Strengthening Patient Advocacy through HR Nurturing Connects: Insights from Post-COVID Bhaktivedanta Hospital
Keywords:
Human Resource Nurturing Connects (HRNCs), Compassion, Empathy, Physicians, Patient Advocacy, BICEPS Scale, PAS Scale, Post-COVID Healthcare, Bhaktivedanta Hospital, Emotional Intelligence in Clinical PracticeAbstract
This study examines the role of Human Resource Nurturing Connects (HRNCs) in strengthening compassion and empathy among physicians and surgeons, and how these qualities influence patient advocacy within clinical practice. A two-arm prospective randomized controlled trial was conducted over a 12-month period involving 30 physicians (15 intervention, 15 control) at Bhaktivedanta Hospital & Research Institute. The intervention group underwent structured HRNCs, including one-on-one coaching, empathetic listening modules, role clarity sessions, and feedback mechanisms. Outcomes were assessed using two validated instruments: the Bhaktivedanta Index of Compassion and Empathy in Physicians and Surgeons (BICEPS) and the Patient Advocacy Score (PAS), each comprising 25 items.
Statistical analysis using the Mann-Whitney U test demonstrated a significant improvement in both BICEPS (mean increase from 65.47 to 83.79) and PAS (mean increase from 64.48 to 90.12) in the intervention group compared to minimal change in the control group. These findings establish that structured HR-based interventions can materially enhance physicians’ empathetic and compassionate conduct, thereby fortifying patient advocacy as a professional obligation. At the same time, higher PAS scores reflect a perceptible strengthening of advocacy by patients, manifested through improved trust, communication, and patient participation in care. The study underscores that HR-driven emotional nurturing is not ancillary but central to patient-centered healthcare, with implications for clinical practice, institutional policy, and broader reforms in post-COVID medical law and ethics.
References
World Health Organization. WHO COVID-19 Dashboard: COVID-19 Cases, World. Available online: https://data.who.int/dashboards/covid19/cases?n=o
Su, Y.; Yuan, D.; Chen, D.G.; Ng, R.H.; Wang, K.; Choi, J.; Li, S.; Hong, S.; Zhang, R.; Xie, J.; et al. Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae. Cell 2022, 185, 881–895.e20.
Tenforde, M.W.; Kim, S.S.; Lindsell, C.J.; Billig Rose, E.; Shapiro, N.I.; Files, D.C.; Gibbs, K.W.; Erickson, H.L.; Steingrub, J.S.; Smithline, H.A.; et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network—United States, March–June 2020. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 993–998.
Callard, F.; Perego, E. How and Why Patients Made Long Covid. Soc. Sci. Med. 2021, 268, 113426.
Nath, A. Long-Haul COVID. Neurology 2020, 95, 559–560.
Perego, E.; Callard, F.; Stras, L.; Melville-Jóhannesson, B.; Pope, R.; Alwan, N.A. Why the Patient-Made Term “Long Covid” Is Needed. Wellcome Open Res. 2020, 5, 224.
Greenhalgh, T.; Sivan, M.; Perlowski, A.; Nikolich, J.Ž. Long COVID: A Clinical Update. Lancet 2024, 404, 707–724.
Gutzeit, J.; Weiß, M.; Nürnberger, C.; Lemhöfer, C.; Appel, K.S.; Pracht, E.; Reese, J.-P.; Lehmann, C.; Polidori, M.C.; Hein, G.; et al. Definitions and Symptoms of the Post-COVID Syndrome: An Updated Systematic Umbrella Review. Eur. Arch. Psychiatry Clin. Neurosci. 2025, 275, 129–140.
National Academies of Sciences, Engineering, and Medicine. A Long COVID Definition; Fineberg, H.V., Brown, L., Worku, T., Goldowitz, I., Eds.; National Academies Press: Washington, DC, USA, 2024.
Chen, C.; Haupert, S.R.; Zimmermann, L.; Shi, X.; Fritsche, L.G.; Mukherjee, B. Global Prevalence of Post-Coronavirus Disease 2019 (COVID-19) Condition or Long COVID: A Meta-Analysis and Systematic Review. J. Infect. Dis. 2022, 226, 1593–1607.
Carfì, A.; Bernabei, R.; Landi, F. Persistent Symptoms in Patients After Acute COVID-19. JAMA 2020, 324, 603.
Jaywant, A.; Gunning, F.M.; Oberlin, L.E.; Santillana, M.; Ognyanova, K.; Druckman, J.N.; Baum, M.A.; Lazer, D.; Perlis, R.H. Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning. JAMA Netw. Open 2024, 7, e2356098.
Perlis, R.H.; Lunz Trujillo, K.; Safarpour, A.; Santillana, M.; Ognyanova, K.; Druckman, J.; Lazer, D. Association of Post–COVID-19 Condition Symptoms and Employment Status. JAMA Netw. Open 2023, 6, e2256152.
Bonham, C.; Juarez, R.; Siegal, N. Long COVID and Unemployment in Hawaii. Int. J. Environ. Res. Public Health 2023, 20, 6231.
MacEwan, S.R.; Rahurkar, S.; Tarver, W.L.; Eiterman, L.P.; Melnyk, H.; Olvera, R.G.; Eramo, J.L.; Teuschler, L.; Gaughan, A.A.; Rush, L.J.; et al. The Impact of Long COVID on Employment and Well-Being: A Qualitative Study of Patient Perspectives. J. Gen. Intern. Med. 2024, 40, 1070–1077.
