Based on the Health Belief Model: A Qualitative Exploration of Factors Influencing Early Screening Behavior for Breast Cancer-Related Lymphedema

Abstract Objective To identify cognitive, affective, and sociocontextual barriers impeding post-operative breast cancer patients’ engagement in breast cancer-related lymphedema (BCRL) screening, thereby informing targeted intervention strategies. Methods study adopted interpretative phenomenology and a semi-purposive sampling method. Data were collected through semi-structured interviews with 20 postoperative breast cancer patients from a tertiary hospital in Suzhou from April to June 2025. The data were analyzed and themes were extracted using Colaizzi’s seven-step analysis method. Results Results A total of 4 themes and 10 sub-themes were identified.Theme 1: Deficiencies and deviations in disease risk perception (ambiguous cognition of disease nature, blunted individual risk perception, limited cognition of disease consequences);Theme 2: Motivations and barriers to screening behavior (cognitive recognition of screening benefits, structural barriers, pessimism about therapeutic efficacy);Theme 3: Social contextual constraints on health actions (influence of family responsibilities and support networks, scarcity of social resources);Theme 4: Self-efficacy in screening decision-making (confidence in overcoming barriers, ability and sense of responsibility for self-management). Conclusion The barriers faced by breast cancer patients in the process of BCRL screening include cognitive, emotional, and social factors. Interventions based on the Health Belief Model, such as strengthening disease cognition education, enhancing screening motivation, improving social support networks, providing flexible screening arrangements, and offering psychological support, are helpful to improve patients' screening compliance. Future studies should further quantify the effectiveness of these interventions to provide stronger support for the health management of breast cancer patients.