Positive attitudes toward physical activity tied to well-being in cancer patients

A multicenter cross-sectional study of 316 cancer patients in Germany has found that self-reported sport participation before diagnosis was not significantly associated with life satisfaction or health literacy, while psychological factors such as positive attitudes and expectations toward physical activity showed measurable links to both well-being and health literacy. The study was conducted between April and November 2024 at one Comprehensive Cancer Center and eleven oncological sites across Germany, and has been published as an open access research paper in the Journal of Cancer Research and Clinical Oncology.

Participants completed a standardized questionnaire covering health literacy, self-reported sport participation, expectations toward physical activity, affective attitudes toward physical activity, use of complementary and alternative medicine (CAM), spirituality, nutrition, and life satisfaction. The researchers analyzed the responses using descriptive statistics, reliability analyses, t-tests, and Spearman’s correlations. Health literacy scores were high overall, with a mean of 3.10 (SD 0.44), and life satisfaction was also high, with a mean of 7.03 on its scale (SD 2.02).

Two negative findings stood out. Health literacy did not differ significantly by self-reported pre-diagnosis sport participation, and life satisfaction likewise did not differ by self-reported pre-diagnosis sport participation. In other words, whether patients said they had engaged in sport before their cancer diagnosis bore no significant relationship to how health literate or satisfied with life they reported being in the survey.

In contrast, the motivational and cognitive measures told a different story. More positive affective attitudes toward physical activity were significantly correlated with health-related expectations toward physical activity (r = 0.580, p < 0.001), with body-related motives (r = 0.471, p < 0.001), and with life satisfaction (r = 0.212, p < 0.001). Because the study is cross-sectional, these correlations cannot establish causal direction: it remains unclear whether positive attitudes foster well-being, whether more satisfied patients hold more positive attitudes, or whether other factors influence both.

The survey also documented frequent use of complementary and alternative approaches. Among the 316 participants, 44.9% reported taking vitamin D supplementation and 37.5% reported taking other vitamins or dietary supplements. The questionnaire’s broad scope, including spirituality and nutrition alongside physical activity and health literacy, reflects the study’s framing of these factors as increasingly recognized influences on coping strategies, quality of life, and well-being in cancer patients, even though the authors note that empirical evidence on their interrelationships remains limited.

The authors conclude that while self-reported sport participation did not show significant associations with life satisfaction, motivational and cognitive factors such as positive attitudes and expectations were linked to health literacy and well-being. They argue that these findings highlight the importance of strengthening patient-centered communication, motivational counseling, and health literacy as key elements of integrative oncology. As with any cross-sectional self-report study, the results describe associations within a single surveyed population at one point in time and rely on participants’ own accounts of their behavior and attitudes; the authors also note that this early-access version of the article is subject to further edits before the final version of record is published.

Subject of Research: Associations between physical activity attitudes, health literacy, and life satisfaction among cancer patients

Article Title: Associations between physical activity expectations, health literacy, and life satisfaction in cancer patients: results of a quantitative cross-sectional study

Article References: Ostendorf, F., Hintze, E., Schütze, L., Keinki, C., Lubgan, D., Fischer von Weikersthal, L., Stoll, C., Ciarlo, G., Büntzel, J., & Hübner, J. (2026). Associations between physical activity expectations, health literacy, and life satisfaction in cancer patients: results of a quantitative cross-sectional study. Journal of Cancer Research and Clinical Oncology. https://doi.org/10.1007/s00432-026-06653-z

Image Credits: AI Generated

DOI: 10.1007/s00432-026-06653-z

Keywords: cancer patients, health literacy, life satisfaction, physical activity, affective attitudes, cross-sectional study, complementary and alternative medicine, vitamin D supplementation, integrative oncology, Germany, quality of life, motivational counseling