Factors Associated with Self-Management Behavior in Patients with Breast Cancer-Related Lymphedema

To construct and validate a structural equation model (SEM) examining the factors associated with self-management behavior in patients with breast cancer (BC)‑related lymphedema (BCRL), and to explore the direct and indirect relationships through which illness perception, psychological coherence, and perceived social support relate to self-management behavior.

Patients with BCRL who attended or were hospitalized in the breast surgery department of our hospital from January 2023 to January 2026 were identified. Medical records and previously completed questionnaire data, including demographic information, the Lymphedema Self-Management Behavior Questionnaire (LSMBQ) for BC patients, the Brief Illness Perception Questionnaire (BIPQ), the Sense of Coherence Scale-13 (SOC-13), and the Perceived Social Support Scale (PSSS), were retrospectively extracted and analyzed.

A total of 236 eligible participants were included. The mean total scores were: LSMBQ, 54.48 ± 10.80 (moderate level), BIPQ, 43.96 ± 7.61; SOC‑13, 63.30 ± 9.34; and PSSS, 40.47 ± 6.83. The SEM demonstrated good fit. Social support and psychological coherence showed significant positive direct associations with self-management behavior, whereas illness perception showed a significant negative direct association. Social support was also indirectly associated with self-management behavior through psychological coherence and illness perception.

Self-management behavior in patients with BCRL was at a moderate level. Social support, psychological coherence, and illness perception were important associated factors. Healthcare professionals should consider enhancing patients' social support and psychological coherence to facilitate better self-management.