Prevalence of physical functional impairments and associations with quality of life: a cross-sectional study in Chinese cancer survivors

BMC Nursing https://doi.org/10.1186/s12912-026-04848-w Article in Press Prevalence of physical functional impairments and associations with quality of life: a crosssectional study in Chinese cancer survivors Ji Lu, Qin Huang, Yi-Mei Du, Zhen Gui, Fei Liu, Xiao-Meng Dou, Jiu-Di Zhong & Ying-Xin Wang Received: 12 January 2026 Accepted: 1 June 2026 Cite this article as: Lu J., Huang Q., Du Y. et al. Prevalence of physical functional impairments and associations with quality of life: a cross-sectional study in Chinese cancer survivors. BMC Nurs (2026). https://doi.org/10.1186/ s12912-026-04848-w A S S We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Prevalence of physical functional impairments and associations with quality of life: a cross-sectional study in Chinese cancer survivors 1,2* Ji Lu, MN, RN 1,2* Qin Huang, MN, RN 1 Yi-mei Du, MN, RN 3 Zhen Gui, PhD 4 Fei Liu, MN, RN 5 Xiao-meng Dou, MN, RN 5 Jiu-di Zhong, MN, RN 4# Ying-xin Wang, MN, RN 1.Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei province, China 2.School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei province, China 3.NYU Shanghai, Shanghai, China 4.Department of Nursing, Peking University First Hospital, Beijing,China 5.Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong province, China * These authors contributed equally to this work. # Address correspondence to Ying-xin Wang, Department of Nursing, Peking University First Hospital, Beijing, China. Email: Abstract Background Physical functional impairments are common among cancer survivors and have a substantial impact on quality of life (QoL). However, evidence remains limited regarding which specific impairments are independently associated with QoL, particularly in non-Western populations. Objective To determine the prevalence of physical functional impairments and to identify impairments independently associated with QoL among Chinese cancer survivors, in order to inform nursing-sensitive assessment and rehabilitation care. Methods A nationwide online cross-sectional survey was conducted in China between 17 and 24 November 2025, with 365 adult cancer survivors included in the final analysis. Physical functional impairments and QoL were assessed using validated patient-reported instruments. Participants were stratified according to the impairment severity. Between-group comparisons were performed using univariate analyses. Associations between impairments and QoL were explored using Spearman correlation, and hierarchical regression analyses were used to identify impairments independently associated with QoL. Results Over 72.13% of participants reported at least one physical functional impairment, and 22.47% met criteria for clinically significant physical E L C I T R A IN S S E R P ACCEPTED ARTICLEMANUSCRIPT IN PRESS dysfunction. The most prevalent impairments were weakness (48.22%), less able to perform daily activities (43.84%), persistent fatigue (38.90%), and pain/aching (33.97%). There were 230 (63.01%) participants who anticipated difficulties attending therapy sessions in hospital. The most commonly perceived barriers to therapy attendance included lack of accompaniment, financial burden, poor physical condition for travel, and transportation difficulties. In regression analyses, advanced disease stage was consistently associated with poorer QoL, whereas completed treatment was associated with better QoL in Model 1. After adjustment for physical functional impairment variables in Model 2, and in Model 3 adjusted only for disease stage and recurrence status, pain/aching, weakness, difficulty in opening the mouth, swallowing or chewing, and easily breathless were consistently independently associated with poorer QoL (all p < 0.05). Conclusions Physical functional impairments are highly prevalent among Chinese cancer survivors and are strongly associated with reduced QoL. Identifying specific impairments independently associated with QoL offers clinically relevant insights for nursing-sensitive assessment and prioritisation of functional needs, with implications for QoL outcomes in cancer survivorship. Keywords Nursing assessment; Physical functional impairments; Quality of life; Cancer survivorship; Patient-reported outcomes; Cross-sectional study 1. Introduction With rapid advances in cancer detection and treatment, survival rates have improved steadily, transforming cancer from a predominantly acute, lifethreatening condition into a chronic disease requiring long-term management (1, 2). A “cancer survivor” refers to an individual from the time of cancer diagnosis through the remainder of life, including those undergoing active treatment as well as those who have completed treatment (3). Consequently, the objectives of oncology care have expanded beyond merely prolonging survival to encompass the preservation and restoration of posttreatment functional capacity and overall well-being (4). Nevertheless, a substantial proportion of individuals living with and beyond a cancer diagnosis, including those undergoing active treatment, experience persistent physical impairments during or after treatment, including pain, fatigue, weakness, dyspnea, lymphedema, and mobility limitations (5). These symptoms can severely restrict daily activities and independence, while also exacerbating psychological distress and compromising health-related quality of lif (...truncated)