Skip to main content

Religiosity and Religious Coping in Patients with COPD: A Cross-Sectional Comparison Between Brazil and the Netherlands and Associations with Physical and Psychological Health


This study aimed to compare religiosity and religious coping (RC) between Brazilian and Dutch patients with chronic obstructive pulmonary disease (COPD) and to examine associations with physical and psychological health. Religiosity, RC, and physical and psychological health were cross-sectionally assessed in 161 patients with COPD (74 from Brazil and 87 from the Netherlands). Brazilian participants showed the greatest religiosity (p < 0.05), and weak correlations were observed between religiosity/RC and exercise capacity and quality of life (p < 0.05 for all analyses). Brazilian patients with COPD had higher religiosity than Dutch patients, and religiosity correlated with functional exercise capacity and quality of life.

This is a preview of subscription content, access via your institution.


  1. Balducci, L. (2018). Geriatric oncology, spirituality, and palliative care. Journal of Pain and Symptom Management, 57(1), 171–175.

    Article  PubMed  Google Scholar 

  2. Botega, N. J., Zomignani, M. R., Garcia, C., & Pereira, W. A. (1995). Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Revista De Saúde Pública, 29(5), 355–363.

    CAS  Article  PubMed  Google Scholar 

  3. Duarte, A. A. M., Lucchetti, G., Teixeira, P. J. Z., & Rigatto, K. (2020). Spirituality and religiosity are associated with quality of life in patients with lung disease. Journal of Religion and Health, 59(4), 1843–1854.

    Article  PubMed  Google Scholar 

  4. Gelpi, M., Argentiero, J., Jones, P. W., & Ronit, A. (2016). A Scoring application for the St George’s respiratory questionnaire. Chest, 150(3), 747–748.

    Article  PubMed  Google Scholar 

  5. Gergianaki, I., Kampouraki, M., Williams, S., & Tsiligianni, I. (2019). Assessing spirituality: Is there a beneficial role in the management of COPD?. NPJ Primary Care Respiratory Medicine 29(23), 1-5.

  6. Hasegawa, T., Kawai, M., Kuzuya, N., Futamura, Y., Horiba, A., Ishiguro, T., Yoshida, T., Sawa, T., & Sugiyama, Y. (2017). Spiritual well-being and correlated factors in subjects with advanced COPD or lung cancer. Respiratory Care, 65(2), 544–549.

    Article  Google Scholar 

  7. Holland, A. E., Spruit, M. A., Troosters, T., Puhan, M. A., Pepin, V., Saey, D., McCormack, M. C., Carlin, B. W., Sciurba, F. C., Pitta, F., Wanger, J., MacIntyre, N., Kaminsky, D. A., Culver, B. H., Revill, S. M., Hernandes, N. A., Andrianopoulos, V., Camillo, C. A., Mitchell, K. E., … Singh, S. J. (2014). An official European respiratory society/American thoracic society technical standard: Field walking tests in chronic respiratory disease. The European Respiratory Journal, 44(6), 1428–1446.

    Article  PubMed  Google Scholar 

  8. Horita, N., Kaneko, T., Shinkai, M., Yomota, M., Morita, S., Rubin, B. K., & Ishigatsubo, Y. (2013). Depression in Japanese patients with chronic obstructive pulmonary disease: A cross-sectional study. Respiratory Care, 58(7), 1196–1203.

    Article  PubMed  Google Scholar 

  9. Joshanloo, M., & Weijers, D. (2016). Religiosity moderates the relationship between income inequality and life satisfaction across the globe. Social Indicators Research, 128(2), 731–750.

    Article  Google Scholar 

  10. Knudson, R. J., Burrows, B., & Lebowitz, M. D. (1976). The maximal expiratory flow–volume curve: Its use in the detection of ventilatory abnormalities in a population study. American Review of Respiratory Disease, 114(5), 871–879.

    CAS  Article  Google Scholar 

  11. Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 278730.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., Crapo, R., Enright, P., van der Grinten, C. P., Gustafsson, P., Jensen, R., Johnson, D. C., MacIntyre, N., McKay, R., Navajas, D., Pedersen, O. F., Pellegrino, R., Viegi, G., Wanger, J., & ATS/ERS Task Force (2005). Standardisation of spirometry. The European Respiratory Journal 26(2), 319–338.

  13. Mishra, S. K., Togneri, E., Tripathi, B., & Trikamji, B. (2017). Spirituality and religiosity and its role in health and diseases. Journal of Religion and Health, 56(4), 1282–1301.

    Article  PubMed  Google Scholar 

  14. Moreira-Almeida, A., Pinsky, I., Zaleski, M., & Laranjeira, R. (2010). Religious involvement and sociodemographic factors: A Brazilian national survey. Revista Psiquiatria Clínica, 37(1), 12–15.

    Article  Google Scholar 

  15. Nascimento, F. A. B., Silva, G. P. F., Prudente, G. F. G., Mesquita, R., & Pereira, E. D. B. (2020). Assessment of religious coping in patients with COPD. Jornal Brasileiro De Pneumologia, 46(1), 1–5.

    Article  Google Scholar 

  16. Netherlands Statistics. (2018, October 23). Over half of the Dutch population are not religious. Retrieved August 3, 2019, from

  17. Panzini, R., & Bandeira, D. (2005). Escala de coping religioso-espiritual (Escala CRE): Elaboração e validação de construto. Psicologia Em Estudo, 10(3), 507–516.

    Article  Google Scholar 

  18. Pargament, K., Feuille, M., & Burdzy, D. (2011). The Brief RCOPE: Current psychometric status of a short measure of religious coping. Religions, 2(1), 51–76.

