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Biomedical subjects

H G Koenig

Publications and source records attributed to H G Koenig.

At least 19 recordsLinked to original sources
PubMed2001

Integrative noetic therapies as adjuncts to percutaneous intervention during unstable coronary syndromes: Monitoring and Actualization of Noetic Training (MANTRA) feasibility pilot.

BACKGROUND: Patients undergoing percutaneous coronary intervention (PCI) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications. Noetic (nonpharmacologic) therapies may reduce anxiety, pain and distress, enhance the efficacy of pharmacologic agents, or affect short- and long-term procedural outcomes. METHODS: The Monitoring and Actualization of Noetic Training (MANTRA) pilot study examined the feasibility of applying 4 noetic therapies-stress relaxation, imagery, touch therapy, and prayer-to patients in the setting of acute coronary interventions. Eligible patients had acute coronary syndromes and invasive angiography or PCI. Patients were randomized across 5 treatment groups: the 4 noetic and standard therapies. Questionnaires completed before PCI reflected patients' religious beliefs and anxiety. Index hospitalization end points included post-PCI ischemia, death, myocardial infarction, heart failure, and urgent revascularization. Mortality was followed up for 6 months after hospitalization. RESULTS: Of eligible patients, 88% gave informed consent. Of 150 patients enrolled, 120 were assigned to noetic therapy; 118 (98%) completed their therapeutic assignments. All clinical end points were available for 100% of patients. Results were not statistically significant for any outcomes comparisons. There was a 25% to 30% absolute reduction in adverse periprocedural outcomes in patients treated with any noetic therapy compared with standard therapy. The lowest absolute complication rates were observed in patients assigned to off-site prayer. All mortality by 6-month follow-up was in the noetic therapies group. In patients with questionnaire scores indicating a high level of spiritual belief, a high level of personal spiritual activity, a low level of community-based religious involvement, or a high level of anxiety, noetic therapies appeared to show greater reduction in absolute in-hospital complication rates compared with standard therapy. CONCLUSIONS: Acceptance of noetic adjuncts to invasive therapy for acute coronary syndromes was excellent, and logistics were feasible. No outcomes differences were significant; however, index hospitalization data consistently suggested a therapeutic benefit with noetic therapy. Of all noetic therapies, off-site intercessory prayer had the lowest short- and long-term absolute complication rates. Definitive demonstration of treatment effects of this magnitude would be feasible in a patient population about 4 times that of this pilot study. Absolute mortality differences make safety considerations a mandatory feature of future clinical trials in this area.

Angioplasty, Balloon, Coronary↗
PubMed2001

A 10-year review of research on chaplains and community-based clergy in 3 primary oncology nursing journals: 1990-1999.

A manual examination of 3 primary oncology nursing journals was conducted to identify quantitative studies about chaplains and community-based clergy that were published between 1990 and 1999. This systematic review identified 7 studies involving chaplains and/or clergy dealing with a range of issues. Although the rate at which such studies were published in the oncology nursing literature was relatively low (1 in 123 studies), this rate far exceeds the rate found in a similar review of psychology journals (1 in 600 studies). The nature of the 7 studies and the issues they addressed are discussed and the authors make recommendations for future collaborative efforts.

Adaptation, Psychological↗
PubMed2001

Religion and coping with serious medical illness.

OBJECTIVE: To review and discuss some of the research published in the last several decades that has addressed the role that religion plays in helping patients cope with serious medical illness. DATA SOURCES: Although this is not a systematic review of the literature, it provides a sampling of the studies that have examined the relationship between religious involvement, coping with illness, and health outcomes. This sampling of studies reflects the findings of a much larger systematic review of research (MEDLINE, Current Contents, Psychlit, Soclit, HealthStar, Cancerlit, CINAHL, and others) during the past century that was recently completed by the authors. DATA EXTRACTION: Epidemiologic studies published in the English-language literature were reviewed and discussed. DATA SYNTHESIS: A number of well-designed cross-sectional and prospective studies have examined the relationship between religious beliefs and activities and adaptation to physical illness in patients with general medical conditions, neurologic disorders, heart disease, renal failure, AIDS, and a host of other physical disorders. This review demonstrates the widespread use of religion in coping with medical illness and provides circumstantial evidence for the possible benefits of this lifestyle factor. CONCLUSIONS: When people become physically ill, many rely heavily on religious beliefs and practices to relieve stress, retain a sense of control, and maintain hope and their sense of meaning and purpose in life. Religious involvement appears to enable the sick, particularly those with serious and disabling medical illness, to cope better and experience psychological growth from their negative health experiences, rather than be defeated or overcome by them.

