Objective <p>To evaluate the effects of “Internet + ” nursing services via a home intelligent management platform (HIM) on respiratory function, psychological status, and quality of life in post-discharge lung cancer surgery patients facing challenges such as rehabilitation knowledge gaps, poor compliance, psychological distress, and communication barriers.</p> Methods <p>A randomized controlled trial enrolled 50 patients undergoing lung cancer surgery at Yichang Central People’s Hospital (September 2023–July 2024). Participants were allocated to an intervention group (<i>n</i> = 25, receiving standard care plus HIM-guided personalized nursing) or a control group (<i>n</i> = 25, standard care only). Outcomes included 6-min walk test (6MWT) distance, Borg Scale, Visual Analog Scale (VAS), Self-Rating Anxiety/Depression Scales (SAS/SDS), and EORTC QLQ-C30 scores, assessed pre-discharge and post-intervention.</p> Results <p>Both groups showed significant within-group improvements in 6MWT distance, functional domains, overall health status, and reductions in Borg, VAS, SAS/SDS, fatigue, and pain scores post-discharge (all <i>P</i> &lt; 0.05). Compared to controls, the HIM group demonstrated superior 6MWT distance, functional domains, overall health (<i>P</i> &lt; 0.05), and greater reductions in Borg, VAS, SAS/SDS, pain, and dyspnea scores (<i>P</i> &lt; 0.05).</p> Conclusion <p>HIM-facilitated continuous nursing significantly enhances respiratory function, psychological well-being, and quality of life in postoperative lung cancer patients, demonstrating clinical value for home-based rehabilitation.</p> <p>Trial registration</p> <p>This trial was registered in the Chinese Clinical Trial Registry at ChiCTR2400093904 (<a href="http://www.chictr.org.cn">http://www.chictr.org.cn</a>) on 13 December 2024.</p>