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High School Teachers' Experiences Working With Latino Immigrant Students Who Have Experienced Trauma, Collette Marie Jiménez Serra
High School Teachers' Experiences Working With Latino Immigrant Students Who Have Experienced Trauma, Collette Marie Jiménez Serra
Walden Dissertations and Doctoral Studies
Latino immigrant students in U.S. public high schools are disproportionately exposed to trauma related to migration experiences, family separation, poverty, and acculturative stress, yet many teachers report feeling underprepared to address students’ trauma-related needs in culturally responsive ways. Limited research has examined high school teachers’ lived experiences implementing trauma-informed practices with Latino immigrant students, particularly from teachers’ own perspectives. The purpose of this transcendental phenomenological study was to explore high school teachers’ lived experiences implementing trauma-informed practices with Latino immigrant students, including their perceptions of preparedness and the factors influencing implementation. Guided by principles of trauma-informed care (TIC) and relational-cultural …
Examining The Challenges Of Providing Mental Health Treatment In Female Correctional Facilities From The Perspective Of Mental Health Professionals, Lacretia Williams
Examining The Challenges Of Providing Mental Health Treatment In Female Correctional Facilities From The Perspective Of Mental Health Professionals, Lacretia Williams
Walden Dissertations and Doctoral Studies
Women in correctional settings frequently experience significant mental health issues that are linked to histories of trauma, abuse, and victimization. Despite increased attention to trauma-informed and gender-responsive approaches, numerous obstacles continue to affect the delivery of mental health treatment within female correctional facilities. Existing literature focuses on systemic and policy concerns, overlooking mental health professionals' experiences. Guided by general systems theory, this qualitative study examined the challenges encountered by providers, including how organizational, environmental, and institutional factors influence treatment implementation. Data collected through semistructured interviews with 10 mental health professionals revealed multiple barriers to effective service delivery, including the complex …
Educators’ Perceptions Of The Challenges Of Reintegrating High School Students Returning From Suspension In A Western Suburban School District In Chicago, Rebecca Moss
Walden Dissertations and Doctoral Studies
The problem that was addressed through this study was that Grade 9–12 educators face challenges in implementing effective behavioral support systems for students returning to school after a suspension. Grounded in Bandura’s social cognitive theory, the purpose of this basic qualitative study was to investigate Grade 9–12 educators’ perceptions of the challenges they face and their recommendations when supporting students who return to school after a suspension in a western suburban Chicago district. Semistructured interviews were conducted with 11 purposely sampled Grade 9–12 educators including administrators, teachers, social workers, school counselors, and school psychologists. Through thematic analysis, four themes emerged. …
Strategies Small Business Leaders Use To Reduce Employee Absenteeism And Improve Productivity, Dawn Eugenia Simington
Strategies Small Business Leaders Use To Reduce Employee Absenteeism And Improve Productivity, Dawn Eugenia Simington
Walden Dissertations and Doctoral Studies
Failure to reduce employee absenteeism remains a significant concern for small business leaders. Without clear and actionable strategies, these leaders may struggle to avoid decreased revenue. Grounded in the resource-based view (RBV) theory, the purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies small business leaders use to reduce employee absenteeism to avoid decreased revenue. Participants included seven small business leaders located in the Southern United States who had used effective strategies to reduce employee absenteeism to avoid decreased revenue. Data were collected from semistructured interviews and publicly available documentation. Three themes emerged from thematic …
A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum
A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum
Walden Dissertations and Doctoral Studies
Exposures to particulate dust matter (PM10 and smaller) from aggregate comminution facilities (ACF) can lead to the onset of environmentally associated pulmonary diseases (EAPDs); acute and chronic asthma (Type I allergic hypersensitivity reaction), chronic pulmonary disease, interstitial lung disease (ILD), and lung cancer. In this environmental epidemiological research study, three primary spatial and spatiotemporal research questions related to nonoccupational exposures from 118 facilities across Georgia were evaluated. Secondary data analysis was conducted from the Centers for Disease Control and Prevention’s (CDC) 2018–2023 Behavioral Risk Factor Surveillance System (BRFSS) and the Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Metropolitan Divisions to …
Associations Between Emotional Intelligence, Gender, And Situational Leadership Style Among Certified Public Accountant Firm Leaders In The Southeastern United States, Amber Holland
Walden Dissertations and Doctoral Studies
Emotional intelligence among certified public accountant (CPA) firm leaders is important for navigating demanding workloads, client pressures, workforce challenges, and complex interpersonal environments. Understanding factors associated with emotional intelligence may help senior CPA firm leaders strengthen leadership effectiveness and workforce stability. The purpose of this quantitative correlational research project was to examine the extent to which situational leadership behaviors and gender predicted emotional intelligence among CPA firm leaders in the southeastern United States. Emotional intelligence theory grounded the research project. Participants were 69 qualifying CPA firm leaders with at least 3 years of leadership experience. Data were collected through an …
