PubMed Health⌕ Search

Biomedical subjects

Harold G Koenig

Publications and source records attributed to Harold G Koenig.

At least 37 records · Page 2Linked to original sources
PubMed2005

Spiritual beliefs and barriers among managed care practitioners.

PURPOSE: Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. METHODS: Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. FINDINGS: Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'. CONCLUSIONS: Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

Adult↗
PubMed2005

Religiosity/spirituality and pain in patients with sickle cell disease.

Religion/spirituality has been identified by individuals with sickle cell disease (SCD) as an important factor in coping with stress and in determining quality of life. Research has demonstrated positive associations between religiosity/spirituality and better physical and mental health outcomes. However, few studies have examined the influence religiosity/spirituality has on the experience of pain in chronically ill patients. Our aim was to examine three domains of religiosity/spirituality (church attendance, prayer/Bible study, intrinsic religiosity) and evaluate their association with measures of pain. We studied a consecutive sample of 50 SCD outpatients and found that church attendance was significantly associated with measures of pain. Attending church once or more per week was associated with the lowest scores on pain measures. These findings were maintained after controlling for age, gender, and disease severity. Prayer/Bible study and intrinsic religiosity were not significantly related to pain in our study. Positive associations are consistent with recent literature, but our results expose new aspects of the relationship for African American patients. We conclude that religious involvement likely plays a significant role in modulating the pain experience of African American patients with SCD and may be an important factor for future study in other populations of chronically ill pain sufferers.

Adaptation, Psychological↗
PubMed2005

A study of religion, ministry, and meaning in caregiving among health professionals in an institutional setting in New York City.

The clinical staff of a large metropolitan nursing home was surveyed about their religious practices, the degree to which they saw their work as a ministry, and the meaning they obtain from being caregivers. Age, race, gender, education, and various other measures were also taken. As hypothesized, religiosity made a significant positive contribution to participants' belief their work was a ministry to those in need. Multiple regression revealed that African American and older staff scored significantly higher on both dependent variables, whereas Caucasians were significantly less likely to view their work as ministry. Staff who worked with long-term patients derived significantly more meaning from their work, but they were no more likely to see it as ministry. Religiosity appears to enhance the meaning caregivers get from their work, and this may be beneficial to patients. Further research may identify other factors that enhance the meaning caregivers get from their work.

Adult↗
PubMed2005

Social versus individual motivation: implications for normative definitions of religious orientation.

The traditional interpretation of "intrinsic" religiousness has fostered an unchallenged assumption that normative and substantive religious motivation is inherently individual and personal. Social motives for religiousness and structured practices have been characterized as "extrinsic" and as lacking in formative significance. We argue that this view is most applicable in American Protestant religions, and hence existing religious motivation scales reflect a distinctly American Protestant view. We then show that social motives and structured ritual practices are, in fact, as normative as individual motivations in several religious traditions. In particular, we describe the social practices and motives normative for Judaism and certain streams of Christianity. We then discuss the potential relevance of this analysis to emotion, collective identity, and moral judgment.

Christianity↗
PubMed2004

Religion, spirituality, and acute care hospitalization and long-term care use by older patients.

BACKGROUND: The impact of religion and spirituality on acute care hospitalization (ACH) and long-term care (LTC) in older patients before, during, and after ACH is not well known. METHODS: Patients 50 years or older consecutively admitted to the general medical service at Duke University Medical Center were interviewed shortly after admission (N = 811). Measures of religiosity were organized religious activity (ORA), nonorganizational religious activity (NORA), religiosity through religious radio and/or television (RTV), intrinsic religiosity, and self-rated religiousness. Measures of spirituality included self-rated spirituality and daily spiritual experiences (DSE). Primary outcome was number of ACH days during an average 21-month observation period. Secondary outcomes were times hospitalized and number of days spent in a nursing home or rehabilitation setting (collectively, long-term care: LTC). Race and sex interactions were examined. RESULTS: In the cross-sectional analysis, ORA was the only religious variable related to fewer ACH days and fewer hospitalizations, an effect that is fully explained by physical health status and that disappeared when examined prospectively. The number of LTC days was inversely related to NORA, RTV, and DSE, effects that were partially explained by social support but not by severity of medical illness. Interactions with race and sex were notable but reached statistical significance only among African Americans and women. In those groups, religious and/or spiritual characteristics also predicted future LTC use independent of physical health and baseline LTC status. CONCLUSIONS: Relationships with ACH were weak, were confined to ORA only, and disappeared in prospective analyses. However, robust and persistent effects were documented for religiousness and/or spirituality in the use of LTC among African Americans and women.

Black or African American↗
PubMed2004

The association between spiritual and religious involvement and depressive symptoms in a Canadian population.

Data from a large epidemiologic survey were examined to determine the relationship of religious practice (worship service attendance), spiritual and religious self-perception, and importance (salience) to depressive symptoms. Data were obtained from 70,884 respondents older than 15 years from the Canadian National Population Health Survey (Wave II, 1996-1997). Logistic regression was used to examine the relationship of the religious/spiritual variables to depressive symptoms while controlling for demographic, social, and health variables. More frequent worship service attendees had significantly fewer depressive symptoms. In contrast, those who stated spiritual values or faith were important or perceived themselves to be spiritual/religious had higher levels of depressive symptoms, even after controlling for potential mediating and confounding factors. It is evident that spirituality/religion has an important effect on depressive symptoms, but this study underscores the complexity of this relationship. Longitudinal studies are needed to help elucidate mechanisms and the order and direction of effects.

