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.