Cultural preferences and compensatory behaviors: a qualitative study of physical activity among Chinese lung cancer survivors undergoing chemotherapy.

[PURPOSE] To explore the barriers and facilitators of physical activity (PA) participation among lung cancer survivors undergoing chemotherapy, focusing on cultural and behavioral determinants.

[METHODS] A descriptive qualitative study guided by social cognitive theory (SCT) was conducted applying a Consolidated Criteria for Reporting Qualitative Research-checklist-informed design. Semi-structured face-to-face interviews were conducted through purposive sampling at a comprehensive hospital in China (2024). Data were transcribed verbatim and mapped to themes according to SCT using conventional content analysis.

[RESULTS] Twenty-one participants, aged 30-82 years, completed the interviews. Three primary themes were identified, along with seven subthemes, based on SCT: (1) navigating activity: a cancer diagnosis as a barrier (fear, debilitation, and fatalism) and facilitator (health crisis triggering behavioral shift), (2) environmental and social dynamics: key contextual factors (prioritization of cultural values: cultural preferences as a barrier; the critical gap in knowledge and safety guidance; and the paradox of social interaction: balancing benefits and costs), and (3) behavioral pitfalls and strategies: from rationalization to sustainable adaptation (the illusion of compensation: a cognitive strategy for inaction; and adaptive self-regulation for sustained engagement).

[CONCLUSIONS] The barriers and facilitators identified may provide nuanced insights into the complexity of PA participation in this population. These findings underscore the urgent need for tailored, culturally resonant interventions that prioritize culturally shaped health beliefs, promote adaptive behavioral strategies, and address the dual role of cancer diagnosis as a barrier and catalyst.