Primary Care Providers In Alabama And Washington Who Provide Care To African American Women With Dense Breast Tissue With And Without A Cancer Diagnosis, Andrea Shermaine Mcdaniel
Primary Care Providers In Alabama And Washington Who Provide Care To African American Women With Dense Breast Tissue With And Without A Cancer Diagnosis, Andrea Shermaine Mcdaniel
Walden Dissertations and Doctoral Studies
African American women with dense breast tissue have experienced challenges related to breast cancer screening, timely follow-up care, and access to diagnostic services. There was limited research showing the experiences of primary care providers (PCPs) who provided care to this population. The purpose of this qualitative phenomenological study was to explore the lived experiences of PCPs in Alabama and Washington who provided care to African American women with dense breast tissue, both with and without a breast cancer diagnosis. The conceptual framework for this study was intersectionality theory, which is used to consider multiple social determinants of health when examining …
Staff Education To Improve Medication Adherence Knowledge In Schizophrenia Care, Richard Emereonye
Staff Education To Improve Medication Adherence Knowledge In Schizophrenia Care, Richard Emereonye
Walden Dissertations and Doctoral Studies
This staff education doctoral project addressed a documented gap in nursing competency, confidence, and documentation related to medication adherence counseling for adults with schizophrenia on an inpatient psychiatric unit. Nonadherence to antipsychotic medication affects an estimated 40% to 60% of adults with schizophrenia and contributes to relapse and avoidable rehospitalization. The practice-focused question was: In a psychiatric care facility, how does a competency-based staff education program on medication adherence strategies for schizophrenia affect nursing staff knowledge, confidence, and competency, as measured by pre- and post-education assessments? The intervention was developed using the analyze, design, develop, implement, and evaluate (ADDIE) model …
Perceptions Of Correctional Officers In Prison Environments And The Coping Mechanisms They Use To Support Work–Life Balance, Amiee C. Ruger
Perceptions Of Correctional Officers In Prison Environments And The Coping Mechanisms They Use To Support Work–Life Balance, Amiee C. Ruger
Walden Dissertations and Doctoral Studies
This qualitative study explored correctional officers’ lived experiences with occupational stress, coping strategies, work–life balance, and psychological well-being. The purpose of the study was to better understand correctional officers’ experiences working in high-stress correctional environments, including how they experienced and managed occupational stress, as well as the factors that influenced their psychological well-being. The Yerkes-Dodson law, Nixon’s human function curve, and the transactional model of stress and coping provided the theoretical framework for the study. Eight correctional officers were recruited using purposive and snowball sampling techniques. Semistructured interviews were conducted through the online meeting platform Zoom, and the data were …
Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama
Staff Education On Early Cpi-Based De-Escalation Strategies And Unit-Based Resources, Doris Onyenji Lerama
Walden Dissertations and Doctoral Studies
This doctoral project was a staff education evidence-based practice initiative implemented at a state-operated adult inpatient psychiatric facility in California. The practice gap was inconsistent nursing staff knowledge of early Crisis Prevention Intervention-based de-escalation strategies and available unit-based resources despite an established crisis-prevention framework. The practice-focused question asked whether a standardized staff education activity would increase staff knowledge, as measured by anonymous pre-education and immediate post-education scores. The purpose was to develop, implement, and evaluate the education using staff knowledge change as the sole measurable outcome. The Johns Hopkins Evidence-Based Practice Model guided appraisal and synthesis of 11 evidence sources …
Strategic Planned Preventive Maintenance To Promote Sustainability In Acute Care Hospitals, Samuel Ngounou
Strategic Planned Preventive Maintenance To Promote Sustainability In Acute Care Hospitals, Samuel Ngounou
Walden Dissertations and Doctoral Studies
Despite advances in healthcare delivery, acute care hospitals often lack standardized strategic planned preventive maintenance (SPPM) protocols, resulting in equipment failures, higher costs, and disruptions to patient care. The purpose of this integrative review was to identify evidence-based best practices for implementing SPPM programs in acute care hospitals. The review question concerned the organizational practices and strategic approaches most effective for implementing an SPPM program. The Donabedian structure–process–outcome model represented the foundational framework for this review. The initial literature search yielded 110 articles. After further assessment, 27 studies were appraised using the Johns Hopkins Nursing evidence-based practice tools. Three low-quality …
Exploring Stigma In Access To Treatment For Women With Co-Occurring Substance Use And Sex Addiction, Maria Alejandra Knox-Lugo
Exploring Stigma In Access To Treatment For Women With Co-Occurring Substance Use And Sex Addiction, Maria Alejandra Knox-Lugo
Walden Dissertations and Doctoral Studies
