Background: Surgical resection is the primary curative treatment for lung cancer, but postoperative pulmonary dysfunction, reduced exercise tolerance, and impaired quality of life are common challenges. This study aimed to evaluate the effectiveness of intelligent breathing training in improving postoperative outcomes for lung cancer patients. Methods: A single-center randomized controlled trial was conducted among eligible lung cancer patients who underwent partial lung resection (July 2024–July 2025). Patients were randomized 1:1 to the intervention group (intelligent breathing training plus routine care) or the control group (routine care). A total of 138 patients were randomized to either the intervention group (n = 68) or the control group (n = 70). Outcomes were assessed at preoperation (T0), discharge (T1), 1 month (T2), and 3 months (T3) postoperatively. Results: At T1, T2, and T3 postoperatively, the intervention group demonstrated significantly superior pulmonary function compared to the control group (all p < 0.05), including higher forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and peak expiratory flow (PEF). Additionally, the intervention group achieved significantly longer 6-min walk distances, higher physical domain scores on the World Health Organization Quality of Life-100 (WHOQOL-100) scale, and lower scores on the Psycho-Social Adjustment to Illness Scale (PAIS-SR) at all postoperative time points (all p < 0.001). Conclusion: Intelligent breathing training effectively improves postoperative pulmonary function, exercise tolerance, and quality of life in lung cancer patients. It provides a feasible and superior alternative to traditional rehabilitation, supporting the integration of intelligent devices into clinical nursing practice.
BerghmansT.LievensY.AaproM.BairdA. M.BeishonM.CalabreseF.Delgado BoltonR. C.GagaM.LöveyJ.LucianiA.PereiraP.ProschH.SaarM.ShackclothM.Tabak-HouwaardG.CostaA.PoortmansP. (2020). European cancer organisation essential requirements for quality cancer care (ERQCC): Lung cancer. Lung Cancer, 150(8), 221–239. https://doi.org/10.1016/j.lungcan.2020.08.017
2.
ChenY. (2024). Effect of health education based on goal execution concept on postoperative pain, health behaviors and respiratory complications in perimenopause lung cancer patients. China Maternal and Child Health Care, 39(18), 3618–3621. https://doi.org/10.19829/j.zgfybj.issn.1001-4411.2024.18.041
3.
DaiY.ZhouY.LuJ. (2025). Evaluation of the effect of respiratory training and sputum elimination intervention based on the whole disease course on postoperative rehabilitation of lung cancer patients. Hebei Medicine, 15(4), 10–14. https://doi.org/10.3969/j.issn.1002-7386
4.
Den OudstenB. L.Van HeckG. L.Van der SteegA. F.RoukemaJ. A.De VriesJ. (2009). The WHOQOL-100 has good psychometric properties in breast cancer patients. Journal of clinical epidemiology, 62(2), 195–205. https://doi.org/10.1016/j.jclinepi.2008.03.006
5.
DongJ.ZhuX. (2024). The effect of enhanced recovery after lung cancer surgery combined with fine surgical nursing on rehabilitation. JPMA. The Journal of the Pakistan Medical Association, 74(5), 874–879. https://doi.org/10.47391/JPMA.9035
6.
DroverH.SinghS. J.OrmeM. W.DaynesE. (2025). Pulmonary rehabilitation healthcare professionals understanding and experiences of the protected characteristics of service users: A qualitative analysis. Chronic Respiratory Disease, 22(20), Article 14799731241307253. https://doi.org/10.1177/14799731241307253
7.
GarlandA.CostaD.WunschH.DzierbaA. L.LizanoD.GershengornH. (2025). Interprofessional team staffing in U.S. intensive care units. Annals of the American Thoracic Society, 22(3), 416–421. https://doi.org/10.1513/AnnalsATS.202404-441OC
8.
HaesevoetsS.ArentsE.CopsD.QuadfliegK.CrielM.RuttensD.StevensD.SurmontV.DemeyerH.BurtinC. (2025). The impact of lung surgery, with or without (neo-)adjuvant therapy, on physical functioning in patients with nonsmall cell lung cancer: A scoping review. European Respiratory Review: An Official Journal of the European Respiratory Society, 34(175), 240156. https://doi.org/10.1183/16000617.0156-2024
9.
JiX.YanY. (2023). Effect of using the active cycle of breathing technique combined with Watson's theory of human caring in rapid patient rehabilitation following lung cancer surgery. Alternative Therapies in Health & Medicine, 29(2), 14–20. https://www.ncbi.nlm.nih.gov/pubmed/36239563
10.
