Effects Of Mindful Breathing Training Combined With Diary-based Rehabilitation Guidance In Patients With Lung Cancer Undergoing Surgery

Aim:The purpose of this study was to explore the effect of mindful breathing training combined with diary-based rehabilitation guidance as well as mindful breathing training on lung cancer patients undergoing surgery.Methods:This study is a single-center,assessor-blinded,three-arm,prospective randomized controlled trial.Patients were recruited from the First Hospital of Jilin University.Finally,102 participants were randomly allocated to the combined intervention group,the mindful breathing group or the control group,with 34 patients in each group.Patients allocated to the control group received routine care.Patients allocated to the mindful breathing group received mindful breathing training as well as routine care.Patients in the combined intervention group received mindful breathing training combined with diary-based rehabilitation guidance as well as routine care.Outcome measures including dyspnea,fatigue,anxiety,depression,compliance,self-efficacy,quality of life(QOL),and postoperative pulmonary complications(PPCs)were collected on the day of admission,one day before surgery,two days after surgery,and discharge day.SPSS 25.0 was used to analyze data,with P< 0.05 indicating statistical significance for all outcome measures.The repeated measures analysis of variance method was used to analyze the outcome indexes of the three groups of patients at different time points.The method of single factor analysis of variance,t-test,the nonparametric rank sum test or chi square test was used to compare the variables between the three groups.Results:(1)It was found that there were no significant differences between groups in baseline characteristics.The outcomes at baseline were collected on admission day and there were no significant difference among the three groups in dyspnea,fatigue,anxiety,depression,self-efficacy and QOL.(2)On the first day before surgery,compared with the control group,the combined intervention group had significant improvement in dyspnea(P=0.001),fatigue(P=0.016),anxiety(P=0.002)and depression(P=0.009).Compared with the control group,the mindful breathing group had significant improvement in dyspnea(P=0.006)and anxiety(P=0.022).Compared with mindful breathing group,the combined intervention group significantly improved self-efficacy(P<0.001).(3)On the second day after surgery,compared with the control group,the combined intervention group had significant improvement in dyspnea(P<0.001),anxiety(P<0.001)and depression(P=0.006).Compared with the control group,the mindful breathing group significantly improved in dyspnea(P<0.001),fatigue(P<0.001)and anxiety(P=0.043).Compared with mindful breathing group,the combined intervention group significantly improved anxiety(P=0.041),depression(P=0.032)and self-efficacy(P<0.001).(4)At discharge,compared with the control group,the combined intervention group had significant improvement in dyspnea(P<0.001),fatigue(P<0.001),anxiety(P<0.001),depression(P=0.002),QOL functional scale(P=0.002),QOL symptom scale(P<0.001),global QOL(P<0.001),and QOL lung cancer specific scale(P=0.011).Compared with the control group,the mindful breathing group significantly improved dyspnea(P=0.004),fatigue(P<0.001),anxiety(P<0.001),QOL symptom scale(P=0.005),and global QOL(P<0.001).Compared with mindful breathing group,the combined intervention group significantly improved dyspnea(P=0.012),compliance(P=0.036),self-efficacy(P=0.005),QOL functional scale(P=0.011)and QOL lung cancer specific scale(P=0.014).(5)There were no significant difference in PPCs among the three groups(P=0.687).Conclusion:(1)The results of this study showed that mindful breathing training combined with diary-based rehabilitation guidance and mindful breathing training alone can effectively improve perioperative physical and psychological symptoms of lung cancer patients.(2)The effect of mindful breathing training combined with diary-based rehabilitation guidance is superior over that of mindful breathing training alone or routine care.It seems that mindful breathing training combined with diary-based rehabilitation guidance can be considered to be introduced into clinical practice to manage the physical and psychological symptoms of lung cancer patients with surgery and promote the rehabilitation of patients.