Table 2.
Summary of themes in BCW categories
| BCW level and category | Protectors | Threats | Both | |
|---|---|---|---|---|
| Behaviour (243) | Capability—physical | Diet, exercise, leisure, peer support, presence (11) | Abuse/assault, lip-reading with mask, working with death, exposure to virus; loss of touch (15) | |
| Capability—psychological | Agent of noble cause, define moral injury, self-care, normalise response | Feelings: anxiety; frustration; helpless; invisible; sad, suicide ideation (28) | Sharing vulnerability, enter other’s suffering | |
| Motivation—automatic | Caring, obligations, feeling: hope; optimism; safe, meaning in loss (13) | Abuse, loss: faith; hope; meaning; trust, feeling: anxiety; betrayal; unvalued; powerless (59) | Change, sacrifice, vulnerability (15) | |
| Motivation—reflective | Self-aware, hope, coping, meaning-making, presence, significance of touch (30) | Feeling devalued, lack of reflection, self at risk, no chance to mourn, witness death/suffering (19) | Destruction and growth, opportunity in pain | |
| Opportunity—physical | Meet physical needs, being/listening in pain/darkness, presence | Elevated stress/anxiety/PTSD/exhaustion/depression, isolation, mask anonymity | Silence | |
| Opportunity—social | Build trust, rituals, bridge patient/family, peer/social support (13) | Distanced, disconnected, lonely, infection, loss: presence; shared moments; support; touch (11) | ||
| Intervention (46) | Coercion | Security staff | Feeling at risk | |
| Education | Routine well-being | Psychological distress in patients | Difficult conversations | |
| Enablement | Basic needs, facilitate self-care | |||
| Environment | Culture of caring, space to share stress | Quiet spaces removed | ||
| Incentivisation | Peer support, training in work hours | |||
| Modelling | Leader recognition, decrease stress | |||
| Persuasion | Financial, employer ethic of care | |||
| Restrictions | Peer support | Social distancing, security staff | Physical safety | |
| Training | Stress/resilience, skills for new roles | Redeployment: anxiety; safety; New workplace | Care of dying | |
| Policy (58) | Communication | Bidirectional leadership, recognition | Mask anonymity | |
| Social planning | Reduce stress, leisure, PPE, support | High stress/low support, burnout, stress | ||
| Fiscal | Develop financial/technical demands | Lack of infrastructure | ||
| Guidelines | Staff care strategy, support staff health | |||
| Legislation | Care for absent loved ones | Lockdown, social isolation | ||
| Regulation | Self-care | |||
| Service provision | Care: capacity to deliver; best available, decrease stress, staff support needs (13) | Brutal rules “for greater good”, loss of high care standards, staff shortages, system overload (10) | Redeployment, care of dying, well-being | |