Harold Koenig

Harold Koenig
Duke University Medical Center | DUMC · Department of Psychiatry and Behavioral Science

MD, MHSc

About

611
Publications
210,897
Reads
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48,187
Citations
Citations since 2016
144 Research Items
20790 Citations
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Additional affiliations
July 1986 - present
Duke University Medical Center
Position
  • Professor of Psychiatry and Behavioral Sciences

Publications

Publications (611)
Article
Full-text available
Hazim Abdulkarim Khatib,1 Waleed Ahmed Alghamdi,2 Ahmed Hussein Subki,3 Nadeem Shafique Butt,4 Mohammed Saad Alsallum,5 Ahmed Salem Alsulaimani,6 Sara Faisal Alnajjar,7 Fahad Daifallah Alzaidi,8 Abdulrahman Ali Alasmari,9 Hussein Mesfer Alshamrani,10 Faten Al-Zaben,2 Harold G Koenig2,11,12 1Department of Internal Medicine, King Abdulaziz Hospital,...
Article
This final issue of JORH for 2022 revisits the topics of (1) cancer, (2) religious philosophy, and (3) uniquely collates a number of papers discussing the theme of death and dying—which seems an appropriate topic given the conclusion and celebration of life for one of the most internationally admired monarchs, Queen Elizabeth II (1926–2022). Lastly...
Article
This article is Open Access via: https://doi.org/10.1007/s10943-022-01648-9 Abstract: In this fifth issue of the Journal of Religion and Health for 2022, four key themes are revisited: (1) mental health, (2) Islam, (3) various clinical issues relating to religiosity and/or spirituality and (4) the ongoing concerns of COVID-19.
Book
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This text is available via Amazon Books: USA: https://www.amazon.com/dp/B0BC29QTFS/. Australia: https://www.amazon.com.au/dp/B0BC29QTFS ABSTRACT: Spiritual readiness is the strength of spirit that enables the warfighter to accomplish the mission with honor. Maintaining spiritual readiness is essential for members of the US Armed Forces and their...
Article
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Objective Work-related musculoskeletal disorders are prevalent in those who use computers, and education using ergonomic principles may be helpful to prevent such conditions. The present study sought to identify how an educational intervention based on the theory of planned behavior (TPB) may be effective for adopting healthy ergonomic postures. M...
Article
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Background Health care professionals face a number of problems during crises, such as the COVID-19. Studies addressed the prevalence of moral injury among healthcare professionals during the COVID-19 outbreak. Lack of a valid standard of moral injury among health care professionals is one of the factors that has made it difficult to identify and tr...
Article
Importance: Despite growing evidence, the role of spirituality in serious illness and health has not been systematically assessed. Objective: To review evidence concerning spirituality in serious illness and health and to identify implications for patient care and health outcomes. Evidence review: Searches of PubMed, PsycINFO, and Web of Scien...
Article
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In this fourth issue of the Journal of Religion and Health for 2022, four key themes are explored: (1) religious and spiritual issues in China, (2) gender-related issues affecting communities, couples, women and men, (3) a multitude of philosophical perspectives regarding medicine, science, health and religion, (4) and an array of new or adapted re...
Article
Article Open Access: https://doi.org/10.1007/s10943-022-01586-6 Abstract: Four key themes are explored in this third issue of the Journal of Religion and Health for 2022: (1) the lead topic for this issue considers the work and spiritual care provided by nurses, which is followed by a series of articles on the subject areas of (2) diabetes and (3)...
Article
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Background: This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human De...
Article
Background Philosophical beliefs regarding the origin of mental illness may underlie resistance to psychiatric treatment and affect attitudes toward the mentally ill. Aim The present study sought to: (1) identify characteristics of medical students who hold mind-brain dualism (MBD) beliefs and (2) determine relationships between MBD beliefs and pe...
Article
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Background Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children. Methods A total of 11...
