Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Applied Health Research and Evaluation

Committee Member

Ann Blair Kennedy

Committee Member

Kathleen Cartmell

Committee Member

Rachel Mayo

Committee Member

Thomas W Britt


The COVID-19 pandemic continues to strain health-care systems throughout the world. While early reports compared its impacts to other contemporary disease outbreaks (e.g., SARS and MERS), it quickly became apparent that COVID-19 would dwarf these contemporary crises, escalating to a scale more on par with the 1918 influenza outbreak. This disaster will have unprecedented effects on health-care workers, among whom burnout was already a serious concern. Burnout and linked phenomena moral distress, compassion fatigue, and secondary trauma are associated with increased turnover and intent to leave health-care professions, decreased quality of care delivered to patients, and poor mental and physical health outcomes among health-care workers. ProjectCOPE: Chronicling health-care prOviders’ Pandemic Experiences is a mixed-methods study exploring the perceptions and capturing the stories of a diverse cohort of health-care workers representing more than 21 distinct professions during the COVID-19 pandemic. Chapter 1 includes an extensive review of literature and summary of methodology for this dissertation’s aims. Special attention is paid to two professions, nursing and massage therapy, which are the subject of analysis in Aim 2. Subsequent chapters are formatted as stand-alone manuscripts, each presenting significance, methodology, results, and discussion for one of the aims. Chapter 2 presents Aim 1: “Describe the sample and experiences of ProjectCOPE participants.” In this mixed-methods study of all ProjectCOPE participants, we explore the differences between professions labeled “essential” versus “non-essential”, and lay the foundation for future study of the potential impact of such policies. The study identified four themes: 1) professional identity, 2) intrinsic stressors, 3) extrinsic factors, and 4) coping strategies. Chapter 3 presents Aim 2: “Compare and contrast experiences of nurses and massage therapists during the COVID-19 pandemic.” This study draws on findings from Aim 1, delving into a mixed-methods analysis of the differences and similarities between nurses’ and massage therapists’ experiences of working during the COVID-19 pandemic, specifically burnout and coping strategies. This study found that, despite some differences in experienced burnout as measured by instruments validated in nurses, similar experiences were reported by both professions. As part of ProjectCOPE, we developed a novel approach to meaningfully include medical students in the processing and sorting of data. Chapter 4 covers Aim 3: “Evaluate novel methodology developed for ProjectCOPE.” This novel methodology is called #Evaluation (pronounced “hashtag evaluation”), and builds on medical students’ knowledge and understanding of social media platforms. This chapter demonstrates #Evaluation is a valuable tool for rapid evaluation and assessment, and for teaching qualitative research to students with little-to-no experience. Finally, Chapter 5 provides an executive summary of findings, limitations, and directions for future research. Here, we highlight this dissertations contributions to science, including an inventory of topics for which these chapters represent the first or early exploration.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.