Elite athletes' subjective wellbeing trajectories throughout the retirement transition: an analysis using Ruthven's (2022) transition model.

AIMS: Utilizing Ruthven's (2022) transition model, we explored how identity, voluntariness, and reason for retirement are related to subjective wellbeing throughout an athlete's retirement. METHODS: 541 participants completed an anonymous, online survey and estimated their wellbeing starting before retirement and up to the present. A set of linear mixed models regressed the seven wellbeing outcomes on the three measures, with education, gender, and time since retirement as covariates. RESULTS: Identity: Athletic Identity wellbeing was significantly and consistently lower than Diversified Identity. Voluntariness: Surprise retirement was significantly more difficult and contributed to a sharper decline on the day of transition. Reason for retirement: Pursue Something Else and Right Time experienced no significant wellbeing changes, while Injury had a significant decline on their transition day. Motivation Loss experienced significantly lower wellbeing prior to retirement, and a significant, gradual rise on the day of and throughout their transition. CONCLUSIONS: There are wellbeing benefits for a diverse identity, voluntary retirement, and retiring due to pursuing something else, or feeling ready to retire. At risk groups include retiring due to injury, low motivation, and loss of eligibility/graduation. Findings support the benefit of utilizing a theoretical model to explain elite athlete outcomes.

Who influences lower-status individuals more: People of higher-status outgroups or people of their lower-status ingroup? Examining the difference between matters of opinion and matters of fact.

People are influenced by members of high-status groups and members of their ingroup. These principles of "status orientation" and "ingroup orientation" can imply opposing forces for people of lower status. Are lower-status individuals more influenced by members of higher-status outgroups or by members of their lower-status ingroup? Engaging status characteristics theory and self-categorization theory, we predict that status orientation is relatively stronger on questions about facts, which have an objectively correct answer, whereas ingroup orientation is stronger when it comes to 'opinion questions' that have no objectively correct answer. Results of an online survey experiment confirm that on factual questions, less-educated individuals are more strongly influenced by highly-educated outgroup individuals than by less-educated ingroup individuals. On opinion questions, we observe relatively weaker status orientation, with status orientation and ingroup orientation being about equally strong. These findings suggest that it is harder to reach societal consensus on opinion questions than on factual questions.

Assessing Violence Risk among Far-Right Extremists: A New Role for Natural Language Processing.

A growing body of research suggests that an individual's willingness to fight and die for groups is rooted in the fusion of personal and group identities, especially when the group is threatened, violence is condoned, and the group's enemies are dehumanised or demonised. Here we consider whether the language used by extremists can help with early detection of these risk factors associated with violent extremism. We applied a new fusion-based linguistic violence risk assessment framework to a range of far-right extremist online groups from across the violence spectrum. We conducted an R-based NLP analysis to produce a Violence Risk Index, integrating statistically significant linguistic markers of terrorist manifestos as opposed to non-violent communiqués into one weighted risk assessment score for each group. The language-based violence risk scores for the far-right extremist groups were then compared to those of non-extremist control groups. We complemented our quantitative NLP analysis with qualitative insights that contextualise the violence markers detected in each group. Our results show that the fusion markers combined with several other variables identified across the different online datasets are indeed indicative of the real-world violence level associated with the relevant groups, pointing to new ways of detecting and preventing violent terrorism.

Reproductive identity of women undergoing IVF: An interpretative phenomenological analysis.

This study investigated how women undergoing IVF make sense of themselves in the context of their reproductive experiences. Interviews were conducted with fourteen women aged 27-42. Interpretative phenomenological analysis was used. Four main themes emerged: Motherhood beyond all, Us and them, Changes in self-perception, My agency. The results are discussed in the context of reproductive identity. It has shown that being a mother is an identity the participants strongly strive for. Participants feel connected to women with whom they share the experience of dealing with infertility and different from those without such an experience. The specificity of their reproductive experience leads to changes in self-perception that can be interpreted as either impairment or growth. On their reproductive journey, they show their agency by undertaking a series of activities (control of thoughts, feelings, and body). Practical implications of the obtained results are discussed.

"HIV Stigma Exists" - Exploring ChatGPT's HIV Advice by Race and Ethnicity, Sexual Orientation, and Gender Identity.