JiaY.ChengG.WangH.MaB.CaiY.RenX.GuJ.ChenO. (2025). Barriers and facilitators to implementing pulmonary rehabilitation guidelines in China: A qualitative study using implementation science frameworks. Health Research Policy and Systems, 23(1), 51. https://doi.org/10.1186/s12961-025-01330-y
LangballeR.SvendsenL.JakobsenE.DaltonS. O.KarlsenR. V.IachinaM.Envold BidstrupP.LeclairA.JørgensenL. B.SkouS. T.EhlersJ. H.TorenholtR.SvendsenM. N. (2023). Nurse navigation, symptom monitoring and exercise in vulnerable patients with lung cancer: Feasibility of the NAVIGATE intervention. Scientific Reports, 13(1), Article 22744. https://doi.org/10.1038/s41598-023-50161-w
13.
LeonardiB.MessinaG.VicarioG.PicaD. G.Di FilippoV.VinciguerraR.FiorelliA.CaputoA.GiorgianoN. M.D'AgostinoA.IovineA.GuarinoA. A.RobustelliM.CorteC. M. D.MorgilloF.VarrialeE.CapaccioD.GrimaldiA.FrancoR. (2025). Rescue surgery for advanced stage lung cancer: A systematic review. Thoracic Cancer, 16(16), Article e70151. https://doi.org/10.1111/1759-7714.70151
14.
LuT.DengT.LongY.LiJ.HuA.HuY.HuJ.WangH.MaJ.ChenS. (2024). Effectiveness and feasibility of digital pulmonary rehabilitation in patients undergoing lung cancer surgery: Systematic review and meta-analysis. Journal of Medical Internet Research, 26(12), Article e56795. https://doi.org/10.2196/56795
15.
MaJ.ZhangY.GaoX.BaoL.XuJ.WangS.LiB. (2025). Analysis of the effectiveness of a total management model in the management of chronic cough after lung cancer surgery. Thoracic Cancer, 16(18), Article e70148. https://doi.org/10.1111/1759-7714.70148
16.
MaX.ZhuangS.HouJ.ZhaoY.XiaoG.ChenM.WangY. (2024). Comparative different interventions to improve exercise adherence in patients in the postoperative breast cancer phase of care: A network meta-analysis. Cancer Nursing, 47(5), 408–420. https://doi.org/10.1097/NCC.0000000000001257
17.
MehdipourA.WileyE.RichardsonJ.BeauchampM.KuspinarA. (2021). The performance of digital monitoring devices for oxygen saturation and respiratory rate in COPD: A systematic review. COPD: Journal of Chronic Obstructive Pulmonary Disease, 18(4), 469–475. https://doi.org/10.1080/15412555.2021.1945021
18.
MeiX.HuangY.ZhouJ. (2024). Prospective self-controlled study of continuous monitoring of basic vital signs of patients after thoracoscopic lung cancer resection with wireless wearable devices. China Clinical Journal of Thoracic and Cardiovascular Surgery, 31(2), 229–235.
19.
Mendizabal-GallasteguiN.ArietaleanizbeaskoaM. S.LatorreP. M.Garcia-AlvarezA.SanchoA.IruarrizagaE.GrandesG. (2023). Nurse-supervised exercise for people with stage IV cancer: The EFICANCER randomized clinical trial. Seminars in Oncology Nursing, 39(4), Article 151448. https://doi.org/10.1016/j.soncn.2023.151448
20.
MisselM.BeckM.DonselP. O.PetersenR. H.BennerP. (2023). Do enhanced recovery after lung cancer surgery programs risk putting primacy of caring at stake? A qualitative focus group study on nurses' perspectives. Journal of Clinical Nursing, 32(13-14), 4037–4048. https://doi.org/10.1111/jocn.16555
21.
MolinaroN.SchenaE.SilvestriS.MassaroniC. (2023). Breathing chest wall kinematics assessment through a single digital camera: A feasibility study. Sensors, 23(15), 6960. https://doi.org/10.3390/s23156960
22.
MugnainiG.TombelliS.BurloneA.BongiolattiS.ViggianoD.IndinoR.GatteschiL.VoltoliniL.GonfiottiA. (2025). Awake thoracic surgery for lung cancer treatment: Where we are and future perspectives-our experience and review of literature. Journal of Cardiothoracic Surgery, 20(1), 62. https://doi.org/10.1186/s13019-024-03313-6
23.
Oncology Society of Chinese Medical Association (2025). Chinese medical association clinical diagnosis and treatment Guidelines for lung cancer. Zhonghua Yixue Zazhi, 105(34), 2918–2959. https://doi.org/10.3760/cma.j.cn112137-20250511-01152
PortilloM. C.AmbrosioL.Lanas MartinR.NavartaM. V.Ursua SesmaM.Riverol FernandezM. (2019). A pilot study on the Spanish version of the psychosocial adjustment to illness scale (PAIS-SR) with carers of people with Parkinson's disease. Nursing open, 6(3), 1262–1268. https://doi.org/10.1002/nop2.329
26.
