Maria Armaou
Post Graduate Research Assistant
Department of Psychology, Health and Professional Development
Research
I am working on the mixed-methods research project "Rapidly formed COVID-19 teams in the NHS - Implications for leadership, team-working, career intentions and individual mental health".
With an academic background in occupational health psychology my core research interests lay within health studies, psychological wellbeing in the workplace and the development and evaluation of digital interventions.
Projects
Publications
Journal articles
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Kulkarni K, Shah R, Armaou M, Leighton P, Mangwani J, Dias J, 'What can we learn from the experiences and expectations of patients on growing waiting lists for planned care in the COVID-19 pandemic?'
Bone & Joint Open 2 (8) (2021) pp.583-593
eISSN: 2633-1462AbstractPublished here Open Access on RADARAims. COVID-19 has compounded a growing waiting list problem, with over 4.5 million patients now waiting for planned elective care in the UK. Views of patients on waiting lists are rarely considered in prioritization. Our primary aim was to understand how to support patients on waiting lists by hearing their experiences, concerns, and expectations. The secondary aim was to capture objective change in disability and coping mechanisms.
Methods. A minimum representative sample of 824 patients was required for quantitative analysis to provide a 3% margin of error. Sampling was stratified by body region (upper/lower limb, spine) and duration on the waiting list. Questionnaires were sent to a random sample of elective orthopaedic waiting list patients with their planned intervention paused due to COVID-19. Analyzed parameters included baseline health, change in physical/mental health status, challenges and coping strategies, preferences/concerns regarding treatment, and objective quality of life (EuroQol five-dimension questionnaire (EQ-5D), Generalized Anxiety Disorder 2-item scale (GAD-2)). Qualitative analysis was performed via the Normalization Process Theory.
Results. A total of 888 patients responded. Better health, pain, and mood scores were reported by upper limb patients. The longest waiters reported better health but poorer mood and anxiety scores. Overall, 82% had tried self-help measures to ease symptoms; 94% wished to proceed with their intervention; and 21% were prepared to tolerate deferral. Qualitative analysis highlighted the overall patient mood to be represented by the terms ‘understandable’, ‘frustrated’, ‘pain’, ‘disappointed’, and ‘not happy/depressed’. COVID-19-mandated health and safety measures and technology solutions were felt to be implemented well. However, patients struggled with access to doctors and pain management, quality of life (physical and psychosocial) deterioration, and delay updates.
Conclusion. This is the largest study to hear the views of this ‘hidden’ cohort. Our findings are widely relevant to ensure provision of better ongoing support and communication, mostly within the constraints of current resources. In response, we developed a reproducible local action plan to address highlighted issues.
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Armaou M, Araviaki E, Musikanski L, 'eHealth and mHealth Interventions for Ethnic Minority and Historically Underserved Populations in Developed Countries: an Umbrella Review'
International Journal of Community Well-Being 3 (2019) pp.193-221
ISSN: 2524-5295 eISSN: 2524-5309AbstractPublished hereHealth disparities among historically disadvantaged populations can undermine the effectiveness of eHealth and mHealth interventions and limit their acceptability among diverse community members. The twin aims of this umbrella review of systematic reviews (SRs) are to summarise the evidence on the characteristics and effectiveness of eHealth and mHealth interventions among underserved populations in developed counties and provide recommendations to community organizers, policy makers and researchers. Comprehensive searches were conducted in bibliographic databases, Google Scholar and references lists for SRs published in English between 2000 and 2019. SRs were selected following a protocol registered with PROSPERO. Two independent reviewers were involved in the selection appraisal process, quality assessment and data extraction process. Six SRs met the inclusion criteria for this umbrella review. The six SRs concerned interventions delivered by computer programmes, cell-phones or other electronic devices. The studies in the SRs reported improvements to physiological well-being, health knowledge and self-management, as well as improvements in psychosocial outcomes. This umbrella review concludes with recommendations for community organizers, policy makers and researches for the formation of guidelines, inclusion of target community members in the development of eHealth interventions and directions for future research.
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Armaou, Konstantinidis, Blake, 'The Effectiveness of Digital Interventions for Psychological Well-Being in the Workplace: A Systematic Review Protocol.'