Adaptation, Psychological↗
PubMed2001

Religion and medicine III: developing a theoretical model.

In this third of a four-article series on religion and medicine, I describe a theoretical model to illustrate the complex pathways by which religion may influence physical health. Genetic factors, childhood training, psychological and social influences, health behaviors, and healthcare practices are discussed as part of this model. Considerable space is given to recent advances in psychoneuroimmunology and to stress-induced cardiovascular changes that demonstrate physiological pathways by which cognitive, emotional, and behavioral processes may influence susceptibility to disease and disease course. I also discuss research illustrating the important role that social support plays in moderating the physiological effects of stress and improving health outcomes. If religious beliefs and practices improve coping, reduce stress, prevent or facilitate the resolution of depression, improve social support, promote healthy behaviors, and prevent alcohol and drug abuse, then a plausible mechanism exists by which physical health may be affected.

Down-Regulation↗
PubMed2001

Religion and medicine II: religion, mental health, and related behaviors.

In this second in a series of articles on religion and medicine, I focus on the relationship between religion and mental health. This discussion is based on a comprehensive and systematic review of a century of research examining religion's relationship to mental health, social support, substance abuse, and other behaviors affecting mental or social functioning. This review includes over 630 separate data-based reports that focus on religion and well-being, hope and optimism, meaning and purpose, depression, suicide, anxiety, psychosis, social support and marital stability, alcohol and drug abuse, cigarette smoking, extra-marital sexual behaviors, and delinquency. Reasons for the associations found are discussed and conclusions drawn in light of the findings.

Health Status↗
PubMed2001

Religion and medicine IV: religion, physical health, and clinical implications.

In the fourth and final article of this religion and medicine series, I summarize the results of a comprehensive and systematic review of research examining religion's relationship to physical health and mortality. This review focuses on pain and disability, cardiovascular disease, immune and neuroendocrine function, susceptibility to infection, cancer, and overall mortality. I also explore what these research findings mean for medical practice and suggest patient-centered applications that are sensitive to ethical concerns.

Health Status↗
PubMed2001

Soldier and family wellness across the life course: a developmental model of successful aging, spirituality, and health promotion. Part I.

The primary purposes of this article are to (1) highlight current challenges facing health promotion advocates within the military and civilian culture; (2) present the strengths and weaknesses of the current Army approach to health promotion and preventive medicine; and (3) present several unifying themes that contribute to enhanced progress within the field of health promotion. A conceptual model that links common goals across the fields of successful aging, health promotion, spirituality and health, and life course is advocated to maximize efficacious interventions and to transform the current Army approach to health promotion. A companion article will describe an integrative model of health promotion and wellness that responds to the challenges and incorporates the unifying themes described in this article.

Aging↗
PubMed2001

Soldier and family wellness across the life course: a developmental model of successful aging, spirituality, and health promotion, Part II.

As an alternative to the current Department of Defense approach to health promotion and related research, which is critiqued in Part I of this article, the authors present a new, integrative health promotion and wellness model. This age-graded model incorporates successful aging, targeted health promotion, and spirituality in the context of the developmental perspective provided by life course constructs. By using an age-graded, multidisciplinary system of assessment, intervention, and follow-up in the context of preparing military personnel and families for the next season of life, this model advocates the prevention of disease and disability, active engagement with life, the maximization of high cognitive and physical functioning, and positive spirituality. Preliminary, selected illustrations from a variation of this model at the U.S. Army War College are provided. Progressive extrapolation of the model to other military leadership schools is proposed as a more efficacious health promotion strategy for the Department of Defense.

