{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:16:49Z","timestamp":1781842609123,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72174011"],"award-info":[{"award-number":["72174011"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore predictors of lymphedema self\u2010management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Further analysis of a multicentre cross\u2010sectional and survey\u2010based study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self\u2010reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self\u2010management behaviours. The final structural model showed good model fit. Social support, self\u2010efficacy and lymphedema knowledge positively affected lymphedema self\u2010management behaviours, directly and indirectly. Self\u2010regulation acted as a crucial mediator between these variables and self\u2010management. The direct path between social support and self\u2010regulation was not significant. Lymphedema knowledge and social support also influenced self\u2010management via illness perception, self\u2010efficacy and self\u2010regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self\u2010management behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self\u2010management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self\u2010efficacy, social support and self\u2010regulation directly and indirectly influenced lymphedema self\u2010management behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study provides a theoretical basis for the assessment and interventions of lymphedema self\u2010management behaviours in breast cancer patients. Lymphedema self\u2010management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross\u2010sectional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What Does This Paper Contribute to the Wider Global Clinical Community?<\/jats:title>\n                    <jats:p>This study focused on identifying and predicting mechanism of self\u2010management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high\u2010risk populations, and inspire the assessment and interventions facilitating self\u2010management behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Registration<\/jats:title>\n                    <jats:p>\n                      This study was registered as an observational study at Chinese Clinical Trial Registry:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.chictr.org.cn\">http:\/\/www.chictr.org.cn<\/jats:ext-link>\n                      (ChiCTR2200057084).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>For breast cancer patients with poor lymphedema self\u2010management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self\u2010management is multi\u2010faced. Strategies targeted at improving social support, self\u2010regulation, knowledge, self\u2010efficacy and illness perception should be also addressed in lymphedema self\u2010management programs, to facilitate more effective improvement of lymphedema self\u2010management behaviours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.15759","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T07:43:22Z","timestamp":1687765402000},"page":"4778-4790","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Predicting lymphedema self\u2010management behaviours in breast cancer patients: A structural equation model with the Integrated Theory of Health Behaviour Change"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0569-8746","authenticated-orcid":false,"given":"Aomei","family":"Shen","sequence":"first","affiliation":[{"name":"Division of Medical &amp; 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