    Article  Google Scholar 

  19. Pedersen, H. F., Pargament, K. I., Pedersen, C. G., & Zachariae, R. (2013). Religious coping and quality of life among severely ill lung patients in a secular society. The International Journal for the Psychology of Religion, 23(3), 188–203.

    Article  Google Scholar 

  20. Pereira, C. A., Sato, T., & Rodrigues, S. C. (2007). New reference values for forced spirometry in white adults in Brazil. Jornal Brasileiro De Pneumologia, 33(4), 397–406.

    Article  PubMed  Google Scholar 

  21. Précoma, D. B., Oliveira, G., Simão, A. F., Dutra, O. P., Coelho, O. R., Izar, M., Póvoa, R., Giuliano, I., AlencarFilho, A. C., Machado, C. A., Scherr, C., Fonseca, F., Santos Filho, R., Carvalho, T., Avezum, Á., Jr., Esporcatte, R., Nascimento, B. R., Brasil, D. P., Soares, G. P., … Mourilhe-Rocha, R. (2019). Updated cardiovascular prevention guideline of the brazilian society of cardiology - 2019. Arquivos Brasileiros De Cardiologia, 113(4), 787–891.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  22. Silva, G. P. F., Morano, M. T. A. P., Viana, C. M. S., Magalhães, C. B. A., & Pereira, E. D. B. (2013). Portuguese-language version of the COPD assessment test: Validation for use in Brazil. Jornal Brasileiro De Pneumologia, 39(4), 402–408.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Silva, G. P. F., Nascimento, F. A. B., Macêdo, T. P. M., Morano, M. T., Mesquita, R., & Pereira, E. D. B. (2018). Religious coping and religiosity in patients with COPD following pulmonary rehabilitation. International Journal of COPD, 13, 175–181.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Singh, D., Agusti, A., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Criner, G. J., Frith, P., Halpin, D., Han, M., López Varela, M. V., Martinez, F., Montes de Oca, M., Papi, A., Pavord, I. D., Roche, N., Sin, D. D., Stockley, R., Vestbo, J., … Vogelmeier, C. (2019). Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: The GOLD science committee report 2019. The European Respiratory Journal, 53(5), 1900164.

    CAS  Article  PubMed  Google Scholar 

  25. Spinhoven, P., Ormel, J., Sloekers, P. P. A., Kempen, G. I. J. M., Speckens, A. E. M., & Van Hemert, A. M. (1997). A validation study of the hospital anxiety and depression scale (HADS) in different groups of Dutch subjects. Psychological Medicine, 27(2), 363–370.

    CAS  Article  PubMed  Google Scholar 

  26. Spruit, M. A., Polkey, M. I., Celli, B., Edwards, L. D., Watkins, M. L., Pinto-Plata, V., Vestbo, J., Calverley, P. M., Tal-Singer, R., Agusti, A., Coxson, H. O., Lomas, D. A., MacNee, W., Rennard, S., Silverman, E. K., Crim, C. C., Yates, J., Wouters, E. F., & Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study investigators (2012). Predicting Outcomes from 6-Minute Walk Distance in Chronic Obstructive Pulmonary Disease. Journal of the American Medical Directors Association 13(3), 291–297.

  27. Strada, E. A., Homel, P., Tennstedt, S., Billings, J. A., & Portenoy, R. K. (2013). Spiritual well-being in patients with advanced heart and lung disease. Palliative and Supportive Care, 11(3), 205–213.

    Article  PubMed  Google Scholar 

  28. Taskin Yilmaz, F., Sabanciogullari, S., & Berk, S. (2021). The effect of religious coping on the satisfaction with life among turkish patients with chronic obstructive pulmonary disease. Journal of Religion and Health.

    Article  PubMed  Google Scholar 

  29. Taunay, T. C. D. E., Gondim, F. A. A., Macêdo, D. S., Moreira-Almeida, A., Gurgel, L. A., Andrade, L. M. S., & Carvalho, A. F. (2012). Validação da versão Brasileira da escala de religiosidade de Duke (DUREL). Revista De Psiquiatria Clinica, 39(4), 130–135.

    Article  Google Scholar 

  30. von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2014). The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495–1499.

    Article  Google Scholar 

  31. World Health Organization. (2017, December 1). Chronic obstructive pulmonary disease (COPD).

  32. Xing, L., Guo, X., Bai, L., Qian, J., & Chen, J. (2018). Are spiritual interventions beneficial to patients with cancer? Medicine, 97(35), 1–11.

    Article  Google Scholar 

Download references


No funding.

Author information




RM helped in conceptualisation, methodology, formal analysis, investigation, writing—original draft. GPFS contributed to conceptualisation, methodology, investigation, writing—original draft, writing—review & editing. FABN helped in conceptualisation, methodology, investigation, writing—review & editing. MAH and DGBM helped in conceptualisation, methodology, writing—review & editing. PVO was involved in formal analysis, writing—original draft, writing—review & editing. DJAJ and EDBP helped in conceptualisation, methodology, formal analysis, writing—review & editing.

Corresponding author

Correspondence to Rafael Mesquita.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mesquita, R., da Silva, G.P.F., do Nascimento, F.A.B. et al. Religiosity and Religious Coping in Patients with COPD: A Cross-Sectional Comparison Between Brazil and the Netherlands and Associations with Physical and Psychological Health. J Relig Health (2021).

Download citation


  • Pulmonary disease
  • Chronic obstructive
  • Outcome assessment (health care)
  • Religion
  • Religiosity
  • Spirituality
  • Cross-sectional studies