Based on the health belief model: a qualitative exploration of factors influencing early screening behavior for breast cancer-related lymphedema.

OBJECTIVE

This study explored postoperative breast cancer patients' experiences, perceptions, and barriers associated with breast cancer-related lymphedema (BCRL) screening.

METHODS

A qualitative descriptive design was employed. Semi-structured interviews were conducted with 20 postoperative breast cancer patients recruited from a tertiary hospital in Suzhou, China, using purposive sampling with maximum variation. Data were analyzed using thematic analysis following the six-phase procedure outlined by Braun and Clarke. Reporting followed the COREQ guidelines.

RESULTS

Four themes were identified: (1) limited understanding and misinterpretation of BCRL risk; (2) motivations and barriers to screening behavior; (3) social and systemic constraints on screening; and (4) self-efficacy and health responsibility. Participants commonly lacked knowledge of BCRL, underestimated their risk, and had limited awareness of its long-term consequences. Screening participation was shaped by perceived benefits, logistical barriers, skepticism regarding effectiveness, and broader social and healthcare system constraints. Self-efficacy and an internalized sense of health responsibility promoted screening despite existing barriers.

CONCLUSION

BCRL screening behavior reflects an interaction between cognitive appraisal, contextual constraints, and health system factors. Interventions should focus on strengthening survivorship follow-up, clinician communication, and access to screening services.