Effects of play therapy in children with cancer: a systematic review and metanalysis

Abstract

Background: Cancer disease generates negative emotions in children such as fear, stress and anxiety, derived from prolonged periods of hospitalization and invasive treatments. In addition, pediatric oncology patients suffer from severe pain. The research question was: What are the effects of play therapy in children with cancer in health-related outcomes? Methods: A systematic review with meta-analysis was performed. The search was done in Pubmed (Medline), CINHAL, SCOPUS and CUIDEN. The search equation was Children AND cancer AND “play therapy”. The search was carried out in March 2024. Results: n = 12 studies were included. The studies show that the application of play therapy and games interventions in children with cancer reduces depressive symptoms, stress, and anxiety. In addition, through these interventions, children can better express their feelings regarding the disease and collaborate in treatment. Two studies had information for a meta-analysis, being the standardized mean difference for anxiety − 0.36(95 %CI -0.68, − 0.03) with p < 0.05 in favor of play therapy group. The meta-analysis only included two small, quasi-experimental studies from the same country, resulting in a high risk of bias and limited generalisability. Conclusions: Although more experimental and robust evidence is needed, the use of traditional play therapy in children with cancer may be beneficial, as it improves symptom expression and communication, while technological games promote distraction, reducing symptoms such as anxiety and fear and facilitating adherence and adaptation to treatment.