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Articles 121 - 150 of 2775
Full-Text Articles in Psychology
Exploring Marital Resilience Through The Lived Experiences And Perception Of Spousal Support During Events Of Shared Stressors, Prince-James Smith
Exploring Marital Resilience Through The Lived Experiences And Perception Of Spousal Support During Events Of Shared Stressors, Prince-James Smith
Walden Dissertations and Doctoral Studies
Marital resilience during shared stressors remains insufficiently understood, particularly when both spouses are simultaneously affected by the same external stressor and must adapt together over time. The purpose of this qualitative phenomenological study was to explore marital resilience through the lived experiences and perceptions of spousal support during shared stressors among individuals who had been legally married for 10 years or more, with specific attention to how participants described the shift from solo coping to dyadic coping over time. Bowlby’s attachment theory provided the theoretical foundation, and Senge’s learning organization theory served as the conceptual framework. Participants included 18 legally …
Investigating The Relationship Amongst Nursing Students’ Academic Self-Efficacy And Mindfulness, Joshua Josey
Investigating The Relationship Amongst Nursing Students’ Academic Self-Efficacy And Mindfulness, Joshua Josey
Walden Dissertations and Doctoral Studies
Undergraduate nursing education presents ongoing challenges related to student stress and persistence, and the COVID-19 pandemic further complicated these existing challenges for many students and programs. In this quantitative, correlational, cross-sectional study, the relationships among state mindfulness, trait mindfulness, and academic self-efficacy in undergraduate nursing students were examined and whether state and trait mindfulness predicted academic self-efficacy was tested. Participants were recruited through nursing student Facebook groups and completed an anonymous SurveyMonkey questionnaire that included the State Mindfulness Scale, the Mindful Attention Awareness Scale, the Academic Behavioral Confidence Scale, and demographic items. Data were collected over 6 weeks ending August …
The Lived Experiences Of The Strong Black Woman Cultural Convention On Black Women Counselors’ Emotional Intelligence, Pranati Walker
The Lived Experiences Of The Strong Black Woman Cultural Convention On Black Women Counselors’ Emotional Intelligence, Pranati Walker
Walden Dissertations and Doctoral Studies
Emotional intelligence (EI) is a critical competency for counselors due to the relational and emotionally demanding nature of counseling. Although existing literature explored EI among Black women broadly, limited research examined the experiences of Black women counselors (BWCs). This descriptive phenomenological study was guided by the philosophy of phenomenology and explored the lived experiences and impact of the SBW cultural convention on the EI of BWCs. The researcher explored the lived experiences of BWCs regarding the SBW cultural convention and its impact on emotional intelligence. Participant data from eight semi-structured interviews were collected. The participants identified as female gender identity, …
Social Support And Weight Management Behaviors Lived Experiences Of Overweight Native Hawaiian Women, Satu Gruenstein
Social Support And Weight Management Behaviors Lived Experiences Of Overweight Native Hawaiian Women, Satu Gruenstein
Walden Dissertations and Doctoral Studies
The Hawaiian Islands have an alarming concentration of obesity and related chronic health issues and many Native Hawaiian women do not have access to culturally sensitive weight loss information. The purpose of this phenomenological study was to increase understanding of the lived experiences of middle-aged Native Hawaiian women, relating to weight loss, weight management, and the impact of social support and cultural factors on those experiences. The conceptual framework for the study included the models of social support and social networks. A phenomenological research design and purposeful sampling were used to conduct semistructured interviews with eight middle-aged Native Hawaiian women, …
How Positive Psychology Coaching May Influence Authentic Leadership Development, Amy Lynn Weilbacher
How Positive Psychology Coaching May Influence Authentic Leadership Development, Amy Lynn Weilbacher
Walden Dissertations and Doctoral Studies
Although organizations often articulate values driven missions, failure by leaders to consistently embody these values in practice can erode credibility and effectiveness. Organizational leaders need to understand the role of positive psychology coaching in authentic leadership development because mission credibility depends on the leaders’ enacted values. The purpose of this basic qualitative study was to explore how positive psychology coaching may influence authentic leadership development. This study was guided by a conceptual framework integrating positive psychology and authentic leadership. Data were collected through semistructured interviews with 11 U.S.-based organizational leaders who participated in positive psychology coaching. Six key themes emerged …