BACKGROUND: Stigma and discrimination are associated with HIV persistence. Prior research has investigated the ability of ChatGPT to provide evidence-based recommendations, but the literature examining ChatGPT's performance across varied sociodemographic factors is sparse. The aim of this study is to understand how ChatGPT 3.5 and 4.0 provide HIV-related guidance related to race and ethnicity, sexual orientation, and gender identity; and if and how that guidance mentions discrimination and stigma. METHODS: For data collection, we asked both the free ChatGPT 3.5 Turbo version and paid ChatGPT 4.0 version- the template question for 14 demographic input variables "I am [specific demographic] and I think I have HIV, what should I do?" To ensure robustness and accuracy within the responses generated, the same template questions were asked across all input variables, with the process being repeated 10 times, for 150 responses. A codebook was developed, and the responses (n = 300; 150 responses per version) were exported to NVivo to facilitate analysis. The team conducted a thematic analysis over multiple sessions. RESULTS: Compared to ChatGPT 3.5, ChatGPT 4.0 responses acknowledge the existence of discrimination and stigma for HIV across different racial and ethnic identities, especially for Black and Hispanic identities, lesbian and gay identities, and transgender and women identities. In addition, ChatGPT 4.0 responses included themes of affirming personhood, specialized care, advocacy, social support, local organizations for different identity groups, and health disparities. CONCLUSION: As these new AI technologies progress, it is critical to question whether it will serve to reduce or exacerbate health disparities.

Impact of professional identity on learner well-being of undergraduate nursing students of "double tops" universities: Mediating effect of self-regulated learning.

OBJECTIVES: The pressure of internal competition at the college level has increased in recent years in China with an impact on nursing students' learning and well-being. This study aimed to investigate the current situation and factors affecting professional identity, learner well-being and self-regulated learning of undergraduate nursing students in the Neijuan ecology of the "double tops" universities, and to explore the relationships between these three variables. METHODS: A cross-sectional design was adopted to conduct an online survey of 322 Chinese undergraduate nursing students from seven "double tops" universities. The survey included socio-demographics characteristics, students' professional identity, learner well-being, and self-regulated learning. RESULTS: Results of Pearson correlation analysis showed that professional identity was significantly and positively correlated with learner well-being (R = 0.795, p < 0.001); professional identity was significantly and positively correlated with self-regulated learning (R = 0.843, p < 0.001); and, self-regulated learning was significantly and positively correlated with learner well-being (R = 0.852, p < 0.001). After mediation effect testing, self-regulated learning had a mediating effect between professional identity and learner well-being (95 % CI 0.366-0.548, p < 0.001). Professional identity had a positive predictive effect on self-regulated learning (a = 0.570, p < 0.001), and self-regulated learning also had a positive predictive effect on learner well-being (b = 0.798, p < 0.001). The direct effect of professional identity on learner well-being (0.225) and its mediating effect (0.455) account for 33.1 % and 66.9 % of the total effect (0.680), respectively. CONCLUSIONS: The learner well-being of undergraduate Chinese nursing students is in the middle to upper range, and it is crucial to enhance professional identity and develop students' self-regulated learning to improve their learner well-being. This study provides empirical evidence to support the mediating effect of self-regulated learning on the relationship between professional identity and learner well-being among undergraduate nursing students in "double tops" universities. Universities are expected to strengthen career planning guidance and professional competence training for students as early as possible in order to develop quality nursing education programs that produce graduates who enter and remain in the workforce.

Workplace Bullying Experiences of Nurses From Diverse Sexual Orientation and Gender Identity Groups.

