Journal of Clinical Psychology in Medical Settings, Vol. 11, No. 3, September 2004 ( C  2004) Religious Coping, Psychological Distress and Disability Among Patients With End-Stage Pulmonary Disease Eileen J. Burker, 1,4 Donna M. Evon, 2 Jan A. Sedway, 1 and Thomas Egan 3 A growing body of literature suggests that individuals who face life-threatening situations turn to religion to help them cope. Religion has been cited as the most frequently used resource to cope with stressful events (K. I. Pargament, 1997). The present study was the first to investigate the religious coping methods of patients with lung disease who are awaiting transplant and to identify which coping methods are associated with distress and disability. The study was an exploratory, cross-sectional analysis of 90 patients with end-stage pulmonary disease who were being evaluated for transplant. Results indicated that religiosity was highly prevalent. Patients employed a combination of religious coping efforts, but mostly used coping meth- ods considered “positive.” Patients with late-onset pulmonary diseases used religious coping strategies more frequently than patients with cystic fibrosis. Hierarchical regression analyses identified a subset of religious coping strategies that predicted 27%, 14%, and 34% of the unique variance in depression, overall disability, and psychosocial disability, respectively. KEY WORDS: religious coping; psychological distress; disability; pulmonary/lung disease; transplantation. Pulmonary disease is one of the top four lead- ing causes of death in America (Anderson & Smith, 2003). Chronic lower respiratory diseases (CLRD) are a group of lung diseases, including chronic ob- structive pulmonary disease (COPD), emphysema, and chronic bronchitis. These diseases are character- ized by a slowly progressive, irreversible bronchial ob- struction, a recurrent productive cough, and breath- lessness on exertion (Van Ede, Yzermansm, & Brouwer, 1999). CLRD is generally diagnosed af- ter age 50 and often causes a shortened lifespan (Rabinowitz & Florian, 1992). Cystic fibrosis (CF) 1 Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 2 Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 3 Department of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4 Correspondence should be addressed to Eileen J. Burker, PhD, Department of Allied Health Sciences, CB#7205, Medical School Wing E, University of North Carolina, Chapel Hill, North Carolina 27599-7205; e-mail: eburker@med.unc.edu. is a genetic disease frequently diagnosed in in- fancy that affects the respiratory, gastrointestinal, and reproductive systems. CF is transmitted as an autoso- mal recessive gene and is most common among Cau- casian populations, particularly in the US and Western Europe. There are a number of important similari- ties between CLRD and CF. Each disease results in poor respiratory function, requires multiple medica- tions to improve pulmonary function, and is generally fatal. There are also important differences between the disorders, such as age of onset. CF is a genetic disorder that is present from birth and is generally di- agnosed within the first few years of life. CLRD are acquired diseases evolving over an extended period of time and are generally diagnosed in late adulthood. Most CLRD patients are between the ages of 50 and 70, whereas the majority of adult CF patients are un- der 30. We found that patients with CF used different nonreligious coping strategies and had significantly lower scores on measures of anxiety than patients with CLRD (Burker, Carels, Thompson, Rodgers, & Egan, 2000). 179 1068-9583/04/0900-0179/0 C  2004 Springer Science+Business Media, Inc.