The Effectiveness of Play Therapy on Anxiety, Pain, and Fatigue in Children with Cancer: A Systematic Review and Meta-Analysis

Objective This systematic review and meta-analysis study aimed to evaluate the effects of play therapy on anxiety, pain and fatigue in children undergoing cancer treatment. Method As a result of the systematic search conducted in six databases, 4 randomised controlled trials were included in the meta-analysis. The samples of the included studies consisted of children aged 6–18 years and the interventions included structured play therapy activities. The samples, intervention duration, measurement tools and statistical data of the studies were summarised and the results were synthesised by meta-analysis. Results In the analysis of a total of 222 children, a significant decrease in anxiety (SMD: -2.28, 95% CI [-4.25, -0.31], p = 0.0002) and pain (SMD: -1.63, 95% CI [-2.08, -1.19], p < 0.00001) was observed after play therapy applications. A positive but not statistically significant trend was found for fatigue. Differences in measurement tools, application content and duration were noted, resulting in a high degree of heterogeneity. Conclusions The play therapy stands out as an effective, child-centred and accessible intervention for reducing psychological and somatic symptoms in children with cancer. It is recommended that future studies develop intervention protocols that are more structured, theoretically based, and examine long-term effects.