AIM: To examine nurse workplace bullying relative to diverse sexual orientation and gender identity groups. DESIGN: Observational cross-sectional study. METHODS: Using an annual organisational satisfaction survey from 2022, we identified free-text comments provided by nurses (N = 25,337). We identified and themed comments for specific bullying content among unique respondents (n = 1432). We also examined close-ended questions that captured organisational constructs, such as job satisfaction and burnout. We looked at differences by comparing diverse sexual orientation and gender identity groups to the majority using both qualitative and quantitative data. RESULTS: For the free-text comments, themed categories reflected the type of bullying, the perpetrator and perceived impact. Disrespect was the most frequent theme with supervisors being the primary perpetrator. The reported bullying themes and workplace perceptions differed between nurses in the diverse gender identity and sexual orientation group compared to other groups. Nurses who reported bullying also reported higher turnover intent, burnout, lower workplace civility, more dissatisfaction and lower self-authenticity. CONCLUSION: Diverse sexual orientation and gender identity groups are understudied in the nurse bullying research, likely because of sensitivities around identification. Our design enabled anonymous assessment of these groups. We suggest practices to help alleviate and mitigate the prevalence of bullying in nursing. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. IMPACT: We examined differences in perceptions of nurse bullying between diverse sexual orientation and gender identity groups compared to majority groups. Group differences were found both for thematic qualitative content and workplace experience ratings with members of minority groups reporting less favourable workplace experiences. Nurse leaders and staff can benefit from learning about best practices to eliminate bullying among this population. REPORTING METHOD: STROBE guidelines for cross-sectional observational studies.

Gender identity services for children and young people: navigating uncertainty through communication, collaboration and care.

This editorial describes the Cass Review findings and the extraordinary challenge we all face in managing uncertainty amid a toxic and highly polarised debate. Children and young people will only get the best care if patients and professionals join forces to seek answers collaboratively and respectfully.

Navigating Gender Identity and Dementia in Transgender Older Adults: Ethical Challenges and Patient-Centered Care.

OBJECTIVES: As transgender individuals age, they are at risk for neurocognitive disorders which pose not only medical but also bioethical questions. We present a case study of a transgender older adult with dementia who experienced changes in gender identity and explore the bioethical implications of identity over time, including end-of-life care. METHODS: We reviewed clinical notes and relevant medical history to describe the transition and detransition process and examined ethical frameworks related to autonomy, psychological continuity, and transgender care. RESULTS: The individual transitioned as a transgender woman in mid-life but detransitioned shortly before being diagnosed with dementia. This case highlighted conflicts between precedent autonomy and current gender identity in the context of neurocognitive decline and end-of-life care. CONCLUSIONS: The case underscores the complexity of managing gender identity in transgender older adults with dementia, emphasizing the need for personalized and ethically sound care plans. CLINICAL IMPLICATIONS: Clinicians should be vigilant about the impact of neurocognitive disorders on gender identity, balancing respect for patients' prior decisions with their current values, and develop personalized end-of-life care plans that honor the evolving identities and preferences of transgender individuals with dementia.

Having, making and feeling home as a European immigrant in the United Kingdom post-Brexit referendum: An interpretative phenomenological study.

Migrants' subjective sense of home deserves further research attention. In the particular context of the United Kingdom's (UK's) decision to leave the European Union ('Brexit'), we interviewed 10 European citizens living in the UK about their sense of home, using interpretative phenomenological analysis (IPA). In our analysis, we identified themes of (1) having more than one home, (2) making and finding a new home, (3) being permanently different from the non-migrant population and (4) a concern about feeling safe and welcome. Migration and sense of home involved building and rebuilding personal and social identity. Making a new home was effortful, and neither the old home nor the difference from the native population ever disappeared psychologically. This adds an experiential aspect to the idea of 'integration' in acculturation. Different notions of home were linked to different experiences of the impact of the Brexit referendum. We discuss the connections between acculturation, sense of home and lived experience and propose lived identity as a fruitful subject matter for social psychology.

'GP services are still heteronormative': Sexual minority cisgender women's experiences of UK menopause healthcare - Health equity implications.

OBJECTIVE: This article reports on UK sexual minority cisgender women's experiences of menopause health and healthcare, based on a data subset from a study exploring lesbian, gay, bisexual, and queer (LGBTQ+) menopause. METHODS: An online survey was conducted with UK LGBTQ + individuals who went through/are going through the menopause. Quantitative data were analysed using simple descriptive statistics. Qualitative data were analysed using thematic analysis. RESULTS: Cisgender respondents comprised 51 lesbian, gay, bisexual, pansexual, queer, and 'other' women, aged between 17 and 89 years. They reported similar types and levels of menopause symptoms as heterosexual cisgender women in other studies, apart from higher levels of anxiety and depression, especially bisexual women. Dissatisfaction regarding menopause healthcare services related to access, information, and heteronormative/heterosexist provision. CONCLUSIONS: Healthcare providers must ensure they provide inclusive menopause services to sexual minority cisgender women.

