The Effect of Laughter Therapy with Mobile Health App on the Self-esteem of Children with Cancer Undergoing Chemotherapy

Background: A key responsibility of medical staff, including nurses, is to promote health, support rehabilitation, prevent disease recurrence, and alleviate treatment symptoms in the pediatric oncology department, both during hospital stays and after discharge. Laughter therapy using a mobile health (mHealth) app provides a non-medicinal, simple, and completely non-invasive approach to boosting the self-esteem of children with cancer who are undergoing chemotherapy. Methods: This quasi-experimental study involved 70 children admitted to the hematology department of Ali ibn Abi Talib Hospital in Zahedan in 2023. Children in the intervention group participated in four laughter therapy sessions using a researcher-created mHealth app in the department's game room. The app featured four games designed to make children happy and laugh, along with guidance on managing chemotherapy side effects. Data were collected using a demographic information form and the Coopersmith Self-esteem Inventory (CSEI). Analysis was conducted using SPSS version 27, with independent samples t-tests and paired samples t-tests applied at a significance level of 0.05 (P < 0.05). Results: The independent samples t-test indicated no significant change in self-esteem levels among children in the control group before and after the intervention. However, the intervention group showed a significant increase in self-esteem post-intervention. As a result, the self-esteem levels in the intervention group were significantly higher than those in the control group (P < 0.001). Conclusions: The initiation of laughter therapy using the mHealth app led to an increase in self-esteem among children with cancer undergoing chemotherapy, compared to their peers. This study demonstrates that laughter therapy with the mHealth app can be an effective tool for enhancing the self-esteem of children undergoing chemotherapy.