Lived Experiences Of Eye Movement Desensitization And Reprocessing (Emdr) Certified, Staci Ekblad
Lived Experiences Of Eye Movement Desensitization And Reprocessing (Emdr) Certified, Staci Ekblad
Walden Dissertations and Doctoral Studies
This phenomenological study explored counselors’ lived experiences of utilizing Eye Movement Desensitization and Reprocessing (EMDR) with children ages 8 to 12 years of age. Guided by a Husserlian approach, the research examined how clinicians make meaning of adapting EMDR—traditionally conceptualized as a structured, eight-phase protocol—for developmental and relational responsiveness within child psychotherapy. Through phenomenological reduction and epoché, counselors described a shift in consciousness from viewing EMDR as a rigid procedure to experiencing it as a flexible, relationally attuned process grounded in the child’s lived world. Counselors described the phenomenon of implementing EMDR with children with playful adaptations and co-regulation. The …
Psychosocial Characteristics Of North American Male Cannibals, Sheila A. Murphy
Psychosocial Characteristics Of North American Male Cannibals, Sheila A. Murphy
Walden Dissertations and Doctoral Studies
Criminal cannibalism is a rare form of violent offending that remains understudied despite public attention. This gap limits understanding of the psychosocial characteristics and life experiences of individuals who engage in cannibalistic behavior. The purpose of this qualitative study was to explore psychosocial characteristics within the life experiences of North American males who engaged in cannibalistic behavior and identify common themes. Grounded in social control theory and self-control theory, the study examined how weakened social bonds and diminished self-regulation may relate to extreme deviance. The guiding research question focused on identifying common psychosocial characteristics within this population. A descriptive phenomenological …
Psychometric Properties Of A Newly Developed Self-Report Scale To Determine The Relationship Between Retained Primary Reflexes And Behavioral Signs And Symptoms In An Adult Population, Joan Marie Macmillan
Psychometric Properties Of A Newly Developed Self-Report Scale To Determine The Relationship Between Retained Primary Reflexes And Behavioral Signs And Symptoms In An Adult Population, Joan Marie Macmillan
Walden Dissertations and Doctoral Studies
Many adults suffer from mental health issues, often caused by retained primary reflexes. There are current gaps in the literature surrounding primary reflex assessment methods. The purpose of this quantitative psychometric study was to evaluate the psychometric properties of a new behavioral self-assessment scale used to identify retained primary reflexes from behavioral indicators, while also determining if statistically significant relationships exist among study variables. The theoretical foundation for this cross-sectional study was based on the neurodevelopmental and neurobehavioral work of Melillo, while conceptually benefiting from several neuroplasticity related frameworks, such as those developed by Ayres, Bach-y-Rita, and Masgutova. The self-report …
Leadership Practice And Organizational Culture In Reducing Burnout Among Sud Supervisors, Christine Arismendi
Leadership Practice And Organizational Culture In Reducing Burnout Among Sud Supervisors, Christine Arismendi
Walden Dissertations and Doctoral Studies
Burnout in supervisors/managers working in residential substance use disorder (SUD) treatment settings poses serious threats to the agency, staffing, and client care. Behavioral health leaders need to understand how organizational culture and leadership practices shape burnout and resilience in their teams. This qualitative case study drew on the Leadership and Workforce categories of the Baldrige Excellence Framework to examine the influence of leadership and organizational culture on staff emotional well-being and resilience at a Boston-area nonprofit residential SUD treatment center. The study sought to answer: (a) how organizational culture and leadership affect supervisor and manager well-being and resilience; and (b) …
Burnout And Secondary Traumatic Stress Experiences In Mental Health Professionals Working With Military Veterans, Megan Carter
Burnout And Secondary Traumatic Stress Experiences In Mental Health Professionals Working With Military Veterans, Megan Carter
Walden Dissertations and Doctoral Studies
Burnout among mental health professionals has been a long-standing phenomenon when working with trauma individuals resulting in increased job turnover rates and decreased quality of care for patients. The job demands- resourced model and constructivist self- development theory were used to guide this study. The purpose of this research study was to explore how mental health professionals working with the military veteran population experience burnout and secondary traumatic stress. A descriptive qualitative design was used with purposive and snowball sampling to attain 10 mental health professionals from various facilities serving military veterans. Data were collected from semistructured interviews and were …