Preprint
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Background Moral injury among healthcare workers received considerable attention in China during the COVID-19 pandemic as a predictor of poor mental health outcomes. This study explored the relationship between moral injury, PTSD, and suicidal behaviors approximately 1 year after the pandemic peaked in this country. Methods An online survey was co...
Article
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Background and Objective: Improving the health literacy in the different populations regarding COVID-19 may be useful in the control of its prevalence. This study examined the psychometric properties of a newly developed disease-specific measure of health literacy related to COVID-19 to be used as a standard measure. Materials and Methods: Relevan...
Article
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Importance Moral injury in health care professionals (HPs) has worsened over the course of the COVID-19 pandemic. The trauma and burnout associated with moral injury has profound implications for the mental health of HPs. Objective To explore the potential factors associated with moral injury for HPs who were involved in patient care during the CO...
Article
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Religion is one of the strategies used to cope with life stressful events, particularly in cancer patients. This study aimed to translate, adapt and validate the 5-item Duke University Religion Index (DUREL) into European Portuguese. This is a cross-sectional study in a sample of cancer patients receiving chemotherapy. Data were collected in July–O...
Article
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Religious and spiritual (R/S) issues impact medical decision-making, particularly among highly R/S populations, for whom existing measures have limitations in identifying levels of R/S commitment. The Belief into Action (BIAc) scale was designed for this purpose and was never tested among hospitalized patients. We interviewed 152 patients (51% men)...
Article
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Moral injury is a complex phenomenon characterized by spiritual, psychological, and moral distress caused by actions or acts of omission inconsistent with an individual’s moral and ethical values. We present two cases from an ongoing randomized controlled trial of a spiritually integrated structured intervention delivered by chaplains for individua...
Article
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Moral injury (MI), originally discussed in relationship to transgressing moral beliefs and values during wartime among military personnel, has expanded beyond this context to include similar emotions experienced by healthcare professionals, first responders, and others experiencing moral emotions resulting from actions taken or observations made du...
Article
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Scale development, validation, and translation are complicated and often arduous procedures that involve considerable cost, time, personnel, and skills necessary to perform the complex statistical analyses required. The need to follow a standard procedure when developing new scales and translating old scales into new languages is essential in order...
Article
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Background: The patient–doctor relationship is one of the most important factors in determining the outcome of healthcare. The first step in establishing this relationship is choosing a physician. This study sought to identify patient preferences concerning the gender of their obstetrics and gynecology (OB-GYN) physician and the effect of religion...
Chapter
This chapter briefly reviews the relationship between Christianity and mental health based on evidence from observational studies, followed by a summary of evidence-based research examining religious/spiritually integrated therapies. Research on the efficacy of Christian religiously-integrated cognitive behavioral therapy (CRCBT) is then reviewed,...
Preprint
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Purpose : Moral injury (MI) is prevalent among healthcare professionals, and has been shown in those experiencing traumatic events to be associated with suicidal thoughts, depression, anxiety, and other adverse mental health outcomes. The present study examines the relationship between religion/ spiritual (R/S) and MI among physicians and nurses in...
Article
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Background Moral injury has been found to be prevalent among healthcare professionals during the COVID-19 public health crisis. Aims The present study examines the relationship between spirituality, moral injury, and mental health among physicians and nurses in mainland China during the COVID-19 pandemic. Method An online cross-sectional study wa...
Chapter
The concluding chapter summarizes more general aspects of different insights from studies among persons from different cultural contexts. Health professions need to identify unmet spiritual needs in patients and their families. Addressing these needs indicates that the healthcare professionals value and respect the person with their specific life s...
Article
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Background Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in Ch...
Article
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Objective: Caring for patients during the COVID-19 pandemic has placed considerable stress on health care professionals (HCPs), increasing their risk of moral injury (MI) and clinician burnout. The present study sought to examine the prevalence and correlates of MI among physicians and nurses in mainland China during the pandemic. Method: A cross-...
