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Students Of Color And Covid-19: Experiences, Coping Strategies, And Supports, Amie S. Kang, Barbora Hoskova, Chung Yu Liu, Arisa Viddayakorn, Molly Binder, Belle Liang, Betty S. Lai Aug 2023

Students Of Color And Covid-19: Experiences, Coping Strategies, And Supports, Amie S. Kang, Barbora Hoskova, Chung Yu Liu, Arisa Viddayakorn, Molly Binder, Belle Liang, Betty S. Lai

Journal of Educational Research and Practice

The coronavirus disease of 2019, known as the COVID-19 pandemic, is a disaster event that posed significant physical, social, financial, and mental health risks to college students. Disproportionate experiences of stressors position students of color as a population particularly vulnerable to the negative impacts of COVID-19, thus, the current study assessed the impact of COVID-19 on undergraduate students of color in the United States. Students participated in semi-structured in-depth interviews about their experiences with stressors during the pandemic. Data were analyzed using conventional content analysis and revealed themes including (a) the pandemic’s impact on students; (b) basic needs as college …


Teachers’ Perspectives In Higher Education On Using Educational Technology During The Covid-19 Pandemic: Observations For Ghana, India, And Serbia, Nikola Koruga, Rohit Nainwal, Angela Kyerewaa Ayisi-Addo Jun 2023

Teachers’ Perspectives In Higher Education On Using Educational Technology During The Covid-19 Pandemic: Observations For Ghana, India, And Serbia, Nikola Koruga, Rohit Nainwal, Angela Kyerewaa Ayisi-Addo

Higher Learning Research Communications

Objective: The purpose of this research was to understand the significant changes and challenges regarding teaching experiences during the coronavirus (COVID-19) crisis in three universities, one each in Africa, Asia, and Europe. The study provides information on how teachers adapted to online teaching under COVID-19 conditions.

Methods: We employed a descriptive phenomenology approach and used an online survey with open-ended questions to collect the data. Braun and Clarke’s six steps of thematic analysis based on the traditions of descriptive phenomenology were employed to analyze the data.

Results: The teachers’ adaptive mechanisms to the COVID-19 crisis could be described through the …


University Administrators’ Visions For The Recovery Of International Student Exchange In A Post–Covid-19 World, Yusuke Sakurai, Yukiko Ishikura, Ryoko Nakano, Yuki Nabeshima, Yu Sengoku, Akito Okada, Sachihiko Kondo May 2023

University Administrators’ Visions For The Recovery Of International Student Exchange In A Post–Covid-19 World, Yusuke Sakurai, Yukiko Ishikura, Ryoko Nakano, Yuki Nabeshima, Yu Sengoku, Akito Okada, Sachihiko Kondo

Higher Learning Research Communications

Objectives: Little is known about how international functions of higher education, such as exchange programmes, can be resumed during recovery from a disruptive global crisis, such as COVID-19. We collected the opinions of administrators of international exchange programmes regarding their plans to resume their exchange programmes in the recovery phase and identified variations in the responses concerning institution type (public vs. private) and the presence or absence of a medical school.

Method: We used multiple-choice survey questions in our study, resulting in 180 valid responses. We examined overall patterns using descriptive statistics and institutional uniqueness using Fisher’s exact test.

Results: …


University Students' First Online Exam Experience: Is It Stressful Or Joyful?, Konul Abasli, Bahar Yakut Ozek, Abdulkhalig Mammadli Apr 2023

University Students' First Online Exam Experience: Is It Stressful Or Joyful?, Konul Abasli, Bahar Yakut Ozek, Abdulkhalig Mammadli

Higher Learning Research Communications

Objectives: The purpose of this study is to determine university students’ views on online exams during the pandemic. The study was carried out with the participation of 15 undergraduate students studying at an engineering university in Azerbaijan.

Methods: Interpretive phenomenology guided the study. Data were collected through semi-structured interviews and analyzed using content analysis.

