Adherence to Pulmonary Rehabilitation after Lung Cancer Surgery: A Cross-Sectional Survey of Clinical and Sociodemographic Predictors

Pulmonary rehabilitation is essential for maximizing recovery after lung cancer surgery, yet its clinical impact is frequently undermined by inadequate patient adherence. This investigation was designed to evaluate postoperative adherence to pulmonary rehabilitation among lung cancer patients and to identify its main determinants. A cross-sectional questionnaire-based survey was administered to individuals who had undergone lung cancer surgery, using a validated tool to gauge their rehabilitation adherence. Associations and independent predictors were examined using correlation analyses and multivariate linear regression. A cohort of 262 patients participated (87.9% response rate). The composite score for pulmonary rehabilitation adherence fell within the moderate range (57.08 ± 9.84), with notable discrepancies across the three assessed dimensions; the “active advice-seeking” dimension recorded the lowest mean item rating (3.48 ± 1.04). Correlation analyses demonstrated significant links between adherence and age (r = -0.621, P = 0.024), educational attainment (r = -0.598, P = 0.017), marital status (r = 0.602, P = 0.040), residential setting (r = 0.647, P = 0.001), per capita monthly household earnings (r = -0.591, P = 0.031), and tumor histological subtype (r = -0.574, P = 0.045). Multivariate linear regression confirmed that advanced age, limited education, being unmarried/widowed/divorced, inhabiting a rural area, reduced household income, and particular lung cancer subtypes independently forecasted weaker adherence. The model provided a solid fit to the data (R² = 0.591, F = 28.558, P < 0.001). Considerable potential remains to improve postoperative pulmonary rehabilitation adherence among lung cancer patients, calling for nuanced, multifaceted strategies to strengthen compliance.