Pietrzak, P.; Hanke, W. The Long COVID and Its Mental Health Manifestations—The Review of Literature. Int. J. Occup. Med. Environ. Health 2024, 37, 360–380.
Hossain, M.M.; Das, J.; Rahman, F.; Nesa, F.; Hossain, P.; Islam, A.M.K.; Tasnim, S.; Faizah, F.; Mazumder, H.; Purohit, N.; et al. Living with “Long COVID”: A Systematic Review and Meta-Synthesis of Qualitative Evidence. PLoS ONE 2023, 18, e0281884.
Yong, S.J. Long COVID or Post-COVID-19 Syndrome: Putative Pathophysiology, Risk Factors, and Treatments. Infect. Dis. 2021, 53, 737–754.
Michelen, M.; Manoharan, L.; Elkheir, N.; Cheng, V.; Dagens, A.; Hastie, C.; O’Hara, M.; Suett, J.; Dahmash, D.; Bugaeva, P.; et al. Characterising Long COVID: A Living Systematic Review. BMJ Glob. Health 2021, 6, e005427.
Gore, S. Stress-Buffering Functions of Social Support: An Appraisal and Clarification of Research Models. In Stressful Life Events and Their Contexts; Dohrenwend, B.S., Dohrenwend, B.P., Eds.; Prodist: New York, NY, USA, 1981.
Cohen, S. Psychosocial Models of the Role of Social Support in the Etiology of Physical Disease. Health Psychol. 1988, 7, 269–297.
Aspinwall, L.G.; Taylor, S.E. A Stitch in Time: Self-Regulation and Proactive Coping. Psychol. Bull. 1997, 121, 417–436.
Szkody, E.; Stearns, M.; Stanhope, L.; McKinney, C. Stress-Buffering Role of Social Support during COVID-19. Fam. Process 2021, 60, 1002–1015.
Grey, I.; Arora, T.; Thomas, J.; Saneh, A.; Tohme, P.; Abi-Habib, R. The Role of Perceived Social Support on Depression and Sleep during the COVID-19 Pandemic. Psychiatry Res. 2020, 293, 113452.
Yang, X.; Yang, X.; Kumar, P.; Cao, B.; Ma, X.; Li, T. Social Support and Clinical Improvement in COVID-19 Positive Patients in China. Nurs. Outlook 2020, 68, 830–837.
Cohen, S.; Wills, T.A. Stress, Social Support, and the Buffering Hypothesis. Psychol. Bull. 1985, 98, 310–357.
Holt-Lunstad, J. Why Social Relationships Are Important for Physical Health: A Systems Approach to Understanding and Modifying Risk and Protection. Annu. Rev. Psychol. 2018, 69, 437–458.
House, J.S. Social Support and Social Structure. Sociol. Forum 1987, 2, 135–146.
House, J.S.; Landis, K.R.; Umberson, D. Social Relationships and Health. Science 1988, 241, 540–545.
Baruch-Feldman, C.; Brondolo, E.; Ben-Dayan, D.; Schwartz, J. Sources of Social Support and Burnout, Job Satisfaction, and Productivity. J. Occup. Health Psychol. 2002, 7, 84–93.
Cutrona, C.E.; Russell, D.W. Type of Social Support and Specific Stress: Toward a Theory of Optimal Matching. In Social Support: An Interactional View; Sarason, B.R., Sarason, I.G., Pierce, G.R., Eds.; J. Wiley & Sons: New York, NY, USA, 1990; pp. 319–366.
Cutrona, C.E.; Suhr, J.A. Controllability of Stressful Events and Satisfaction With Spouse Support Behaviors. Commun. Res. 1992, 19, 154–174.
Benson, J.J.; Oliver, D.P.; Washington, K.T.; Rolbiecki, A.J.; Lombardo, C.B.; Garza, J.E.; Demiris, G. Online Social Support Groups for Informal Caregivers of Hospice Patients with Cancer. Eur. J. Oncol. Nurs. 2020, 44, 101698.
Langford, C.P.H.; Bowsher, J.; Maloney, J.P.; Lillis, P.P. Social Support: A Conceptual Analysis. J. Adv. Nurs. 1997, 25, 95–100.
Terry, G.; Hayfield, N.; Clarke, V.; Braun, V. Thematic Analysis. In The SAGE Handbook of Qualitative Research in Psychology; Sage Publications: Thousand Oaks, CA, USA, 2017; pp. 17–37.
Fitzgerald Miller, J. Assessment of Loneliness and Spiritual Well-Being in Chronically Ill and Healthy Adults. J. Prof. Nurs. 1985, 1, 79–85.
Holloway, I.; Sofaer-Bennett, B.; Walker, J. The Stigmatisation of People with Chronic Back Pain. Disabil. Rehabil. 2007, 29, 1456–1464.
Younger, J.B. The Alienation of the Sufferer. Adv. Nurs. Sci. 1995, 4, 53–72.
de Oliveira Almeida, K.; Nogueira Alves, I.G.; de Queiroz, R.S.; de Castro, M.R.; Gomes, V.A.; Santos Fontoura, F.C.; Brites, C.; Neto, M.G. A Systematic Review on Physical Function, Activities of Daily Living and Health-Related Quality of Life in COVID-19 Survivors. Chronic Illn. 2023, 19, 279–303.
Lüscher, J.; Scholz, U.; Bierbauer, W. Social Support, Distress and Well-Being in Individuals Experiencing Long-COVID: A Cross-Sectional Survey Study. BMJ Open 2023, 13, e067166.
Downloads
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
