{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T21:01:38Z","timestamp":1787950898704,"version":"build-2784847793"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the knowledge\u2013belief\u2013practice (KBP) regarding lymphedema prevention among postoperative breast cancer patients and identify its psychosocial determinants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Postoperative patients were selected using a convenience sampling method. A general information collection, questionnaires, a Chinese version of the Distress Disclosure Index (DDI), and the Hospital Anxiety and Depression Scale (HADS) were used. Multivariate linear regression was used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total scoring rate of knowledge, belief, and practice was 58.51%, with the lowest for knowledge and highest for belief. The level of knowledge, belief, and practice was positively correlated with self-representation and negatively with anxiety and depression. The multivariate linear regression showed that receiving health education on the knowledge, family income, anxiety, depression, and self-expression levels were the critical factors influencing lymphedema.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The level of knowledge, belief, and practice is at the lower-to-middle level in China, with poor knowledge mastery, and the level of practice needs to be improved. Healthcare personnel should conduct health education to improve patients\u2019 knowledge level related to lymphedema and enhance the correct health beliefs of the patients. Meanwhile, they should also pay attention to their psychological health status to help them improve the level of self-expression and carry out personalized interventions according to the influencing factors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1474419","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T05:22:30Z","timestamp":1748841750000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Knowledge, belief, and practice in prevention of lymphedema in postoperative breast cancer patients and analysis of associated factors"],"prefix":"10.3389","volume":"13","author":[{"given":"Qinqin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunli","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"ref1","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.3322\/caac.21565","article-title":"Cancer treatment and survivorship statistics, 2019","volume":"69","author":"Miller","year":"2019","journal-title":"CA Cancer J 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patients after breast cancer surgery","volume":"19","author":"Shi","year":"2022","journal-title":"China Medical Herald"},{"key":"ref10","author":"Li","year":"2009"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"8027","DOI":"10.1007\/s00520-021-06390-8","article-title":"Breast cancer-related lymphedema patient and healthcare professional experiences in lymphedema self-management: a qualitative study","volume":"29","author":"Zhao","year":"2021","journal-title":"Support Care Cancer"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1007\/s13187-016-1026-1","article-title":"The importance of awareness and education in patients with breast cancer-related 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curve","volume":"36","author":"Zhang","year":"2020","journal-title":"Chin J Pract Nurs"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/j.childyouth.2018.09.038","article-title":"Community-based learning collaboratives and participant reports of interprofessional collaboration, barriers to, and utilization of child trauma services","volume":"94","author":"Hanson","year":"2018","journal-title":"Child Youth Serv Rev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"205","DOI":"10.2147\/DMSO.S290639","article-title":"Dietary knowledge, attitude and practice (KAP) among the family members of patients with type 2 diabetes mellitus (T2DM) and its influence on the KAP of T2DM patients","volume":"14","author":"Hu","year":"2021","journal-title":"Diabetes Metab Syndr Obes"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1245\/s10434-010-0941-3","article-title":"The effect of providing information about lymphedema on the 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