Article
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Background Measuring implicit attitudes is difficult due to social desirability (SD). A new method, the Emotion Based Approach (EBA), can solve this by using emotions from a display of faces as response categories. We applied this on an EBA Spirituality tool (EBA-SPT) and an Actual Situation tool (EBA-AST). Our aim was to assess the structure, reli...
Article
Introduction Spiritual well-being can impact quality of life and survival among diseased populations, similarly to sleep. Despite beneficial effects of spiritual-based practices on sleep, few studies have investigated an association between these attributes. Our goal was to explore correlations between measures of sleep quality and spirituality amo...
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Background Although mental distress and quality of life (QoL) impairments because of the pandemic have increased worldwide, the way that each community has been affected has varied. Aims This study evaluated the impact of social distancing imposed by coronavirus disease-2019 (COVID-19) on Brazilians’ mental health and QoL. Method In this cross-se...
Article
The coronavirus pandemic (COVID-19) is predicted to increase burnout in health professionals (HPs), but little is known about moral injury (MI) in this context. We administered the Moral Injury Symptoms Scale for Health Professionals (MISS-HP) and the abbreviated Maslach Burnout Inventory via online survey to a global sample of 1831 HPs in April an...
Article
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Social scientists have increasingly recognized the lack of diversity in survey research on American religion, resulting in a dearth of data on religion and spirituality (R/S) in understudied racial and ethnic groups. At the same time, epidemiological studies have increasingly diversified their racial and ethnic representation, but have collected fe...
Article
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This paper describes the development and initial psychometric testing of the baseline Spirituality Survey (SS-1) from the Study on Stress, Spirituality, and Health (SSSH). The SS-1 contains a mixture of items selected from validated existing scales and new items generated to measure important constructs not captured by existing instruments, and our...
Article
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This study aimed to analyze the moderating effect of religion between sociodemographic variables, lifestyle, and self-referred physical and mental health. Cross-sectional study with non-randomized sample of 392 participants. The Eight Natural Remedies Questionnaire was used to assess lifestyle. Religion was found to be positive predictor between ag...
Book
This book aims to help readers appreciate the many-faceted relationship between Christianity, one of the world’s major faith traditions, and the practice of psychiatry. Chapter authors in this book first consider challenges posed by historical antagonisms, church-based mental health stigma, and controversy over phenomena such as hearing voices. Nex...
Article
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Objective Religiosity has been repeatedly proposed as protective in the development of depression, sociopathy and addictions. ADHD frequently co-occurs with these same conditions. Although ADHD symptoms may affect religious practice, religiosity in ADHD remains unexplored. Method Analyses examined data from >8000 subjects aged 12 to 34 in four wav...
Article
This study examined the prevalence and predictors of moral injury (MI) symptoms in 181 healthcare professionals (HPs; 71% physicians) recruited from Duke University Health Systems in Durham, North Carolina. Participants completed an online questionnaire between November 13, 2019, and March 12, 2020. Sociodemographic, clinical, religious, depression...
Article
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Spirituality, an established resource within rural America, serves as an important coping mechanism for crises of chronic illness. We examined the effects of spirituality on chronic kidney disease (CKD) maintenance in the rural community of Robeson County, North Carolina. We conducted nine focus group discussions and 16 interviews involving 80 dive...
Article
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Background Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China. Methods A total of 583 nurses and 2423 physicians were r...
Article
We assessed the efficacy of a spiritually-integrated cognitive-behavioral educational group intervention for reducing stress, anxiety, depression, and blood pressure during pregnancy and improving delivery outcomes. A randomized controlled trial was conducted in 84 pregnant women randomly assigned to either the intervention or a control group. Demo...
Article
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Anxiety and fear adversely affect the physiological systems that protect individuals from infection. This article comments on the role that religious faith and practice can play in helping individuals remain free from infection by the coronavirus and in helping to moderate the effects of infection if that should occur. The author provides six recom...