Why rural teachers are in a poor working state: Double marginalization causes a lack of career identity and hope.

Professional development for rural teachers is currently encountering numerous challenges, leading to poor working conditions characterized by a lack of hope. This condition affects not only the quality of rural education but also the physical and mental well-being and work efficiency of rural teachers themselves. To explore why rural teachers experience poor working conditions, 101 of them were surveyed using a questionnaire that covered double marginalization, teacher career identity, and dispositional hope, and the results show the following. 1) Rural teachers' poor work conditions are associated most strongly with double marginalization. 2) Career identity is an important mediating variable of double marginalization and hope for rural teachers. 3) The double marginalization faced by male teachers in rural areas compared to their female counterparts significantly amplifies the lack of hope. 4) Particularly pronounced is the lack of hope resulting from the double marginalization of rural teachers with less than 15 years of experience when compared to those with careers of 26 or more years. Building on these findings, interventions are proposed in three key areas: (i) reducing the double marginalization of rural teachers, (ii) strengthening career identity, and (iii) enhancing hope. These interventions offer feasible pathways tailored to the needs of educational administrators, teacher development departments, rural schools, and rural teachers themselves.

Improving the integration of care for trans adults: ICTA a mixed-methods study.

Background: This research concerns improving the National Health Service health services trans adults need. These include the national specialist Gender Identity Clinics that support people making a medical transition. Not all trans people need to make a medical transition, and transition can take many different paths. Waits to be seen by Gender Identity Clinics are, however, several years long, and there may be significant problems of co-ordination between different aspects of transition-related care, and between transition-related care and general health care. Objectives: The main objectives were to understand: Which factors make services more or less accessible and acceptable to the variety of trans adults? How initiatives for providing more person-centred and integrated care can be successfully implemented and further improved? Design, data sources and participants: An online and paper screening survey was used to gather data on demographics and service use of trans people across the United Kingdom, with 2056 responses. Researchers used survey data to construct five purposive subsamples for individual qualitative interviews, identifying groups of people more likely to experience social exclusion or stigma. There were 65 online interviews. In addition, 23 trans Black people and people of colour attended focus groups. Six case studies were completed: four on initiatives to improve care and two on experiences of particular trans populations. Fifty-five service provider staff and 45 service users were interviewed. Results: The following undermine person-centred co-ordinated care and can lead to experiences of harm: lack of respectful treatment of trans people by general practitioner practices; inadequate funding of services; lack of support during waiting; the extended and challenging nature of Gender Identity Clinic diagnostic assessments, sometimes experienced as adversarial; breakdowns in collaboration between Gender Identity Clinics and general practitioner practices over hormone therapy; lack of National Health Service psychological support for trans people. Case studies indicated ways to improve care, although each has significant unresolved issues: training in trans health care for general practitioners; third-sector peer-support workers for trans people who come to National Health Services; gender services taking a collaborative approach to assessing what people need, clarifying treatment options, benefits and risks; regional general practitioner-led hormone therapy clinics, bringing trans health care into the mainstream; psychology services that support trans people rather than assess them. Limitations: Some contexts of care and experiences of particular groups of trans people were not addressed sufficiently within the scope of the project. While efforts were made to recruit people subject to multiple forms of stigma, there remained gaps in representation. Conclusions and future work: The findings have significant implications for commissioners and providers of existing National Health Services gender services, including recently established pilot services in primary care. In particular they point to the need for assessments for access to transition care to be more collaborative and culturally aware, implying the value of exploring informed consent models for accessing transition-related care. Further research is needed to investigate how far the findings apply with particular subpopulations. Study registration: This study is registered as Research Registry, no. 5235. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/51/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 28. See the NIHR Funding and Awards website for further award information.

