Objective To explore the application effect of recurrence fear intervention program based on stepped care model in young and middle-aged breast cancer patients.

Methods A total of 80 breast cancer patients were randomly selected as the study subjects, and randomly divided into an observation group and a control group, with 40 cases in each group. The observation group received recurrence fear intervention program based on stepped care model for young and middle-aged breast cancer patients, while the control group received routine nursing. The fear of cancer recurrence (FCR) levels, metacognition scores, sleep quality scores, and quality of life scores were compared between the two groups before and after the intervention.

Results After intervention for 3, 6, 9, and 12 weeks, the FCR scores of patients in the two groups gradually decreased with time compared to before intervention (P ＜ 0.01), and the FCR scores in the observation group were lower than those in the control group at these tune points (P ＜ 0.05 to P ＜ 0.01). After 12 weeks of intervention, the sleep quality, metacognition, and quality of life scores in the observation group were higher than those in the control group and before intervention (P ＜ 0.05).

Conclusions The recurrence fear intervention program based on stepped care model for young and middle-aged breast cancer patients can effectively reduce the FCR level of patients, and improve the patients' metacognition, sleep quality and quality of life.