Article
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This study aims to develop and assess the psychometric properties of a measure of moral injury (MI) symptoms for identifying clinically significant MI in health professionals (HPs), one that might be useful in the current COVID-19 pandemic and beyond. A total of 181 HPs (71% physicians) were recruited from Duke University Health Systems in Durham,...
Article
Background Type 2 diabetes mellitus (T2DM) is a common chronic disease with an increase in prevalence within developing countries. The aim of this study was to determine the efficacy of a structured educational program for improving lifestyle and health-related measures in Iranians with T2DM. Methods A randomized controlled trial was conducted in...
Article
Oral health problems are common among pregnant women. The objective of this study was to examine the effectiveness of motivational interviewing (MI) as a behavior‐change technique to enhance self‐efficacy and oral health among pregnant women. A randomized controlled trial was conducted with 112 pregnant Iranian women. Women in the intervention grou...
Article
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Objectives: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. Methods: In this single-group experimental study, 58 police o...
Preprint
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Aims To assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China. Methods: A total of 583 nurses and 2,423 physicians were recruited from across mainland China. An online survey was conducted using the Chinese version of the MISS-HP from March 27 to April 26,...
Preprint
Full-text available
Background Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China. Methods: A total of 583 nurses and 2,423 physicians were...
Article
The evidence base on the relationship between religion and mental health is growing rapidly, and we summarise the latest research on the topic. This includes studies on religious involvement and depression, bipolar disorder, suicide, post-traumatic stress disorder (PTSD), substance use disorders, personality disorder, chronic psychotic disorder, ma...
Article
Background: Studies have shown parental religious involvement was associated with better health behaviors of their children. However, the relationship between parental religiosity and child dietary behaviors remains unclear. Objectives: This study aimed to examine the relationship between parental religious involvement and the dietary behaviors...
Article
In an earlier article we reviewed the latest research on the relationship between religious involvement and mental health, the effects of religiosity on mental health and well-being over time and the impact of religious interventions. Here we focus on clinical applications that may be useful to psychiatrists and other mental health professionals. W...
Article
Studies of religiosity and mental health largely characterize religiousness as stable over time. However, research shows that religiosity likely changes significantly with development. It is unclear whether associations of religiosity with mental health also change over the lifespan. Latent growth curves were created to quantify changes in multiple...
Article
Moral injury (MI) is a relatively new syndrome among military personnel with symptoms of post‐traumatic stress disorder (PTSD). While MI has received considerable attention in the psychological sciences, the syndrome has received relatively little notice within psychiatry. MI has been defined as the negative emotions that emerge from transgressing...
Article
Full-text available
Background Caring for patients during the COVID-19 pandemic has placed considerable stress on healthcare professionals (HCPs), increasing their risk of moral injury (MI) and clinician burnout. The present study sought to examine the prevalence and correlates MI among physicians and nurses in mainland China during the pandemic. Methods A cross-secti...
Article
Moral injury (MI) is a syndrome thought to be separate from posttraumatic stress disorder (PTSD), yet having some overlap. To determine the overlap, we examined the relationship between MI and the four DSM-5 PTSD symptom clusters (B, C, D, E) in US veterans and active duty military (ADM). The 45-item Moral Injury Symptom Scale (MISS-M) was administ...
Article
Background The mechanism explaining how religiosity is linked to telomere length (TL) is unclear. The current study examines depression as a possible mediator. Methods In this cross-sectional study of 1,742 community-dwelling residents aged 55 or over, the Duke University Religion Index (DUREL) and Geriatric Depression Scale (GDS) were administrate...
Article
Background: Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgical residents regarding pati...
Article
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Spirituality is considered a universal phenomenon, but research addressing the spiritual needs of adolescents in the context of health and illness is limited. The aim of this article is to provide a description of how the spiritual development framework (SDF) was used in conducting research with adolescents. An exemplar of a qualitative descriptive...