Results: Research findings showed that students experienced various problems in the online exam process. The inability to solve the technical problems encountered during exams and the perception that the instructors did not have sufficient knowledge about the conduct of the online exams made it difficult for …


Parent Perspectives On How The Covid-19 Pandemic Affected Symptoms Of Autism Spectrum Disorder In Their Children, Desiree Marie Vanderlick Jan 2023

Parent Perspectives On How The Covid-19 Pandemic Affected Symptoms Of Autism Spectrum Disorder In Their Children, Desiree Marie Vanderlick

Walden Dissertations and Doctoral Studies

Autism is a disorder that is characterized by struggles with socialization anddevelopmental delays that often involve much guidance and support. The purpose of this study was to explain the experience of parents as they attempted to manage behaviors related to symptoms of autism during the worldwide quarantine prompted by COVID-19. This study aimed to close the gap in literature and explore to see if there were any concerns that could be addressed by future studies. The study was framed around Bowen’s theory, which addresses emotions within a family unit, and the interdependence theory, which addresses how humans thrive to be …


Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …


Adult Learners With Learning Disabilities’ Motivation To Succeed In Higher Education Online Learning During Covid19, Sara Michelle Rodriguez Jan 2023

Adult Learners With Learning Disabilities’ Motivation To Succeed In Higher Education Online Learning During Covid19, Sara Michelle Rodriguez

Walden Dissertations and Doctoral Studies

Many students had to transition to online learning due to the COVID-19 pandemic while other students were already enrolled in online education. Online study may hold additional struggles for students with learning disabilities. The problem addressed in this qualitative, phenomenological study was the motivating factors of online higher education students who have a learning disability during the COVID-19 pandemic. The theoretical foundation was Maslow’s hierarchy of needs. Data were gathered through 10 semistructured interviews and then analyzed through the thematic analysis yielding five themes: (a) lack of professional support, (b) resources, (c) support system, (d) consistent motivation, and (e) low …


The Self-Efficacy Of Counselors Providing Telemental Health Services During The Covid-19 Pandemic, Chelsea Threadgill Jan 2023

The Self-Efficacy Of Counselors Providing Telemental Health Services During The Covid-19 Pandemic, Chelsea Threadgill

Walden Dissertations and Doctoral Studies

Since the onset of the COVID-19 pandemic, counselors have had to adapt and evolve to meet the needs of clients and the growing need for mental health services. In addition to a lack of experience providing telemental health (TMH) services, many counselors had received little or no TMH training or continuing education prior to the onset of the COVID-19 pandemic. Counselor self-efficacy (CSE) may be an important factor in determining how counselors have been impacted by the increase in provision of TMH services, and the areas where they are needing more support. The purpose of this quantitative study was to …


The Lived Experiences Of Burnout Among Human Service Professionals Working With Domestic Violence Victims During Covid-19., Michelle J. Clark Jan 2023

The Lived Experiences Of Burnout Among Human Service Professionals Working With Domestic Violence Victims During Covid-19., Michelle J. Clark

Walden Dissertations and Doctoral Studies

Abstract Job-related aspects of working in the mental health and human service field, such as job demands, workload, excessively long hours, and leadership roles, are known to cause burnout. Feelings of burnout and job-related stress may have been exacerbated during the COVID-19 pandemic, especially for professionals working with those experiencing domestic violence. The purpose of this hermeneutic phenomenological study was to explore the lived experiences of burnout among human service professionals (HSPs) working with domestic violence victims during COVID-19. Relational cultural and burnout theories provided the conceptual framework for this study. The data collected from the nine participants were obtained …


Structural Empowerment Of Nurse Leaders In New York State During The Covid-19 Pandemic, Tracey Braithwaite Jan 2023

Structural Empowerment Of Nurse Leaders In New York State During The Covid-19 Pandemic, Tracey Braithwaite

Walden Dissertations and Doctoral Studies

The current phenomenological study explored the lived experience of Acting Chief Nursing Officers, Chief Nursing Officers, Chief Nursing Executives (henceforth CNOs) at hospitals in New York State who were charged with responding to executive orders while maintaining quality of patient care despite staffing constraints, inadequate supplies, or lack of additional support for the duties associated with their role. Their experience of structural empowerment in relation to the COVID-19 pandemic was also studied. The theoretical framework was Kanter’s theory of structural empowerment that addressed organizational behavior in the context of employee empowerment. The research question addressed how the CNOs perceived their …


