AbstractThis study tested a model of adjustment to cancer in which social support, disease impact, and religious coping were hypothesized to have an impact on adjustment to cancer that was mediated by self‐efficacy. Two hundred and ninety‐two people with cancer completed questionnaires. Three analyses were undertaken: first, the structure of the Religious Problem Solving Scale was assessed by a factor analysis in which two factors emerged, Deferring–Collaborative and Self‐Directing; second, the resulting factors' relationships to outcome measures were assessed through correlational and regression analyses; third, a mediated model of coping was tested with self‐efficacy as a mediating variable between religious coping and adjustment. The Deferring–Collaborative factor had positive relationships with most of the variables and was partially mediated by self‐efficacy. The results indicate that religious coping has no relationship to quality of life, a positive relationship with adjustment, and was more important in this study than available social support. Copyright © 2003 John Wiley & Sons, Ltd.