Article
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Objectives: To examine oncology patients’ beliefs about the transmissible nature of cancer or its treatments and to determine the correlates thereof. Design: Cross-sectional. Participants: Sixty-nine hospital outpatients completed the questionnaire. Methods: Beliefs about the spread of cancer, chemotherapy, and radiation therapy with physical conta...
Article
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Objective: The current study seeks to examine the relationship between religiosity and telomere length (TL) in an older Chinese Muslim sample and to explore the moderating effect of religiosity on the relationship between high-risk polymorphisms and TL. Methods: A cross-sectional study of 1,692 community-dwelling adults aged 55 or older was conduct...
Chapter
The problem is an acute one. A survey a few years ago by the Physicians’ Foundation found that half of US physicians reported being pessimistic about the medical profession, one-third indicated feeling overworked and extended beyond their capacity to perform, and almost half said they were planning to either retire or do whatever it takes to reduce...
Chapter
Picking up the schedule for the day, Dr. Jonas notices with a sigh that Mrs. Smith is slotted for a 10:00 am appointment. This will be her third visit to the practice in 6 weeks with the same vague complaints. He had already run a battery of routine diagnostic blood work and imaging and did the appropriate workups for her symptoms, searching for ev...
Article
Background: Designing a health promotion program to increase physical activity may contribute to weight management. The purpose of this study was to investigate a theory of planned behavior (TPB) program to address this problem in military people. Methods: Eighty-four obese/overweight military personnel were randomised into the intervention or c...
Article
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Background: Moral injury (MI) involves distress over having transgressed or violated core moral boundaries, accompanied by feelings of guilt, shame, self-condemnation, loss of trust, loss of meaning, and spiritual struggles. MI is often found in Veterans and Active Duty Military personnel with posttraumatic stress disorder (PTSD). MI is widespread...
Article
Introduction: Many studies have linked hope with better mental health and lower risk of suicide. This is especially true in those who have experienced severe physical or emotional trauma. Religious involvement is associated with greater hope. We examine here the relationship between hope, religiosity, and mental health in a sample of Veterans and...
Article
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Little research has assessed the relationship between religiosity and mental health awareness in low- and middle-income countries. This study identified a representative sample of 2,425 communitydwelling adults in Ningxia, China and administered the Duke University Religion Index, the Mental Health Knowledge Questionnaire, the Mental Health Attitude...
Article
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We examined multiple dimensions of religiosity and their relationship to the four DSM-5 PTSD symptom clusters among US Veterans and Active Duty Military (ADM), hypothesizing that religiosity would be most strongly inversely related to negative cognitions/emotions (Criterion D symptoms) and less strongly to neurobiologically based symptom clusters (...
Article
Objective: To compare the quality of life (QOL) and frequency of hospital admission (FHA) in the past 4 months between congestive heart failure (CHF) patients involved in a structured heart failure program (HFP) compared with waitlisted controls. Methods: This study, employing an ex-post-facto comparative cross-sectional design, involved 80 pati...
Article
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Medically induced posttraumatic stress disorder (PTSD) is a growing health concern, given its negative impact on mental, emotional, and physical functioning. There is substantial research that indicates that military personnel and veterans (ADMP/V) are at risk for PTSD. This article explores vulnerability factors that can contribute to the developm...
Article
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Background: Nosocomial infection (NI) is common in health care settings. Educational strategies such as mobile teaching methods for health care providers may help to resolve this problem. This pilot study assessed the influence of a text messaging program to improve intensive care unit nurses' knowledge, attitude, and practice related to NI preven...
Article
The aim of this descriptive study was to examine the prevalence and perceived intensity of potentially morally injurious events (PMIEs) in a group of VA chaplaincy service users. A secondary aim was to examine the relationship between PMIEs, spiritual injury, and religiosity. A convenience sample of veterans (n = 84), participants in a spiritual in...