RankinN. M.McGregorD.StoneE.ButowP. N.YoungJ. M.WhiteK.ShawT. (2018). Evidence-practice gaps in lung cancer: A scoping review. European Journal of Cancer Care, 27(2), Article e12588. https://doi.org/10.1111/ecc.12588
27.
SalvadoS.GriloE.HenriquesH.FerrazI.GasparF.BaixinhoC. (2025). Pulmonary rehabilitation nursing interventions promoting self-care in elderly people with chronic obstructive pulmonary disease (at home). Healthcare (Basel), 13(17), 2176. https://doi.org/10.3390/healthcare13172176
28.
SkaarhoejM. G.OlesenM. L.FrimannS. S.BergenholtzH.RostedE. (2025). Guided self-determination for patients with non-small cell lung cancer: Patients' experiences of a nurse-led person-centred intervention. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society, 76(6), Article 102864. https://doi.org/10.1016/j.ejon.2025.102864
29.
SmolarzB.LukasiewiczH.SamulakD.PiekarskaE.KolacinskiR.RomanowiczH. (2025). Lung Cancer-Epidemiology, pathogenesis, treatment and molecular aspect (Review of literature). International Journal of Molecular Sciences, 26(5), 2049. https://doi.org/10.3390/ijms26052049
30.
SpruitM. A.SinghS. J.GarveyC.ZuWallackR.NiciL.RochesterC.RehabilitationA. E. T. F. o. P.HollandA. E.LareauS. C.ManW. D. C.PittaF.SewellL.RaskinJ.BourbeauJ.CrouchR.FranssenF. M. E.CasaburiR.VercoulenJ. H.VogiatzisI.ATS/ERS Task Force on Pulmonary Rehabilitation. (2013). An official American thoracic society/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188(8), e13–e64. https://doi.org/10.1164/rccm.201309-1634ST
31.
SuX. E.WuS. H.HeH. F.LinC. L.LinS.WengP. Q. (2024). The effect of multimodal care based on Peplau's interpersonal relationship theory on postoperative recovery in lung cancer surgery: A retrospective analysis. BMC Pulmonary Medicine, 24(1), 59. https://doi.org/10.1186/s12890-024-02874-5
32.
VargoM.GerberL. H.GilchristL. S.FisherM. I. (2025). Recommendations for interventions to improve function in patients with lung Cancer: A Clinical practice guideline. Cancer Medicine, 14(13), Article e70626. https://doi.org/10.1002/cam4.70626
33.
Wade-McbaneK.KingA.UrchC.Jeyasingh-JacobJ.MilneA.BoutillierC. L. (2023). Prehabilitation in the lung cancer pathway: A scoping review. BMC Cancer, 23(1), 747. https://doi.org/10.1186/s12885-023-11254-x
34.
Whish-WilsonG. A.EdbrookeL.CavalheriV.Calulo RiveraZ. T.CavallaroM.SellerD. R.ParryS. M. (2025). Empowering recovery: A Co-Designed intervention to transform care for operable lung cancer. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 28(2), Article e70196. https://doi.org/10.1111/hex.70196
35.
WuW.QiuR. (2025). The effect of nursing-based enhanced recovery after surgery on quality of life in lung cancer patients receiving surgery: A systematic review and meta-analysis. Nursing and Health Sciences, 27(2), Article e70094. https://doi.org/10.1111/nhs.70094
36.
WuX.LiangX.LiY.ZhengR. (2024). Development and testing of the knowledge-attitudes-practices questionnaire for nurses on the perioperative pulmonary rehabilitation of patients with lung cancer. Asia-Pacific Journal of Oncology Nursing, 11(4), Article 100387. https://doi.org/10.1016/j.apjon.2024.100387
37.
XuM.LinW.LiuH. (2024). Summary of the best evidence for respiratory exercise in perioperative lung cancer patients. Journal of Nursing Management, 24(5), 430–436.
38.
ZhangY.YuC.DingR. (2025). Effect of solution-focused nursing combined with respiratory exercise in patients after radical lung cancer surgery. Clinical Research in Medicine, 42(4), 705–708. https://doi.org/10.3969/j.issn.1671-7171.2025.04.042
39.
ZhouN.Ripley-GonzalezJ. W.ZhangW.XieK.YouB.ShenY.QiuL.FuS.ZhangC.DunY.GaoY.LiuS. (2025). Preoperative exercise training decreases complications of minimally invasive lung cancer surgery: A randomized controlled trial. The Journal of Thoracic and Cardiovascular Surgery, 169(2), 516–528. https://doi.org/10.1016/j.jtcvs.2024.04.009
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