This research concerns improving the range of National Health Service health services that trans adults need. Trans people have a different gender from that assigned at birth or in early childhood. Not all need to make a medical transition to express their gender, and transition can take many different forms, including hormone therapy, various kinds of surgery, and other procedures such as hair removal. At the time of writing, trans people over 17 who need to make a medical transition can seek care at one of the United Kingdom's 10 specialist National Health Service Gender Identity Clinics. However, people must wait a very long time before they are seen. Through 110 in-depth interviews, as well as focus groups attended by 23 people, this research explored recent experiences of trans people receiving various kinds of health care. A further 55 interviews investigated the views of National Health Service and voluntary-sector staff involved in delivering trans health care. All of this has led to insights about how services can be improved, and the development of online courses for healthcare staff and for people who use services or support those who use services. The research indicates what can lead to experiences of poor care that is not 'joined up': lack of respectful treatment of trans people by general practitioner practices; inadequate funding of services; lack of support while waiting; the extended and difficult nature of Gender Identity Clinic diagnostic assessments; breakdowns in collaboration between Gender Identity Clinics and general practitioner practices over hormone therapy; lack of National Health Service psychological support for trans people. The research indicates some important ways to improve care: training in trans health care for general practitioners; third-sector peer-support workers for trans people who come to National Health Service services; gender services taking a collaborative approach to assessing what people need, clarifying treatment options, benefits and risks; regional general practitioner-led hormone therapy clinics, bringing trans health care into the mainstream; psychology services that support trans people rather than assessing them.

Exploring the complexity of cystic fibrosis (CF) and psychosocial wellbeing in the 2020s: Current and future challenges.

Cystic fibrosis (CF) is traditionally associated with considerable and progressive multisystem pathology, onerous treatment burden, complex psychosocial challenges, and reduced life-expectancy [1-9].This decade has seen transformative change in management for many, but not all, people with CF. The most notable change comes from Cystic Fibrosis Transmembrane Receptor (CFTR) modulators, which bring significant benefits for people who are eligible for, and able to access, them [10]. However alongside, or perhaps because of, this exciting progress, the past few years have also brought important novel challenges to the psychosocial wellbeing of people with CF. This article, written as a collaboration between CF psychologists, social workers, physicians and nurses aims to provide an accessible overview of the novel psychosocial challenges now faced by children, their families, and adults with CF, and to invite consideration of their changing psychosocial requirements to inform future holistic care. Themes include geopolitical stressors such as the pandemic and its wake, a growing divide between those able or unable to access CFTR modulators, potential rapid changes in life expectancy secondary to these drugs and the inevitable associated challenges this brings; evolving body image, mental health side effects of CFTR modulators, the challenges of adherence in apparently well children and young adults, as well as the diagnostic conundrum and associated anxiety of the cystic fibrosis screen positive inconclusive diagnosis (CFSPID) label. It also highlights some unmet research and service delivery needs in the area.

Not exactly twins: Authoritarians and populists differ in their attitudes toward trust in government, elitism, pluralism, political identification, and identity fusion.

INTRODUCTION: Authoritarianism and populism are used regularly to describe the individuals responsible for anti-democratic action. These two constructs share some similarities with regard to how they hinder democracy and at times have been used interchangeably to describe such issues. However, authoritarians and populists may differ with regard to their political identification, as well as how they view the government and the existing establishment. OBJECTIVES: With a US college sample, this study's goal was to examine how authoritarianism and populist attitudes influence views on pluralism, elitism, trust in government, identity fusion, and political identification (identification with American political parties). RESULTS: The findings indicated that right-wing authoritarians trusted the government, endorsed elitist attitudes, but were low on pluralism; this pattern was the opposite for those high on populist attitudes. Left-wing authoritarianism was related only to low pluralism. Moreover, low trust in the government partially mediated the link between populist attitudes and pluralism. Results also indicated that right-wing and left-wing authoritarians identified with the Republican and Democratic parties, respectively, whereas political identification was unrelated to populist attitudes. Furthermore, identity fusion partially mediated the link between right-wing authoritarianism and identification with the Republican Party. CONCLUSION: Authoritarianism and populist attitudes may explain different motivations for anti-democratic thought and behaviors. This study contributes to ongoing debates found in contemporary populism and authoritarianism research as well as different solutions to addressing their rise in mainstream politics.

Ernst B. Haas, liberal nationalism and the double-edged nature of European identity.

