Self-efficacy-enhancing active cycle of breathing technique (SEE-ACBT) is an effective and economic pulmonary rehabilitative method for patients with lung cancer postoperatively, according to a study published in the European Journal of Oncology Nursing.

Curative surgical resection is the most commonly used procedure for patients with early non-small cell lung cancer (NSCLC). Weak respiratory musculature and sputum retention may cause postoperative pulmonary complications (PPC) such as pneumonia and atelectasis, leading to worse health-related and economic outcomes.

For this quasi-experimental pre-post test study, investigators enrolled 162 patients with NSCLC waiting to undergo lung resection and assigned them to receive routine perioperative care (breathing and deep coughing exercises) alone or with SEE-ACBT (ie, breathing control, thoracic expansion exercises, and forced expiration technique).

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Results showed that sputum weight, the primary outcome, was nonsignificantly increased after day 1, and significantly increased after days 2 and 3 postoperatively in patients in the SEE-ACBT arm compared with patients in the standard care arm.

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Patients in the SEE-ACBT arm also demonstrated significant improvements in the 6-minute walk test, exercise-self efficacy, and duration of oxygen inhalation vs patients who received routine care only.

Researchers observed economic benefits as well; patients in the SEE-ACBT saved on average $767.60 in hospitalization costs compared with patients assigned to routine care.

The authors concluded that “SEE-ACBT is an effective and economical short-term pulmonary rehabilitation method. Pulmonary rehabilitation should focus on increasing motivational behaviors. Further studies should be implemented to explore the long-term effects of SEE-ACBT.”


Yang M, Zhong J, Zhang J, et al. Effect of the self-efficacy-enhancing active cycle of breathing technique on lung cancer patients with lung resection: a quasi-experimental trial [published online March 5, 2018]. Eur J Oncol Nurs. doi: 10.1016/j.ejon.2018.02.009