e23162 Background: To explore the effects of nursing intervention based on gratitude extension-construction theory on gratitude level, recurrence fear and post-traumatic growth of patients after breast cancer surgery. Methods: 104 patients with breast cancer treated in a large general hospital from August 2023 to January 2024 were selected as the study objects, and randomly divided into control group and intervention group with 52 cases in each group. The control group received routine nursing intervention, and the intervention group was treated with nursing intervention based on gratitude extension and construction theory on the basis of routine nursing intervention. The intervention plan included organizing patients to give motivational lectures before discharge, watching gratitude videos, and teaching patients to carry out positive memory, gratitude meditation and gratitude expression every day through bedside talk. After discharge, patients were instructed to conduct interest cultivation, gratitude expression, gratitude visit, gratitude diary and gratitude sharing through phone or wechat follow-up. After 12 weeks, the results were evaluated by general information questionnaire, gratitude level questionnaire, Cancer Recurrence Fear Scale, and post-traumatic Growth Rating Scale. Results: After intervention, the gratitude level of the intervention group was significantly higher than that of the control group (P < 0.001), the total score and all dimension scores of fear of cancer recurrence were significantly lower than those of control group (P < 0.05), post-traumatic growth score and all dimensions were higher than those of control group (P < 0.001). Conclusions: This study established a set of scientific, practical and effective intervention program suitable for patients with breast cancer after surgery to improve the level of gratitude, alleviate the fear of cancer recurrence, and promote post-traumatic growth, and verified that the intervention program can effectively improve the level of gratitude of patients, especially in the aspect of gratitude around people and matters. It can also alleviate the fear of cancer recurrence, overall worry, health worry, female worry, role worry, death worry, etc. Post-traumatic growth has been significantly improved, especially in terms of personal strength and interpersonal relationship improvement. Under the general trend that breast cancer has become the largest cancer in the world, it is one of the effective ways to improve the psychological state of breast cancer patients, and it is worth promoting in breast cancer patients.