Covid-19 Social Isolation And Young Adult Mental Well-Being And Socioeconomic Status As A Moderator, Falescia Ware Matlock Jan 2023

Covid-19 Social Isolation And Young Adult Mental Well-Being And Socioeconomic Status As A Moderator, Falescia Ware Matlock

Walden Dissertations and Doctoral Studies

AbstractIt is not currently known how social distancing guidelines impact mental health for emerging adults and whether socioeconomic status moderates this relationship. The psychosocial development theory states that emerging adults experience a psychological conflict—intimacy versus isolation—where the goal is to seek connections. Without connection, emerging adults are likely to experience impaired psychological well-being, which was exacerbated by the COVID-19 pandemic. The purpose of this study was to examine the effects of perceived social distancing guidelines on the mental health of emerging adults and if this relationship is moderated by socioeconomic status. This study followed a quantitative comparative design of emerging …


Foster Youth's Experience With Visitation During The Covid-19 Pandemic., Carrie Player Sexton Jan 2023

Foster Youth's Experience With Visitation During The Covid-19 Pandemic., Carrie Player Sexton

Walden Dissertations and Doctoral Studies

Much has been learned about how the shelter-in-place (SIP) orders imposed during the coronavirus disease 2019 (COVID-19) pandemic affected children socially and emotionally. However, less was known about how the youths in foster care settings experienced visitation with their approved visitors because of the shelter-in-place order. In this phenomenological study, the lived experiences of 10 foster youths between the ages of 16 and 18 years during the COVID-19 SIP were explored using semi structured interviews. The theory that grounded this study was Ainsworth and Bowlby's attachment theory. Evernote was used to guide, store, observe, and record the data in one …


Food Insecure Single Mothers’ Perceptions In Accessing School Nutrition Programs During Covid-19, Deshona Williams Liburd Audain Jan 2023

Food Insecure Single Mothers’ Perceptions In Accessing School Nutrition Programs During Covid-19, Deshona Williams Liburd Audain

Walden Dissertations and Doctoral Studies

Global pandemics and natural disasters can cause basic human needs hardships. Being able to access adequate nutritious food is a fundamental basic human need. Food insecurity remains a dominant concern in underdeveloped countries prior to natural disaster and global pandemic. During the COVID-19 pandemic of 2020 low-income United States Virgin Islands single mothers’ dilemma was accessing available nutritious foods for their school-aged children through nutrition assistance programs. An interpretative phenomenological qualitative study was conducted to explore the types of lived experiences these single mothers faced. The social ecological model (SEM) was used as the conceptual framework for the study. The …


Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks Jan 2023

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …


Lived Experiences Of Job-Hopping Millennials During The Covid-19 Pandemic, Dottie Dancy Jan 2023

Lived Experiences Of Job-Hopping Millennials During The Covid-19 Pandemic, Dottie Dancy

Walden Dissertations and Doctoral Studies

Millennials, also known as “the job-hopping generation,” are on the brink of becoming the largest generation in the workforce by 2025. In March 2020, a global pandemic was declared due to the spread of the virus known as COVID-19, which led to more than 5.3 million deaths globally. Prior research has been conducted concerning the job-hopping tendencies of Millennials, but previous studies have not incorporated the life-changing event of the global pandemic and how it may have changed the beliefs and attitudes of the Millennial generation. The purpose of this qualitative study was to explore the voluntary job-hopping beliefs and …


Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks Jan 2023

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …


Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot Jan 2023

Occupational Burnout Factors Among Correctional Mental Health Providers, Morgan Gruhot

Walden Dissertations and Doctoral Studies

Burnout rates of correctional employees are higher than employees in the general public. The purpose of this study was to identify how occupational factors impact burnout rates among correctional mental health workers. Grounded in the job-demands theoretical model, this study compared burnout rates among mental health staff within county jails and state prisons. Burnout was measured using the Maslach Burnout Inventory and Occupational factors were measured using the Areas of Work life Survey and Pandemic Experience and Perception Survey. Data was analyzed using IBM SSPS software to address multiple a priori directional research questions. Research questions considered how occupational factors …


Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …


Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula Jan 2023

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …


The Self-Efficacy Of Counselors Providing Telemental Health Services During The Covid-19 Pandemic, Chelsea Threadgill Jan 2023

The Self-Efficacy Of Counselors Providing Telemental Health Services During The Covid-19 Pandemic, Chelsea Threadgill

Walden Dissertations and Doctoral Studies

Since the onset of the COVID-19 pandemic, counselors have had to adapt and evolve to meet the needs of clients and the growing need for mental health services. In addition to a lack of experience providing telemental health (TMH) services, many counselors had received little or no TMH training or continuing education prior to the onset of the COVID-19 pandemic. Counselor self-efficacy (CSE) may be an important factor in determining how counselors have been impacted by the increase in provision of TMH services, and the areas where they are needing more support. The purpose of this quantitative study was to …


Lockdowns During The Covid-19 Pandemic And Domestic Violence Among Virginians, Kenneth G. Gordon Jan 2023

Lockdowns During The Covid-19 Pandemic And Domestic Violence Among Virginians, Kenneth G. Gordon

Walden Dissertations and Doctoral Studies

AbstractThe domestic violence (DV) dilemma spans millennia and has devastated individuals, families, and societies. DV prevalence rose between 20% and 50% worldwide and over 5% among Virginians since early 2020 during COVID-19. Abuse victims’ vulnerability increased during the lockdown periods due to the extended time spent with perpetrators. DV victims visited emergency departments for their nonfatal physical injuries. The purpose of the study was to examine COVID-19-related lockdown effects on DV prevalence, perpetrator characteristics, and hospitalizations among Virginians. Bronfenbrenner’s socioecological model served as the theoretical foundation. Descriptive analyses showed that DV prevalence among Virginians rose from 37.5% in 2019 to …


A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre Jan 2023

A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …


Factors Leading To Alcohol Relapse During The Covid-19 Pandemic, Robert Michael Ibraham Jan 2023

Factors Leading To Alcohol Relapse During The Covid-19 Pandemic, Robert Michael Ibraham

Walden Dissertations and Doctoral Studies

Little research has been conducted exploring contributing stressors from the COVID-19 pandemic that may have led to alcohol relapse among individuals diagnosed with alcohol use disorders (AUDs). Prior to the pandemic, alcohol use was at an all-time high; during the pandemic, the rates of substance use rose significantly more. AUDs are a leading mental health problem with over 32.6 million meeting diagnostic criteria in the United States. This study was conducted to explore self-identified factors leading up to relapse during the COVID-19 pandemic among individuals diagnosed with AUDs, with a focus on the circumstances and events leading up to relapse. …


Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks Jan 2023

Occupational Stress In Long Term Care In Georgia And Virginia During The Covid-19 Pandemic, Lacountess Renee Hooks

Walden Dissertations and Doctoral Studies

Nursing staff working in long-term care settings experience high levels of occupational stress related to many factors that can lead to poor outcomes for the nursing staff and the residents. In 2020, the World Health Organization declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, a pandemic which over the course of 3 years, has added an additional source of work-related stress for long-term care nursing staff. This quantitative cross-sectional study was guided by the job demand-control-support model to explore perceived stress and nursing stress among nursing staff working in the long-term care setting in Georgia and …


A Qualitative Study Of Moral Distress In Physicians During The Covid-19 Pandemic, William Washington Jan 2023

A Qualitative Study Of Moral Distress In Physicians During The Covid-19 Pandemic, William Washington

Walden Dissertations and Doctoral Studies

Abstract The spread of Coronavirus (COVID-19) created a pandemic and had a world-shattering effect on healthcare organizations. As a result, many healthcare professionals were exposed to health situations that stretched them beyond their professional ethics, mental health, and emotional capacity. Throughout the last 30 years, moral distress has been understood as the type of stress that medical professionals experience. Research has substantially grown regarding COVID-19 and moral distress, exposing gaps in the ability of experts to care as they should. Moral distress was a term created to define the emotional disruption that occurs when a professional cannot work within their …