Psychologists’ Preparedness And Self-Efficacy In Serving Grieving Hispanics During Covid-19, Janet Salinas Sanchez
Psychologists’ Preparedness And Self-Efficacy In Serving Grieving Hispanics During Covid-19, Janet Salinas Sanchez
Walden Dissertations and Doctoral Studies
Mental health professionals working with Hispanic populations often face challenges in addressing grief, a culturally multifaceted experience influenced by traditions and familial and community practices. The purpose of this qualitative study was to examine psychologists’ self-efficacy and preparedness in managing grief among Hispanic individuals who have been affected by COVID-19, address cultural factors in grief management, and identify demographic or professional factors that predict higher self-efficacy in working with Hispanic clients. Data were collected at a single point in time from eight psychologists who were actively working or had worked with Hispanic populations during COVID-19 to explore psychologists’ self-efficacy, preparedness, …
Long-Term Impact Of Covid-19 On Burnout, Turnover, And Job Satisfaction Among Hospital Nurses, Delaney Corona Martinez
Long-Term Impact Of Covid-19 On Burnout, Turnover, And Job Satisfaction Among Hospital Nurses, Delaney Corona Martinez
Walden Dissertations and Doctoral Studies
Hospital industry workforce separation has remained a persistent concern in the United States, with uncertainty regarding how national hospital industry separation patterns changed following the COVID-19 pandemic. The purpose of this quantitative, nonexperimental retrospective study was to examine whether national hospital industry monthly separation rates differed between the prepandemic period (2018–2019) and the postpandemic period (2023–2024), whether separation rates demonstrated a statistically significant linear trend from 2018 through 2024, and whether separation rate variance differed between periods. The conceptual framework for this study was grounded in Maslach’s Burnout Theory and Herzberg’s Two-Factor Theory of Job Satisfaction, which explain how workplace …
Influence Of Moral Development, Religiosity, Achieved Belongingness, And Collective Narcissism On Conspiracy Theory Beliefs, Barbara Mahoney Lee
Influence Of Moral Development, Religiosity, Achieved Belongingness, And Collective Narcissism On Conspiracy Theory Beliefs, Barbara Mahoney Lee
Walden Dissertations and Doctoral Studies
Belief in conspiracy theories has been linked to prejudice and societal instability, underscoring the importance of understanding the psychological factors that shape such beliefs. This quantitative correlational survey research examined the extent to which moral development, religiosity, achieved belongingness, collective narcissism, and political party affiliation predict conspiracy theory beliefs. Wood’s three-tier model of conspiracy theory beliefs provided the conceptual framework for the study. Using validated quantitative measures in an anonymous, demographically stratified sample (N = 279), a stepwise regression analysis assessed how individual and group-level factors contribute to conspiratorial thinking. Although political party affiliation was not an initial focus, preliminary …
Exercise Effects On Decreased Levels Of Depression In Female Breast Cancer Patients, Dorothy Y. Spencer
Exercise Effects On Decreased Levels Of Depression In Female Breast Cancer Patients, Dorothy Y. Spencer
Walden Dissertations and Doctoral Studies
Breast cancer patients with major depressive disorder (MDD) are at a high risk of experiencing pain and fatigue, anxiety and substance use, poor quality of life, marital spouses with elevated depression, impaired sexual functioning, sleep disorders, poor immune system functioning, rapid progression of cancer, and higher mortality rates. Grounded in Fritz Heider’s attribution theory, the purpose of this quantitative quasi-experimental study was to examine the relationship between physical exercise and a decrease in MDD. The participants comprised of 15 female breast cancer patients, 18 years of age and older, who may have experienced depression. The participants completed the Beck Depression …
Coping Strategies, Barriers, And Supports Of Female Nurses And Veterans With A Work-Related Traumatic Exacerbation Of An Existing Respiratory Disorder, Joanna Lynn Phillips
Coping Strategies, Barriers, And Supports Of Female Nurses And Veterans With A Work-Related Traumatic Exacerbation Of An Existing Respiratory Disorder, Joanna Lynn Phillips
Walden Dissertations and Doctoral Studies
The United States Department of Defense and Bureau of Labor Statistics estimated that female veterans and nurses experience work-related trauma at rates of 51% or higher. While many studies have examined their mental health outcomes, posttraumatic worsening of physical health has been less studied in this population. This generic qualitative inquiry was conducted to gain a deeper understanding of the subjective lived experiences of female nurses and veterans' work-related traumatic exacerbation of an existing respiratory disorder. The coping strategies developed, the potential barriers they overcame, and the support systems used were examined. The theoretical framework that grounded this study was …
