AIM: Given the high incidence of postoperative cognitive decline and reduced self-efficacy in lung cancer patients undergoing radical thoracoscopic surgery, this study aimed to investigate the effect of evidence-based nursing combined with health empowerment intervention on self-efficacy and cognitive function in this patient population.

METHODS: A total of 516 patients who underwent thoracoscopic radical lung cancer surgery between February 2021 and June 2025 in The First People’s Hospital of Zunyi were included. The patients were divided into an observation group (232 cases, who received evidence-based nursing combined with health empowerment intervention) and a control group (284 cases, who received conventional nursing). General data of the patients, along with their visual analogue scale (VAS) scores, forced vital capacity (FVC), maximal voluntary ventilation (MVV), forced expiratory volume in 1 second to FVC ratio (FEV1/FVC), General Self-Efficacy Scale (GSES) score, and Mini-Mental State Examination (MMSE) score, were collected.

RESULTS: There was no significant difference between the two groups in terms of baseline characteristics (p > 0.05). After the intervention, the observation group achieved significantly greater improvement than the control group in terms of VAS pain scores, pulmonary function indices (FVC, MVV, FEV1/FVC), GSES scores and MMSE scores (p < 0.001). In addition, the total incidence of postoperative adverse reactions was significantly lower in the observation group than in the control group (7.76% vs. 13.73%, p = 0.031).

CONCLUSIONS: Evidence-based nursing combined with health empowerment intervention significantly relieves postoperative pain, promotes recovery of lung function, enhances self-efficacy and cognitive function, and reduces the incidence of postoperative adverse events.