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

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 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.