从抗癌治疗到无病生存的过渡期，乳腺癌患者面临很多挑战，包括对长期内分泌治疗方案的参与配合，自我形象改变等治疗后遗症的应对。我们前期研究发现，乳腺癌患者服药依从性较低，病耻感普遍存在，生活质量下降。我们还发现，乳腺癌患者在过渡期不能够获得足够的来自医护人员的专业支持。目前，全球范围内缺乏乳腺癌健康管理模式网络干预的研究,其成本效果分析未见报道。基于此，我们提出健康管理可以改善乳腺癌患者过渡期生活质量，线上网络干预比线下面对面干预和常规照护具有更低的成本/效果。本课题拟：①将自我效能理论和社会交流理论相结合，构建乳腺癌健康管理模式，分为线上、线下两种不同形式进行干预；②采用多中心、单盲、临床随机对照试验，探索该模式线上线下干预对乳腺癌患者服药依从性、病耻感、和生活质量的影响；③进行线上、线下干预和常规照护一年的成本效果分析。本研究旨在探索一种连续可及、经济有效的乳腺癌健康管理模式。

Abstract: After the end of primary curative breast cancer treatment, women go through the transition from “patient” to “survivor”. This transition is characterized by multiple challenges including participating long-term adjuvant endocrine therapy and dealing with body image disturbance. Our previous study showed low rate of adjuvant endocrine therapy adherence, high prevalence of self-stigma, as well as decreased quality of life for breast cancer survivors. We also found that women could not receive adequate support from healthcare professionals during transition phase. There is limited randomized controlled trials to test the app-based health programs targeting at women’s adjuvant endocrine therapy adherence and breast cancer self-stigma. To the best of our knowledge, no cost-effectiveness analysis has been conducted on such programs. Thus, we hypothesize that Breast Cancer Health program will improve the quality of life for breast cancer survivors, and it is more cost-effective to provide an app-based Breast Cancer Health program than a clinic-based program and routine care. In this study, based on Bandura’s self-efficacy theory and the social exchange theory, a Breast Cancer Health program will be developed. We will examine the effectiveness and cost-effectiveness of Face-to-Face and Mobile Breast Cancer Health program for breast cancer survivors on the adjuvant endocrine therapy adherence, breast cancer self-stigma, and quality of life. A single-blinded, multi-centre, randomised, three-group pre-and post-tests experimental design is proposed. This study aims to explore a continuous, effective, and cost-effective health management model for breast cancer survivors.