Despite the high prevalence of substance use disorder among adult women in the United States, treatment engagement remains low, particularly for women experiencing co-occurring substance use disorder and compulsive sexual behavior. Although stigma is a documented barrier for individuals with substance use or compulsive sexual behavior in accessing and remaining engaged in behavioral health services, its effects on treatment access for adult women with co-occurring substance and compulsive sexual behavior have not been adequately scrutinized. The purpose of this generic qualitative study was to explore how human services and behavioral health professionals perceive stigma experienced by adult women with co-occurring …
Counselors-In-Training’S Perceptions Of Counselor Educators’ And Supervisors’ Roles In Developing Grief Counseling Self-Efficacy, Tonya Andrews
Counselors-In-Training’S Perceptions Of Counselor Educators’ And Supervisors’ Roles In Developing Grief Counseling Self-Efficacy, Tonya Andrews
Walden Dissertations and Doctoral Studies
Counselors-in-training (CITs) encounter grieving clients despite limited grief-specific preparation. Understanding these experiences could inform preparation for supporting grieving clients. Guided by Bandura’s self-efficacy theory, this qualitative hermeneutic phenomenological study explored these perceptions. The purposive sample included 10 CITs who were master’s-level students completing field experience or postgraduate counselors under clinical supervision, lacked independent licensure, attended or graduated from Council for Accreditation of Counseling and Related Educational Programs (CACREP)–accredited programs without required stand-alone grief coursework. None had a direct supervisory, instructional, or evaluative relationship with the researcher. The research question was: How did CITs perceive and make meaning of the role …
Oral Health Provider's Perspective: The Impact Of Public Health Programs Improving Patients' Access In Marginalized Communities, Bridgette Long Hickey
Oral Health Provider's Perspective: The Impact Of Public Health Programs Improving Patients' Access In Marginalized Communities, Bridgette Long Hickey
Walden Dissertations and Doctoral Studies
Access to public oral healthcare in Alabama’s Black Belt Region has been a persistent systemic challenge for working poor adults ages 19–64. This population continues to face barriers to oral healthcare because of socioeconomic disparities, geographic isolation, lack of insurance, provider shortages, limited infrastructure, and the need to travel long distances for quality or specialized services. This study investigated whether public health programs have improved access to oral healthcare for working poor adults in rural communities, from the perspective of oral healthcare providers. The Social Ecological Model served as the theoretical framework. Data were collected through semi-structured interviews with 13 …
Sustaining Small Tutorial, Coaching, And Shadow Education Operations In Nigeria, Adeyinka Adebose Dawodu
Sustaining Small Tutorial, Coaching, And Shadow Education Operations In Nigeria, Adeyinka Adebose Dawodu
Walden Dissertations and Doctoral Studies
Some tutorial and training center managers lack effective strategies effective business sustainability strategies, resulting in poor performance and reduced profitability. Tutorial business stakeholders realize that failure of these centers creates a loss of opportunities for Nigerian youth who depend on their training and preparatory services. Grounded in the performance prism framework, the purpose of this qualitative multiple case study was to identify and explore effective strategies that Nigerian Tutorial/training center managers use to sustain their centers beyond 5 years. The participants were six managers of tutorial/training business centers who have sustained their centers in nonaffluent areas of Lagos and Ogun …
Medical School Admissions Officers' Perceptions On Lower Admissions Rates Of Black Applicants In Georgia, Wanda Sebrena Thomas
Medical School Admissions Officers' Perceptions On Lower Admissions Rates Of Black Applicants In Georgia, Wanda Sebrena Thomas
Walden Dissertations and Doctoral Studies
The problem addressed through this study was the disproportionate lower admission rates of Black students compared to their White counterparts at a Georgia medical school. Grounded in Bourdieu’s theory of social reproduction, the purpose of this study was to explore admission officers’ perceptions on the factors contributing to lower admission rates of Black applicants at a Georgia medical school. For this basic qualitative design, semistructured interviews with 10 admissions officers were conducted. Through Saldaña’s first- and second-cycle coding procedures, the following nine themes emerged: (a) Medical College Admission Test scores create barriers for Black applicants; (b) unequal educational resources and …
Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran
Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran
Walden Dissertations and Doctoral Studies
Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …
Exploring Sub-Saharan African Immigrants’ Perceptions Of The American Criminal Justice System, Martin B. Kalala
Exploring Sub-Saharan African Immigrants’ Perceptions Of The American Criminal Justice System, Martin B. Kalala
Walden Dissertations and Doctoral Studies
This qualitative phenomenological study explored sub-Saharan African immigrants’ perceptions of the United States criminal justice system, including law enforcement, courts, and correctional institutions. Despite the significant and growing presence of sub-Saharan African immigrants in the United States, their perspectives remain underrepresented in criminal justice research. Grounded in critical race theory and informed by a narrative inquiry lens, this study sought to understand how race, immigrant status, and cultural background shape perceptions of fairness, trust, and legitimacy within the justice system. Data were collected through semi-structured interviews with 21 sub-Saharan African immigrants residing in the United States. The data were analyzed …
