Psychological motivation and adherence to physical activity participation in patients recovering from cancer

Objective: To explore the types of motivation, adherence influences, and their interaction mechanisms of physical activity participation among patients in cancer rehabilitation and serve as a fundamental groundwork for devising tailored behavioral intervention strategies and enhancing adherence. Methods: A mixed research method was used to include 300 patients recovering from breast, colorectal, and lung cancers. Quantitative analyses were conducted through the revised physical activity Motivation Inventory (EMI-2) and adherence logs, and semi-structured interviews were conducted with 30 patients, and the data were integrated by using latent category analysis (LCA), multiple regression, and phenomenological analysis. Results: Patient motivations were categorized as health maintenance (45.67%), social engagement (30.33%), and medically driven (24.00%); self-efficacy (β = 0.32, p = 0.007) and the identification of core predictors, notably family support (β = 0.25, p = 0.021); and the qualitative interviews revealed that medical guidance (76.67%) and digital tools (53.33%) were key facilitators, while physical fatigue (63.33%) was the main barrier. Adherence scores were significantly higher in health maintenance patients (72.31 ± 12.14 vs. 58.93 ± 18.29, p < 0.001). Conclusion: Physical activity behavior of patients in cancer rehabilitation is driven by both intrinsic motivation and external support, and the construction of a “doctor-patient-family-community” triadic support system can improve long-term adherence, and future research needs to deepen the intervention strategy by combining metabolic-immune mechanisms.