Background:Physical activity provides substantial survival and quality-of-life benefits for cancer survivors, yet participation remains suboptimal globally, particularly in the Middle East and North Africa (MENA) regions. This study represents the first comprehensive examination of physical activity barriers and facilitators among Tunisian cancer survivors.Methods:This cross-sectional study recruited 120 cancer survivors ≥3 months post-chemotherapy completion from University Hospital Farhat Hached, Sousse, Tunisia (October–December 2024). Participants completed validated questionnaires via structured telephone interviews: the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Physical Activity Barriers After Cancer scale (PABAC), the Fatigue Assessment Scale (FAS), and the Patient Activation Measure (PAM-13). Statistical analyses included descriptive statistics, receiver operating characteristic (ROC) analysis, correlation analyses, and multivariable regression modeling with Bonferroni correction for multiple comparisons.Results:Participants (mean age 51.89 ± 10.2 years, 73.9% female) demonstrated significant physical activity declines post-chemotherapy: moderate activity decreased from 31.1% to 1.7% (p< 0.001), median intensity declined from 297 to 44 MET-min/week (p< 0.001). Mean PABAC score was 29.72 ± 5.13, with cognitive barriers predominating (2.85 ± 0.58). Fatigue was universal (100%), with 21% reporting severe fatigue (FAS ≥ 35). Only 26.1% received exercise guidance from healthcare professionals. PABAC demonstrated excellent predictive performance for physical inactivity (AUC = 0.805, 95%CI: 0.724–0.887). Independent predictors of higher barriers included fatigue severity (β = 0.466,p< 0.001), low patient activation (β = −0.091,p= 0.010), and advanced cancer stage (β = 1.932,p= 0.008).Conclusions:Tunisian cancer survivors experience substantial, multidimensional barriers to physical activity, with inadequate healthcare guidance representing a critical system-level gap. Findings support the development of culturally adapted, multidisciplinary interventions that target modifiable cognitive and symptom-related barriers, while enhancing patient activation and healthcare provider engagement.
背景：体力活动能为癌症幸存者带来显著的生存获益和生活质量改善，然而全球范围内患者参与度仍不理想，中东和北非地区尤为突出。本研究首次系统探讨突尼斯癌症幸存者体力活动的阻碍因素与促进因素。 方法：这项横断面研究于2024年10月至12月期间，从突尼斯苏塞Farhat Hached大学医院招募了120名完成化疗≥3个月的癌症幸存者。通过结构化电话访谈，参与者完成了以下标准化量表：国际体力活动问卷简版、癌症后体力活动障碍量表、疲劳评估量表及患者激活测量量表。统计分析包括描述性统计、受试者工作特征曲线分析、相关性分析以及经Bonferroni校正的多重比较多元回归模型。 结果：参与者平均年龄51.89±10.2岁，女性占73.9%。化疗后体力活动水平显著下降：中等强度活动参与率从31.1%降至1.7%（p<0.001），中位活动强度从297 MET-分钟/周降至44 MET-分钟/周（p<0.001）。体力活动障碍量表平均得分29.72±5.13，认知障碍最为突出（2.85±0.58）。疲劳普遍存在（100%），其中21%报告严重疲劳。仅26.1%的患者获得医疗专业人员的运动指导。体力活动障碍量表对缺乏体力活动的预测效能优异。疲劳严重程度、患者激活水平低及癌症晚期分期是体力活动障碍的独立预测因素。 结论：突尼斯癌症幸存者面临多维度、显著的体力活动障碍，医疗指导不足是系统层面的关键缺口。研究结果支持开发文化适配的多学科干预方案，针对可调控的认知与症状相关障碍，同时提升患者自我管理能力与医疗专业人员的参与度。
肿瘤(癌症)患者之家