Strategic Effort For Employee Retention In The Financial Industry, Gail Nichole Flores
Strategic Effort For Employee Retention In The Financial Industry, Gail Nichole Flores
Walden Dissertations and Doctoral Studies
Failure to properly retain financial industry employees can cause a chain reaction of detrimental issues, including financial consequences, high turnover rates, and vulnerabilities to an organization’s overall health and success in the industry. Financial industry leaders may struggle to maintain an appealing organization for current and prospective employees, hindering their ability to retain talent profitably and sustainably and gain a competitive advantage in the financial industry. The purpose of this qualitative pragmatic inquiry project was to identify and explore effective strategies that financial industry leaders use to retain employees and remain profitable and sustainable. Using Herzberg’s two–factor theory of motivation, …
The Role Of Counselors In Facilitating Family Involvement In The Treatment Of Individuals With Severe Mental Illness: An Interpretative Phenomenological Analysis, Shanice Stephenson-Walcott
The Role Of Counselors In Facilitating Family Involvement In The Treatment Of Individuals With Severe Mental Illness: An Interpretative Phenomenological Analysis, Shanice Stephenson-Walcott
Walden Dissertations and Doctoral Studies
The purpose of this qualitative study was to explore counselors’ experiences with family involvement in the treatment of individuals with severe mental illness (SMI). Although family involvement has been associated with improved treatment outcomes, limited research has explored counselors’ experiences facilitating family involvement in SMI treatment, leaving a gap in understanding the challenges counselors face in clinical practice. Guided by Heidegger’s hermeneutic phenomenology, this Interpretative Phenomenological Analysis (IPA) study included six licensed professional counselors experienced in counseling individuals with SMI. The research question asked: How do counselors experience family involvement facilitation in the treatment of individuals with severe mental illness? …
Staff Education To Improve 7-Day Post-Discharge Psychiatric Follow-Up, Michael Curtis Kwashie
Staff Education To Improve 7-Day Post-Discharge Psychiatric Follow-Up, Michael Curtis Kwashie
Walden Dissertations and Doctoral Studies
Too many psychiatric patients leave the hospital without a follow-up appointment, a gap that may cost lives. Research has consistently shown that the days immediately after discharge from psychiatric inpatient or emergency care are among the most dangerous in a patient’s trajectory, marked by elevated suicide risk, relapse, and avoidable readmission. Yet, across behavioral health settings, completion of outpatient follow-up within 7 days of discharge remains inconsistent; typically, standardized processes are often missing. This doctoral project in staff education was created to fill that gap and examined whether implementing a standardized discharge transition protocol, supported by targeted, interdisciplinary staff education, …
Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta
Implementation Of An Evidence-Based Multifactorial Fall-Prevention Staff Education Program In A Long-Term Care Facility., Peter Mufua Tumenta
Walden Dissertations and Doctoral Studies
Walden University College of Nursing This is to certify that the doctoral study by Peter Mufua Tumenta has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Melanie Braswell, Committee Chairperson, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2026 Executive Summary Falls are a significant patient safety concern among older adults in long-term care (LTC) facilities. This Doctor of Nursing Practice quality improvement project implemented and evaluated a standardized, evidence-based multifactorial fall-prevention staff education program to improve …
The Perception Of Gay Black Males Concerning Cultural Responsiveness Of Police Officer Use Of Force, Christopher M. Collier
The Perception Of Gay Black Males Concerning Cultural Responsiveness Of Police Officer Use Of Force, Christopher M. Collier
Walden Dissertations and Doctoral Studies
Police officers’ use of force on the public has been a popular topic of conversation over the last decade. Political campaigns, social media platforms, and neighborhood groups have expressed concerns about how police officers use force disproportionately within various communities. Suggestions have been made to increase police training, promote body-worn cameras, and foster greater transparency to hold police officers accountable for actions that may be unethical or illegal. This study sought to understand if cultural environments have an effect on law enforcement’s interaction with Black same gender loving males (BSGLM). Understanding the use of force was derived from BSGLMs’ perspectives …
Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson
Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson
Walden Dissertations and Doctoral Studies
Multiple myeloma (MM) patients have the lowest 5-year cancer survival rates due, in part, to the time it takes for symptoms to develop and the presence of one to four high-risk cytogenetic abnormalities (HRCA). The Terminal Nucleotidyltransferases 5 (TENT5) subfamily, which regulates myeloma cell migration and tumorigenesis, may also increase the risk for developing MM and impact survival rates. The purpose of this study was to investigate the association between the number of HRCA and TENT5 mutation hits with disease outcomes in MM patients while controlling for the stage of the disease (i.e., I, II, or III) at diagnosis. The …
Clinicians’ Perceptions Of Mental Health Care Access For Middle-Aged, Black Women Post-Sexual Assault, Monica Latrice Bolton
Clinicians’ Perceptions Of Mental Health Care Access For Middle-Aged, Black Women Post-Sexual Assault, Monica Latrice Bolton
Walden Dissertations and Doctoral Studies
No abstract provided.
Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba
Staff Education To Improve Sleep Hygiene Knowledge And Competency Among Nursing Staff On An Inpatient Behavioral Health Unit, Jennings Ubadi Mekoba
Walden Dissertations and Doctoral Studies
This staff education project addressed the gap in standardized knowledge and implementation of evidence-based sleep hygiene interventions among nursing staff on an inpatient behavioral health unit. Sleep disturbances affect 80%–90% of psychiatric patients and directly impact treatment outcomes and recovery. I developed the practice-focused question to consider whether an evidence-based sleep hygiene education program would enhance the awareness, knowledge, and practices of the nursing staff regarding sleep hygiene interventions. A thorough literature review of 23 high-quality sources formed the background for the development of a structured educational intervention that encompassed assessment methodologies, nonpharmacological interventions, environmental interventions, and patient education interventions. …
Barriers To Psychological Care: Lived Experiences Of Adults With Spinal Muscular Atrophy, Hovhannes Nazaryan
Barriers To Psychological Care: Lived Experiences Of Adults With Spinal Muscular Atrophy, Hovhannes Nazaryan
Walden Dissertations and Doctoral Studies
Adults with spinal muscular atrophy (SMA) may experience significant disability-related stressors, yet mental health services remain underused within this population. Although prior research has identified barriers to service use among individuals with SMA and people with disabilities more broadly, there is less literature about how adults with SMA experience the mental health care system. The purpose of this qualitative phenomenological study was to explore lived experiences of adults living in the United States with SMA as they relate to this system. Guided by the biopsychosocial model and Andersen’s behavioral model, the study involved addressing the question: What are lived experiences …
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Walden Dissertations and Doctoral Studies
Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …
Phenomenological Study Of Protective Buffering By Afsoc Civilian Spouses During Military Deployments, Janell C. Cotton
Phenomenological Study Of Protective Buffering By Afsoc Civilian Spouses During Military Deployments, Janell C. Cotton
Walden Dissertations and Doctoral Studies
Protective buffering (PB) is used by civilian military spouses to withhold or deny stressful information or concerns to protect their spouse, others, or themselves, from upset or burden. This coping mechanism is commonly used during military deployments, yet is associated with negative physical, psychological, and social consequences. The purpose of this phenomenological qualitative study was to explore the lived experience of when and why civilian military spouses engage in PB during military deployments. Guided by the communication privacy management theory and the transactional stress and coping theory, the study examined the civilian spouses’ perceptions of their active-duty spouses’ stressors, and …
The Psychosocial Experience Of Black Pentecostal Pastors In Western America Post-Pandemic, Isaiah Kelley
The Psychosocial Experience Of Black Pentecostal Pastors In Western America Post-Pandemic, Isaiah Kelley
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic disrupted religious institutions, altering how Black pastors provided spiritual leadership, community support, and social connection. Limited research has examined how these disruptions affected the social identity and psychosocial well-being of African American Pentecostal pastors. This qualitative phenomenological study explored the lived experiences of 11 African American Pentecostal pastors in the western United States following COVID-19 church closures. Guided by social identity theory, semi-structured interviews examined changes in participants’ social identity. Data were analyzed using Moustakas’s phenomenological approach: first- and second-cycle coding, member checking, reflective journals, and thematic analysis. Four themes emerged: psychological and emotional burden, social isolation …