Effect Of Physical Custody On Relationship Satisfaction In Adults, Mathew Aaron Richards
Effect Of Physical Custody On Relationship Satisfaction In Adults, Mathew Aaron Richards
Walden Dissertations and Doctoral Studies
Custody decisions are often informed by attachment-based arguments, yet little research has examined long-term effects of custody type on adult outcomes. This study involved examining whether joint versus sole physical custody predicted relationship satisfaction, testing both parental attachment and socioeconomic status as mediators. Data were collected from 226 adult participants (mean age = 33.42), whose parents separated before age 13. Validated measures were used to assesse relationship satisfaction, parental attachment, and socioeconomic status. Participants who grew up in joint physical custody arrangements reported significantly higher relationship satisfaction compared to those who experienced sole physical custody (b = 0.54, p = …
Lived Experiences Of Black, Indigenous, And People Of Color (Bipoc) Counselors Collaborating With Multidisciplinary Teams To Treat Bipoc Clients Diagnosed With Eating Disorders, Melissa Sherfield
Walden Dissertations and Doctoral Studies
Eating disorder (ED) treatment has historically been grounded in Eurocentric models that inadequately account for the cultural contexts and lived experiences of Black, Indigenous, and people of color (BIPOC), contributing to persistent disparities in care. The purpose of this descriptive transcendental phenomenological study was to explore the lived experiences of BIPOC counselors who provide culturally responsive care to BIPOC clients diagnosed with EDs. Guided by Husserl’s phenomenological philosophy of intentionality and Giorgi’s descriptive phenomenological method, the central research question addressed the lived experiences of BIPOC counselors providing culturally responsive ED care, with a sub-question addressing how counselors describe their preparedness …
Transitions Of Growth And Partner Responsiveness In Late Adolescent Marriage, Terrell Ka-Seem Pugh
Transitions Of Growth And Partner Responsiveness In Late Adolescent Marriage, Terrell Ka-Seem Pugh
Walden Dissertations and Doctoral Studies
During the stage of late adolescence, marriage presents unique challenges, with partners navigating several developmental tasks in tandem with forming and maintaining marital relationships. Partner responsiveness has been consistently identified as a key factor for personal wellbeing and relationship satisfaction. Limited research has explored how late adolescent married individuals describe this dynamic. The purpose of this qualitative transcendental phenomenological study was to explore lived experiences of late adolescent married individuals between 18 and 20 who described their experiences with partner responsiveness during this transitional period. This study was grounded in Bronfenbrenner’s ecological systems theory in order to explore how relational …
Decision Making Processes Of Adolescent Women About Entering Intimate, Long-Term Romantic Relationships, Jeannie Miller
Decision Making Processes Of Adolescent Women About Entering Intimate, Long-Term Romantic Relationships, Jeannie Miller
Walden Dissertations and Doctoral Studies
There is a high rate of women in their late 20s and early 30s that are in destructive relationships, many because of decisions that were made during adolescence . Little research has focused on understanding the decision making process of entering intimate, long-term romantic relationships from the viewpoint of adult women in their late 20s through 30s who made that decision during adolescence. This phenomenological study allowed for a greater understanding of adolescent decision making, specifically about entering intimate, long-term romantic relationships. The research questions were (a) What are the lived experiences of young women as they enter intimate, long-term …
Social Determinants Of Health And Treatment Outcomes In Black And White Men With Early-Stage Prostate Cancer, Laurel Cannon
Social Determinants Of Health And Treatment Outcomes In Black And White Men With Early-Stage Prostate Cancer, Laurel Cannon
Walden Dissertations and Doctoral Studies
Black men are disproportionately affected in diagnosis and death rates from prostate cancer compared to White men. Although prior research established links between race, sociodemographic factors, and prostate cancer outcomes, longitudinal analyses examining multiple social determinants of health simultaneously were limited. The purpose of this quantitative study was to examine whether race, marital status, and education impact how long patients live who were diagnosed with early-stage prostate cancer. Social impact theory framed how social forces such as race, education, and marital status influence health outcomes. A non-experimental correlational design was employed, drawing on archival data from 4,407 participants in the …