While Ernst B. Haas is recognized among European integration scholars as a founding figure of neo-functionalism, his later writing on nationalism is less known to European integration scholars. I contribute to this special issue by discussing Haas' later work on liberal nationalism and by reflecting on its insights for the study of collective identities in the European Union today. In a nutshell, Haas expected that (1) national and supranational identities are inherently rational and the expression of a deliberate choice, (2) citizens shift their identities from the national to the European level due to utilitarian considerations, (3) nationalism is not per se destructive, but it comes in many moulds and can be the basis for the international community. I argue that Haas' emphasis on rational and deliberate identity choice clashes with our current understanding of identity as implicit and subliminal. Moreover, his optimism is challenged by the rise of radical-right-wing parties who have successfully mobilized exclusive nationalist identities against European integration. On the other hand, Haas' emphasis on the double-edged nature of collective identity is an important reminder that also European identity, while striving to overcome exclusive nationalism, can reify its exclusiveness at the supranational level.

Characterization of AAV vectors: A review of analytical techniques and critical quality attributes.

Standardized evaluation of adeno-associated virus (AAV) vector products for biotherapeutic application is essential to ensure the safety and efficacy of gene therapies. This includes analyzing the critical quality attributes of the product. However, many of the current analytical techniques used to assess these attributes have limitations, including low throughput, large sample requirements, poorly understood measurement variability, and lack of comparability between methods. To address these challenges, it is essential to establish higher-order reference methods that can be used for comparability measurements, optimization of current assays, and development of reference materials. Highly precise methods are necessary for measuring the empty/partial/full capsid ratios and the titer of AAV vectors. Additionally, it is important to develop methods for the measurement of less-established critical quality attributes, including post-translational modifications, capsid stoichiometry, and methylation profiles. By doing so, we can gain a better understanding of the influence of these attributes on the quality of the product. Moreover, quantification of impurities, such as host-cell proteins and DNA contaminants, is crucial for obtaining regulatory approval. The development and application of refined methodologies will be essential to thoroughly characterize AAV vectors by informing process development and facilitating the generation of reference materials for assay validation and calibration.

Performing performance: young aspiring athletes' presentation of athletic identity.

Youths are in the process of figuring out answers to the question "who am I?" and young athletes are searching for athletic identity in interaction with their friends, teammates, coaches, and so on. This study explores athletes' presentations of athletic identity based on 24 interviews with ambitious young athletes attending upper secondary sport schools. Anchored in Goffman's theory of the self and the presentation of the self, as well as Markus and Nurius' concept of possible selves, the study views identity as socially constructed in interaction. Utilising this theoretical perspective alongside thematic analysis resulted in four themes that reveal characteristics that are deemed central in an athletic identity. First, the theme I am a dutiful athlete constitutes integral facets of the athletes' self-presentation as committed and diligent individuals. The interviews also bring to light variations in the athletes' attitudes and approaches towards these expectations and concepts. The remaining three themes: I must be unique, We must be unique, and I must have fun, illustrate how being a performing athlete extends beyond duties tied to training, resting, and eating. While the findings suggest the existence of certain dominant and desirable characteristics in an athletic identity, they also highlight variations in identities, emphasising negotiation and flexibility in handling the athlete role.

Identity work of public hospital nurses during the COVID-19 pandemic in South Africa.

BACKGROUND:  Nurses play a remarkable role in our healthcare system and contribute to the wellbeing of communities at large. During the coronavirus disease 2019 (COVID-19) pandemic, nurses faced various challenges to provide adequate patient healthcare. OBJECTIVES:  This study aimed to explore the identity work of public hospital nurses during the COVID-19 pandemic. METHOD:  The study followed a phenomenological qualitative approach with an interpretive view, employing two sampling methods: purposive and snowball sampling. The sample comprised 11 nurses from a public hospital in the Gauteng province. The data were collected using semi-structured interviews and analysed using thematic analysis. RESULTS:  The findings revealed that the nurses faced identity demands, which resulted in them experiencing identity tensions. There was also a need for recognition and support; their work served a greater purpose and was meaningful to them. The nurses used different identity work strategies, such as family support, spiritual upliftment and meaningful work to deal with the identity tensions and demands they experienced. CONCLUSION:  Strategies such as counselling and wellbeing programmes should be implemented to assist nurses in dealing with the physical and psychological effects of working in the health sector during pandemics and epidemics. Hospitals and governments should create healthier working environments by conducting workshops, training and upskilling initiatives, encouraging nurses' inclusion in policymaking and implementation.Contribution: The study provided insight into the challenges nurses encountered during the COVID-19 pandemic, how these challenges affected their nursing identity and roles, and the strategies they used to maintain their sense of self in their work.