International Journal of Environmental Research and Public Health 17 (1) (2019)
ISSN: 1661-7827 eISSN: 1660-4601AbstractOBJECTIVE\nMETHODS\nCONCLUSION\nPsychological well-being has been associated with desirable individual and organisational outcomes. This systematic review aims to assess the effectiveness of digital interventions for the improvement of psychological well-being and/or the prevention/management of poor mental well-being in the workplace.\nThis review protocol is registered in PROSPERO (CRD42019142428). Scientific databases including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials (CENTRAL) and EMBASE will be searched for relevant studies published between January 1990 and July 2019. Studies will be included if they report specific primary and secondary outcomes of digital interventions delivered to adults in the workplace for the improvement of their psychological wellbeing and/or the prevention/management of poor mental well-being and were published in English. Following screening of titles and abstracts, full texts of potentially eligible papers will be screened in duplicate to identify studies that assess the effectiveness of those digital interventions. Discrepancies will be resolved through consensus or by consulting a third reviewer. An integrated narrative synthesis will assess included studies' findings, and a meta-analysis will be performed if included studies appear to be homogeneous. The "Cochrane Collaboration's Risk of Bias" tool and the JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Quasi-Experimental Studies will be used to appraise included studies.\nThe results of this work will provide recommendations on the use of digital interventions for the promotion of psychological well-being at work. It will also guide the development of future workplace digital interventions and subsequent primary research in this field.Published here -
Grunfeld, Schumacher, Armaou, Woods, Rolf, Sutton, Zarkar, Sadhra, 'Feasibility randomised controlled trial of a guided workbook intervention to support work-related goals among cancer survivors in the UK.'
BMJ Open 9 (1) (2019)
ISSN: 2044-6055 eISSN: 2044-6055AbstractOBJECTIVES\nDESIGN\nSETTING\nPARTICIPANTS\nINTERVENTION\nOUTCOME MEASURES\nRESULTS\nCONCLUSIONS\nTRIAL REGISTRATION NUMBER\nEmployment following illness is associated with better physical and psychological functioning. This study aimed to assess the feasibility and acceptability of a theoretically led workbook intervention designed to support patients with cancer returning to work.\nParallel-group randomised controlled trial with embedded qualitative interviews.\nOncology clinics within four English National Health Service Trusts.\nPatients who had received a diagnosis of breast, gynaecological, prostate or colorectal cancer and who had been receiving treatment for a minimum of two weeks.\nA self-guided WorkPlan workbook designed to support patients with cancer to return to work with fortnightly telephone support calls to discuss progress. The control group received treatment as usual and was offered the workbook at the end of their 12-month follow-up.\nWe assessed aspects of feasibility including eligibility, recruitment, data collection, attrition, feasibility of the methodology, acceptability of the intervention and potential to calculate cost-effectiveness.\nThe recruitment rate of eligible patients was 44%; 68 participants consented and 58 (85%) completed baseline measures. Randomisation procedures were acceptable, data collection methods (including cost-effectiveness data) were feasible and the intervention was acceptable to participants. Retention rates at 6-month and 12-month follow-up were 72% and 69%, respectively. At 6-month follow-up, 30% of the usual care group had returned to full-time or part-time work (including phased return to work) compared with 43% of the intervention group. At 12 months, the percentages were 47% (usual care) and 68% (intervention).\nThe findings confirm the feasibility of a definitive trial, although further consideration needs to be given to increasing the participation rates among men and black and ethnic minority patients diagnosed with cancer.\nISRCTN56342476; Pre-results.Published here -
Armaou, Schumacher, Grunfeld, 'Cancer Survivors' Social Context in the Return to Work Process: Narrative Accounts of Social Support and Social Comparison Information.'
Journal of Occupational Rehabilitation 28 (3) (2018) pp.504-512
ISSN: 1053-0487 eISSN: 1573-3688AbstractPurpose Returning to work is a process that is intertwined with the social aspects of one's life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients' perceptions of the role of their social context in relation to returning to work following treatment. Methods Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers' support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions Two functions of the social context of returning to work after cancer were apparent in the participants' narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one's readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual's successful return to the workplace.Published here -
Schumacher, Armaou, Rolf, Sadhra, Sutton, Zarkar, Grunfeld, 'Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors.'
BMC Psychology 5 (1) (2017)
ISSN: 2050-7283 eISSN: 2050-7283AbstractBACKGROUND\nMETHODS\nRESULTS\nCONCLUSIONS\nTRIAL REGISTRATION\nReturning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work.\nAs part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis.\nParticipants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention.\nThe self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process.\nCurrent Controlled Trials ISRCTN56342476 . Retrospectively registered 14 October 2015.Published here