Aging↗
PubMed2000

The many methods of religious coping: development and initial validation of the RCOPE.

The purpose of this study was to develop and validate a new theoretically based measure that would assess the full range of religious coping methods, including potentially helpful and harmful religious expressions. The RCOPE was tested on a large sample of college students who were coping with a significant negative life event. Factor analysis of the RCOPE in the college sample yielded factors largely consistent with the conceptualization and construction of the subscales. Confirmatory factor analysis of the RCOPE in a large sample of hospitalized elderly patients was moderately supportive of the initial factor structure. Results of regression analyses showed that religious coping accounted for significant unique variance in measures of adjustment (stress-related growth, religious outcome, physical health, mental health, and emotional distress) after controlling for the effects of demographics and global religious measures (frequency of prayer, church attendance, and religious salience). Better adjustment was related to a number of coping methods, such as benevolent religious reappraisals, religious forgiveness/purification, and seeking religious support. Poorer adjustment was associated with reappraisals of God's powers, spiritual discontent, and punishing God reappraisals. The results suggest that the RCOPE may be useful to researchers and practitioners interested in a comprehensive assessment of religious coping and in a more complete integration of religious and spiritual dimensions in the process of counseling.

Adaptation, Psychological↗
PubMed2000

Religious involvement and mortality: a meta-analytic review.

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20-1.39), indicating that people high in religious involvement were more likely to be alive at follow-up than people lower in religious involvement. Although the strength of the religious involvement-mortality association varied as a function of several moderator variables, the association of religious involvement and mortality was robust and on the order of magnitude that has come to be expected for psychosocial factors. Conclusions did not appear to be due to publication bias.

Adult↗
PubMed2000

Does private religious activity prolong survival? A six-year follow-up study of 3,851 older adults.

BACKGROUND: Previous studies have linked higher religious attendance and longer survival. In this study, we examine the relationship between survival and private religious activity. METHODS: A probability sample of elderly community-dwelling adults in North Carolina was assembled in 1986 and followed for 6 years. Level of participation in private religious activities such as prayer, meditation, or Bible study was assessed by self-report at baseline, along with a wide variety of sociodemographic and health variables. The main outcome was time (days) to death or censoring. RESULTS: During a median 6.3-year follow-up period, 1,137 subjects (29.5%) died. Those reporting rarely to never participating in private religious activity had an increased relative hazard of dying over more frequent participants, but this hazard did not remain significant for the sample as a whole after adjustment for demographic and health variables. When the sample was divided into activity of daily living (ADL) impaired and unimpaired, the effect did not remain significant for the ADL impaired group after controlling for demographic variables (hazard ratio [RH] 1.11, 95% confidence interval [CI] 0.91-1.35). However, the increased hazard remained significant for the ADL unimpaired group even after controlling for demographic and health variables (RH 1.63, 95% CI 1.20-2.21), and this effect persisted despite controlling for numerous explanatory variables including health practices, social support, and other religious practices (RH 1.47, 95% CI 1.07-2.03). CONCLUSIONS: Older adults who participate in private religious activity before the onset of ADL impairment appear to have a survival advantage over those who do not.

Activities of Daily Living↗
PubMed2000

Religion and medicine I: historical background and reasons for separation.

Religion and medicine have a long, intertwined, tumultuous history, going back thousands of years. Only within the past 200-300 years (less than 5 percent of recorded history) have these twin healing traditions been clearly separate. This series on religion and medicine begins with a historical review, proceeding from prehistoric times through ancient Egypt, Greece, and early Christianity through the Middle Ages, the Renaissance, and the Age of Enlightenment, when the split between religion and medicine became final and complete. Among the many reasons for the continued separation is that religion may either be simply irrelevant to health or, worse, that it may have a number of negative health effects. I review here both opinion and research supporting this claim.

History, 15th Century↗