Factors Leading To Alcohol Relapse During The Covid-19 Pandemic, Robert Michael Ibraham Jan 2023

Factors Leading To Alcohol Relapse During The Covid-19 Pandemic, Robert Michael Ibraham

Walden Dissertations and Doctoral Studies

Little research has been conducted exploring contributing stressors from the COVID-19 pandemic that may have led to alcohol relapse among individuals diagnosed with alcohol use disorders (AUDs). Prior to the pandemic, alcohol use was at an all-time high; during the pandemic, the rates of substance use rose significantly more. AUDs are a leading mental health problem with over 32.6 million meeting diagnostic criteria in the United States. This study was conducted to explore self-identified factors leading up to relapse during the COVID-19 pandemic among individuals diagnosed with AUDs, with a focus on the circumstances and events leading up to relapse. …


Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard Jan 2023

Clinicians' Perceptions Of Telehealth Services During The Covid-19 Pandemic In Virginia, Johnetta Hill Guishard

Walden Dissertations and Doctoral Studies

The onset of COVID-19 introduced unprecedented changes to how U.S. public health services were delivered. Many public and private agencies faced mandatory closures, social distancing mandates, and rapid transitions to telehealth interventions and treatment. Mental health clinicians witnessed disruptions in continuity of care and an increase in mental health risks overall. Although some studies have been conducted to survey clinicians’ perceptions of the usefulness and ease of use of technology-based interventions, knowledge about mental health clinicians’ experiences and perceptions in Virginia was sparse. The purpose of this generic qualitative study was to explore how mental health clinicians in Virginia described …


Adult Learners With Learning Disabilities’ Motivation To Succeed In Higher Education Online Learning During Covid19, Sara Michelle Rodriguez Jan 2023

Adult Learners With Learning Disabilities’ Motivation To Succeed In Higher Education Online Learning During Covid19, Sara Michelle Rodriguez

Walden Dissertations and Doctoral Studies

Many students had to transition to online learning due to the COVID-19 pandemic while other students were already enrolled in online education. Online study may hold additional struggles for students with learning disabilities. The problem addressed in this qualitative, phenomenological study was the motivating factors of online higher education students who have a learning disability during the COVID-19 pandemic. The theoretical foundation was Maslow’s hierarchy of needs. Data were gathered through 10 semistructured interviews and then analyzed through the thematic analysis yielding five themes: (a) lack of professional support, (b) resources, (c) support system, (d) consistent motivation, and (e) low …


A Qualitative Study Of Moral Distress In Physicians During The Covid-19 Pandemic, William Washington Jan 2023

A Qualitative Study Of Moral Distress In Physicians During The Covid-19 Pandemic, William Washington

Walden Dissertations and Doctoral Studies

Abstract The spread of Coronavirus (COVID-19) created a pandemic and had a world-shattering effect on healthcare organizations. As a result, many healthcare professionals were exposed to health situations that stretched them beyond their professional ethics, mental health, and emotional capacity. Throughout the last 30 years, moral distress has been understood as the type of stress that medical professionals experience. Research has substantially grown regarding COVID-19 and moral distress, exposing gaps in the ability of experts to care as they should. Moral distress was a term created to define the emotional disruption that occurs when a professional cannot work within their …


A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre Jan 2023

A Leadership Perspective On Preventing Counselor Burnout In A Behavioral Health Setting During Covid-19, Claudia P. De La Torre

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, there was a high need for mental health services, which resulted in a shortage of mental health clinicians. This shortage of mental health clinicians then resulted in a high burnout rate due to client intake. This doctoral case study was grounded in the Baldrige Excellence Framework and focused on how a behavioral health organization in South Texas managed burnout in clinicians during the COVID-19 pandemic. This study aimed to help behavioral health leaders find a solution to preventing burnout during a high demand pandemic. This doctoral study had several data sources, including semistructured interviews with three …