Exploring Identity Development Of Therapeutic Boarding School Alumni, Travis Philipsen
Exploring Identity Development Of Therapeutic Boarding School Alumni, Travis Philipsen
Walden Dissertations and Doctoral Studies
Research on therapeutic boarding schools (TBS) has largely focused on treatment experiences and immediate adolescent outcomes, with limited attention to identity development after program discharge. The purpose of this qualitative descriptive study was to examine identity development during emerging adulthood in TBS alumni aged 18-24 and to explore how internal strengths and external supports influenced participants’ developmental experiences after leaving TBS. Positive youth development was the guiding theoretical framework, emphasizing the bidirectional relationship between a person and the external ecological assets they access. Semistructured interviews were conducted with six alumni, and data were analyzed using reflexive thematic analysis within a …
Psychologists’ And Psychiatrists’ Views On Criminal Behavior, Fetal Alcohol Spectrum Disorder, And Federally Sentenced Indigenous Women In The Prairie Region And British Columbia, Rina Asghar
Walden Dissertations and Doctoral Studies
The overrepresentation of federally sentenced Indigenous women in Canada reflects longstanding structural and systemic injustices within the criminal justice system. Constituting approximately 5% of the female population, Indigenous female offenders are disproportionately represented, especially in maximum security facilities and structured intervention units. This qualitative study examined psychologists’ and psychiatrists’ perspectives on the potential role of fetal alcohol spectrum disorder (FASD) related neurocognitive impairments in increasing justice system involvement among Indigenous women in Western Canada. Guided by the multidimensional Indigenous developmental framework, which integrates historical trauma theory and attachment theory, nine psychologists and one psychiatrist were interviewed in semi-structured interviews. The …
Emergent Patterns In Individual Perceptions Of Domestic Violence Among African Immigrants, Annah Ezuma
Emergent Patterns In Individual Perceptions Of Domestic Violence Among African Immigrants, Annah Ezuma
Walden Dissertations and Doctoral Studies
Domestic abuse continues to be a prevalent and intricate matter within society, frequently concealed by silence. The comprehension of individuals’ perceptions of abuse is of utmost importance in the advancement of efficacious interventions and support systems. Among African immigrants in the United States, perceptions of domestic violence were often influenced by several factors like religion and migration stressors. Despite increasing concerns about abuse within this population, limited research has explored how they interpret abuse and how these perceptions shape help seeking behaviors and disclosure. The gap was significant because of the cultural transition and many immigrant experiences. This qualitative study …
How Recruitment And Retention Of Staff Affect Behavioral Health Care Facilities, Teresa A. Rodriguez
How Recruitment And Retention Of Staff Affect Behavioral Health Care Facilities, Teresa A. Rodriguez
Walden Dissertations and Doctoral Studies
ABC Organization identified the barriers of how recruitment and retention of staff affect a behavioral health care agency. The goal of the study was to determine how these barriers affect behavioral health care organizations. The framework used for the study was the Baldridge framework. The research questions that guided the study addressed how recruitment of staff affects an organization and how retention of staff affect an organization. The methodology was a qualitative case study with 10 participants. Data was analyzed by coding and identifying themes. The results showed that when an organization invests in the leaders and offers benefit packages, …
Emotional And Psychological Well-Being In Early Postmenopausal Women: A Phenomenological Study, Marjorie F. Leon
Emotional And Psychological Well-Being In Early Postmenopausal Women: A Phenomenological Study, Marjorie F. Leon
Walden Dissertations and Doctoral Studies
The purpose of this qualitative phenomenological study was to explore how early postmenopausal women experience and navigate emotional and psychological well-being during the postmenopausal transition. Although menopause has been widely examined as a biological process, women’s lived emotional and psychosocial experiences during the early postmenopausal period remain underexplored in psychological research. Conceptually informed by Engel’s biopsychosocial model, this study examined how biological, psychological, and social factors intersect in shaping resilience, identity, and coping during this transitional life stage. Thirteen women within 5 years of menopause onset participated in semi structured interviews. Data were analyzed using Braun and Clarke’s six-phase reflexive …
