Buchholz, Jill

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Objective: A significant challenge facing young breast cancer (BC) survivors is learning how to manage fear of cancer recurrence (FCR) during survivorship. Limited tailored FCR interventions and age-appropriate support exist. This Doctor of Nursing (DNP) project, based upon best practice guidelines, aimed to evaluate how a Lifestyle Management Coaching Intervention (LMCI) could help young female BC survivors learn how to decrease and manage their FCR more effectively and experience improved health outcomes.

Method: Eligible participants were female BC survivors aged 18-59 with Stage I-III BC demonstrating elevated baseline FCR screening scores during the extended survival period recruited from the Edward-Elmhurst Health (EEH) system located in Illinois. Pre/post-intervention testing of Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) scores, the Paired t-test for statistical analysis, and a one-time end-of-program survey were utilized.

Intervention: The 10-week virtual FEARLESS LMCI designed by the principal investigator consisted of ten, hour-long weekly BC-specific health coaching sessions and focused on helping participants incorporate eight healthful lifestyle management pillars into their daily lives: (F) Fearing Less, (E) Eating Well/Nutrition, (A) Activity, (R) Rest/Restoration, (L) Love of Self/Purpose, (E) Environment, (S) Sleep, and (S) Stress Management. Twelve (N= 12) survivors completed the LMCI.

Results: The Paired t-test concluded that the FEARLESS LMCI was effective in reducing FCR among the participants with a significant mean decrease of 6.75 points in FCRI-SF scores, 95% CI [3.92, 9.58], t(11) = 5.24, p < .001. Participants met the eight FEARLESS post-intervention adaptive goals at least 75% of the time. All participants reported that the LMCI helped them learn to manage FCR more effectively, cope better, and restore health. The LMCI also enhanced perceived self-love, longevity, and legacy among the participants. iv

Conclusion: The FEARLESS DNP project findings provide clear evidence in support of utilizing a virtual LMCI for unmanaged FCR among young BC survivors. FCR should be screened for and addressed in the clinical setting according to best practices.

Key Words: young breast cancer survivor, fear of cancer recurrence, FCR, Fear of Cancer Recurrence Inventory Short Form, FCRI-SF, FCR factors, FCR interventions, nutrition, physical activity, exercise, rest, sleep, stress, coping, lifestyle modifications, wellness coaching, health coaching