inability to share information with patients, development of mobile applications, infrastructure investment, telecommunication barriers, changed management, lack of technical capabilities, and cultural barriers.
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    The impact of ultra-fast broadband on telehealth in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Information Sciences in Information Technology at Massey University, Albany, New Zealand [print title]
    (Massey University, 2013) Varnosafaderani, Siamak R.
    In recent years, many countries around the world have introduced Information and Communications Technologies (ICTs) in their healthcare industry, in a bid to improve their productivity and the effectiveness of their services, triggering the eHealth phenomenon. As a component of eHealth, telehealth– which refers to a set of expertise and methods that integrate the world of ICT with the healthcare sector, providing medical care and education over a distance– is revolutionazing the healthcare sector. One of the most important ICTs used in the provision of telehealth is broadband internet. The bandwidth of the broadband connection determines the speed and quality of communications. Ultra-fast broadband– currently defined as connections with bandwidth greater than 100Mbps for downloads and 50Mbps for uploads– has made possible connections and communications on a scale and of a quality never before possible. The capacity to traverse geographical boundaries in real time and transfer large amounts of information has made ultra-fast broadband a soughtafter tool in many businesses. The main objective of this research is to study the impact of ultra-fast broadband internet on the development and quality of telehealth systems, especially in New Zealand. This thesis provides an overview of current broadband technologies available for running successful telehealth services, and studies the application and importance of broadband internet in the field of healthcare. It also provides a summary of the evolution of the use of ICTs, broadband technologies in particular, by health systems and a brief look at the future of these technologies in healthcare sectors, mainly in New Zealand. This thesis will conclude the importance of broadband internet in telehealth and its related services, and that the provision of telehealth would be near to impossible without ICTs such as broadband. This thesis will also conclude the introduction of ultra-fast broadband into telehealth in New Zealand to be a significant step forward as evident in telehealth projects overseas.