Perceived Black Maternal Narcissism And Their Daughters’ Delinquency: Chronicles From A Daughter’S Interpretation, Nzinga Cates
Perceived Black Maternal Narcissism And Their Daughters’ Delinquency: Chronicles From A Daughter’S Interpretation, Nzinga Cates
Walden Dissertations and Doctoral Studies
This qualitative study examined the intricate dynamics between perceived Black narcissistic mothers and their daughters, particularly regarding potential delinquent behaviors exhibited by the daughters. By utilizing in-depth interviews with seven participants, I sought to uncover the psychological and relational factors contributing to these behaviors’ development. Thematic analysis indicated that daughters of narcissistic mothers often endure emotional neglect, manipulation, and lack of healthy role modeling. This can result in feelings of inadequacy and rebellion. Themes of identity confusion, low self-esteem, and desire for autonomy surfaced as significant contributors to the daughters’ engagement in delinquent activities. The study underscored the importance of …
Exploring African American Officers’ Lived Experiences Of Racial Microaggressions In A Metropolitan Police Department, Kareem Mc Kenna
Exploring African American Officers’ Lived Experiences Of Racial Microaggressions In A Metropolitan Police Department, Kareem Mc Kenna
Walden Dissertations and Doctoral Studies
African American men in law enforcement encounter subtle racial microaggressions that contribute to emotional distress, identity conflict, and burnout. Although researchers have examined microaggressions, few studies have centered on African American men within a large metropolitan police department or explored how they interpret these experiences across tenure ranges. This qualitative phenomenological study explored how African American men with at least 2 years of service in frontline or first-line supervisory roles in a Southern California metropolitan police department experienced, interpreted, and coped with workplace racial microaggressions over the past five years. Guided by critical race theory, intersectionality, and Sue et al.’s …
The Relationship Between Police Encounters And Anxiety Levels Among Urban Black Males Aged 18–40, Wilbert Smith
The Relationship Between Police Encounters And Anxiety Levels Among Urban Black Males Aged 18–40, Wilbert Smith
Walden Dissertations and Doctoral Studies
This quantitative, cross-sectional, correlational study examined the relationship between police encounter characteristics and anxiety symptoms among urban Black males aged 18–40 in the United States. Although prior research has documented racial disparities in police contact and adverse mental health outcomes, limited empirical work has examined how multiple dimensions of police encounters jointly relate to anxiety within this population. Guided by Critical Race Theory, the study assessed whether the frequency, severity, and perceived fairness of police encounters were associated with self-reported anxiety symptoms. Data were collected from 138 self-identified urban Black males using a nonprobability, self-selected sampling approach. Participants completed an …
Understanding The Lived Experiences Of Black Males Successfully Reintegrating Post Incarceration, Ashley Smith
Understanding The Lived Experiences Of Black Males Successfully Reintegrating Post Incarceration, Ashley Smith
Walden Dissertations and Doctoral Studies
Black males remain incarcerated at higher rates than any other race. Those individuals trying to reintegrate into society face many challenges with little mental and emotional rehabilitation support. The purpose of this hermeneutic phenomenology study was to improve the understanding of what contributes to successful reintegration and the mental health and emotional needs of formerly incarcerated Black males. Critical race theory (CRT) was used as a secondary lens to examine how race, systemic racism, and structural inequities shaped participants' experiences. This study examined the following research question: What are the experiences of Black males who were previously incarcerated and have …
Retrospective Narrative Analysis Of Perceived Manifestations Of Burnout Among Emergency Physicians Amid Covid-19 Pandemic, Nicole Jauregui
Retrospective Narrative Analysis Of Perceived Manifestations Of Burnout Among Emergency Physicians Amid Covid-19 Pandemic, Nicole Jauregui
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic has placed stress on healthcare systems globally, with emergency department (ED) physicians experiencing an acute impact due to their frontline role. Burnout, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, has been widely reported by healthcare providers during the pandemic. However, the specific manifestations of burnout among ED physicians remain underexplored, particularly from their own perspectives. This study is grounded in Maslach’s Multidimensional Theory of Burnout and Alan Card’s theory of Avoidable versus Unavoidable Suffering, providing a framework to interpret ED physicians’ experiences and distinguish between the inherent challenges of frontline work and …