Adolescent↗
PubMed2004

Religion, spirituality, and medicine: research findings and implications for clinical practice.

A growing body of scientific research suggests connections between religion, spirituality, and both mental and physical health. The findings are particularly strong in patients with severe or chronic illnesses who are having stressful psychologic and social changes, as well as existential struggles related to meaning and purpose. Recent studies indicate that religious beliefs influence medical decisions, such as the use of chemotherapy and other life-saving treatments, and at times may conflict with medical care. This article addresses the ways physicians can use such information. Spirituality is an area that makes many physicians uncomfortable, since training in medical schools and continuing medical education programs are limited. Not only do most physicians lack the necessary training, they worry about spending additional time with patients and overstepping ethical boundaries. While these concerns are valid, each can be addressed in a sensible way. Taking a spiritual history, supporting the patient's beliefs, and orchestrating the fulfillment of spiritual needs are among the topics this article will address. The goal is to help physicians provide medical care that is sensitive to the way many patients understand and cope with medical illness.

Attitude of Health Personnel↗
PubMed2004

Spiritual care: whose job is it anyway?

The use of spirituality and religion in coping with illness is widespread among primary care patients. Although the overwhelming majority of healthcare providers agree that they should be aware of patients' spiritual beliefs, that these beliefs may influence their healing, and that patients benefit from spiritual care, there remains considerable debate about who should inquire about spiritual beliefs and deliver spiritual care. The authors, a physician and a chaplain, propose that, in general, the role of the physician is to assess spiritual needs as they relate to healthcare (ie, briefly screen) and then refer to a professional pastoral caregiver as indicated (ie, to address those needs). The chaplain is the spiritual care specialist on the healthcare team and has the training necessary to treat spiritual distress in all its forms. Seeing the physician as the generalist in spiritual care and the chaplain as the specialist is a helpful model.

Physician's Role↗
PubMed2004

Religion, spirituality, and health in medically ill hospitalized older patients.

OBJECTIVES: To examine the effect of religion and spirituality on social support, psychological functioning, and physical health in medically ill hospitalized older adults. DESIGN: Cross-sectional survey. SETTING: Duke University Medical Center. PARTICIPANTS: A research nurse interviewed 838 consecutively admitted patients aged 50 and older to a general medical service. MEASUREMENTS: Measures of religion included organizational religious activity (ORA), nonorganizational religious activity, intrinsic religiosity (IR), self-rated religiousness, and observer-rated religiousness (ORR). Measures of spirituality were self-rated spirituality, observer-rated spirituality (ORS), and daily spiritual experiences. Social support, depressive symptoms, cognitive status, cooperativeness, and physical health (self-rated and observer-rated) were the dependent variables. Regression models controlled for age, sex, race, and education. RESULTS: Religiousness and spirituality consistently predicted greater social support, fewer depressive symptoms, better cognitive function, and greater cooperativeness (P<.01 to P<.0001). Relationships with physical health were weaker, although similar in direction. ORA predicted better physical functioning and observer-rated health and less-severe illness. IR tended to be associated with better physical functioning, and ORR and ORS with less-severe illness and less medical comorbidity (all P<.05). Patients categorizing themselves as neither spiritual nor religious tended to have worse self-rated and observer-rated health and greater medical comorbidity. In contrast, religious television or radio was associated with worse physical functioning and greater medical comorbidity. CONCLUSION: Religious activities, attitudes, and spiritual experiences are prevalent in older hospitalized patients and are associated with greater social support, better psychological health, and to some extent, better physical health. Awareness of these relationships may improve health care.

Academic Medical Centers↗
PubMed2004

Faith-based and secular pathways to hope and optimism subconstructs in middle-aged and older cardiac patients.

This study was designed to fill gaps in the new field of positive psychology. Using data from two sequential interviews, this study examined the effect of faith-based and secular pathways to hope and optimism among 226 middle-aged and older patients facing a major medical crisis-cardiac surgery. Structural equation modeling demonstrated that religious faith factors contributed to the agency component of hope and dispositional optimism indirectly through the use of prayer as a coping strategy. Other sociodemographically resourcable factors affected both the agency and pathway components of hope as well as dispositional optimism and dispositional pessimism directly or indirectly through their effects on emotional distress.

Adaptation, Psychological↗
PubMed2004

Religious coping methods as predictors of psychological, physical and spiritual outcomes among medically ill elderly patients: a two-year longitudinal study.

A total of 268 medically ill, elderly, hospitalized patients responded to measures of religious coping and spiritual, psychological and physical functioning at baseline and follow-up two years later. After controlling for relevant variables, religious coping was significantly predictive of spiritual outcome, and changes in mental and physical health. Generally, positive methods of religious coping (e.g. seeking spiritual support, benevolent religious reappraisals) were associated with improvements in health. Negative methods of religious coping (e.g. punishing God reappraisal, interpersonal religious discontent) were predictive of declines in health. Patients who continue to struggle with religious issues over time may be particularly at risk for health-related problems.

Adaptation, Psychological↗
PubMed2004

A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998-2000.

Based on the content analysis of quantitative research appearing in three medical journals, the authors conclude that, despite the shared ideal of providing spiritual care to patients on the part of physicians and chaplains, there is little attention given in these journals demonstrating and promoting this shared perspective. Suggestions for future research that would focus on this common medicine/religion interface and concern are noted.

Clergy↗