Andersen model factors, cancer symptom help-seeking, and psycho-physical health among patients with breast cancer: A cross-sectional mediation study

Background Advances in screening and treatment have extended survival for women with breast cancer, yet many continue to experience symptom burden and psychological distress; inadequate or delayed help-seeking can restrict timely use of health services and adversely affect psychological and physical health outcomes. Guided by the Andersen Behavioral Model of Health Service Use, this study examines the pathway from hope to help-seeking to psychological and physical health, aiming to inform targeted nursing interventions and resource allocation. Methods A cross-sectional survey was conducted among 430 breast cancer patients recruited from three tertiary hospitals in Zhejiang Province, China, between January and August 2025. After excluding incomplete questionnaires, 412 valid responses were analyzed. Measures included the Herth Hope Index, the Breast Cancer Symptom Help-Seeking Capability Scale, and the Psycho-Physical Health Scale, along with sociodemographic and clinical variables. Mediation analyses were conducted using the PROCESS macro in IBM SPSS Statistics version 27.0. Results Age (β = 0.27, p  < 0.01), education level (β = 0.32, p  < 0.001), and hope (β = 0.44, p  < 0.001) were positively associated with cancer symptom help-seeking, which in turn was negatively related to psycho-physical health (β = -0.35, p  < 0.001). In addition, hope (β = -0.30, p  < 0.001) and annual health check-up frequency (β = -0.23, p  < 0.01) demonstrated significant direct protective effects on psycho-physical health, whereas tumor stage was not significant. The final model explained 36.6% of the variance in help-seeking and 32.2% of the variance in psycho-physical health. Conclusion Findings support applying Andersen’s Behavioral Model to breast cancer survivorship. Cancer symptom help-seeking is a modifiable mediator linking individual predispositions and psychosocial resources to health outcomes. Enhancing hope, strengthening help-seeking capacity, and ensuring regular contact with health services may improve psycho-physical well-being.