The Role of Gamification in Enhancing Treatment Adherence Motivation in Children with Cancer: A Systematic Review

Introduction Childhood cancer poses significant challenges that affect both physical and psychological aspects of treatment adherence. Gamification-integrating engaging and interactive elements-has gained recognition as a promising tool to enhance compliance, reduce anxiety, and improve patient cooperation. Serious digital games foster a sense of control, minimize stress, and encourage active participation in medical routines. This systematic review examines the impact of gamification on adherence to treatment in pediatric oncology. Methods: A comprehensive search was conducted across Web of Science, PubMed, Scopus, and Google Scholar, between ۲۰۱۰ to ۲۰۲۵. The search included the keywords "gamification," "pediatric," "neoplasm," and "compliance." Studies meeting inclusion criteria were independently reviewed, extracting data related to treatment adherence, stress reduction, patient engagement, and digital dependency issues. The PRISMA checklist guided study selection, and the ROBIS tool was used for quality assessment of articles. Results: A total of ۱۸ studies were analyzed. Among them, ۱۴ studies (۷۷%) demonstrated a significant improvement in adherence rates, whereas ۴ studies (۲۳%) emphasized gamification's role in reducing anxiety and stress among pediatric cancer patients. A study involving ۲۴ children revealed that ۸۰% showed an increased willingness to continue treatment, and ۷۵% of children aged ۶-۱۲ demonstrated improved self-care behaviors such as hygiene, nutrition, and rest. Moreover, knowledge assessments before and after game-based interventions indicated that children's understanding of cancer and its treatment improved notably. Further comparative analysis revealed that three studies addressed concerns about excessive screen dependency, indicating that some children developed a habit of prolonged mobile phone use due to digital interventions, potentially affecting social engagement and real-world interactions. Serious digital games like Pets vs Onco and mobile applications such as HomeTown played a crucial role in enhancing treatment compliance through interactive education, health reminders, and structured learning tools. Experts suggest that while gamification is effective, its implementation should include measures to mitigate digital overuse in young patients.: Conclusion Gamification-based interventions in pediatric oncology significantly enhance treatment adherence, reduce stress, and improve self-care routines. However, concerns related to screen dependency warrant further investigation to optimize digital strategies. Integrating interactive education, entertainment-driven therapy, and psychological support strengthens treatment engagement and patient-provider communication. Future research should refine gamified approaches to balance therapeutic benefits with reduced digital reliance, ensuring long- term effectiveness.

کلیدواژه ها:

gamification ، pediatric ، neoplasm ، compliance ، treatment adherence