Impact of Exercise Rehabilitation and Behavioral Interaction Nursing on Postoperative Quality of Life and Psychological Outcomes in Lung Cancer Patients

Wenhui ZhengJinghua JI^*

• The First Affiliated Hospital of China Medical University, Shenyang, China

Background: Patients with lung cancer face significant physical and psychological challenges after surgery. Exercise rehabilitation and behavioral interventions show promise, but their combined association with postoperative lung cancer outcomes remains underexplored. Objective: To evaluate the association between combined exercise rehabilitation, behavioral interaction nursing, and postoperative outcomes in patients with lung cancer. Methods: This retrospective cohort study, reported according to the STROBE guidelines, included 205 patients with lung cancer (January 2023-December 2024) categorized into intervention (n=103) and control (n=102) groups based on the documented postoperative care pathway each patient received. Propensity score matching and multivariate analyses were performed to address potential confounding factors. Primary and secondary outcomes were assessed at baseline, 2, 4, and 8 weeks, and at the 5-month follow-up. Results: The intervention group demonstrated improvements in all domains. Quality of life scores (QLICP-LU) increased substantially from 62.5±8.9 to 79.6±6.3, representing a 27.3% improvement, versus minimal change in controls from 61.2±9.1 to 60.5±9.2 (between-group difference 19.1 points, P<0.001). Arterial oxygenation improved significantly (PaO₂: 89.3±5.7 vs 78.2±6.1 mmHg; SaO₂: 98.0±1.3% vs. 94.5±2.0%, both P<0.001). Muscle tone recovery showed substantial enhancement, with 48.2% and 55.5% improvements in the upper and lower extremities, respectively, compared to the controls (P<0.001). Systemic inflammation decreased markedly (hs-CRP level: 20.9% reduction vs. stable controls, P<0.001). Psychological outcomes revealed notable improvements: depression prevalence decreased by 62.0% (17.5% vs. 46.1%) and anxiety declined by 53.3% (24.3% vs. 52.0%, both P<0.001). Hope scores increased by 34.5%, and self-efficacy improved by 28.5% (both P<0.001). These associations persisted through the 5-month follow-up; however, residual confounding cannot be excluded from the study. Conclusion: Combined exercise rehabilitation and behavioral interaction nursing were associated with enhanced multidimensional postoperative recovery, suggesting that this approach may represent a promising comprehensive rehabilitation strategy for patients with lung cancer. Given the observational design and potential for unmeasured confounding, prospective randomized controlled trials are essential to establish causality and confirm these findings.