Interactive Narratives and Serious Games in Oncology and Grief Support: A Systematic Literature Review

The impact of oncological diseases extends far beyond the clinical patient, profoundly affecting the mental health of caregivers, family members, and volunteers who navigate complex emotional landscapes of grief, anxiety, and trauma. While the domain of digital health has seen a proliferation of serious games aimed at pediatric patient education and treatment adherence, the specific perspective of the “second-order patient”, the caregiver or survivor, remains significantly under-explored. The primary objective of this study is to systematically review the current state of interactive narratives in oncology, palliative care, and grief support, identifying research gaps to inform the broader design space of empathy-driven serious games. Following the PRISMA guidelines, 31 articles were selected from an initial query of 116 records. Interventions were categorized into Serious Games, Games, and Gamification. The analysis reveals a critical thematic transition: early interventions relied heavily on biological “battle” metaphors to empower patients, whereas the current literature advocates for “thanatosensitive” designs that foster empathy. However, a distinct research gap persists regarding narratives that explore post-loss meaning reconstruction and the hospital volunteer experience. Synthesizing these findings, this paper establishes an evidence-based theoretical framework demonstrating a significant opportunity for games that prioritize dialogue and emotional processing over traditional winning conditions. As a practical application of these findings, we also briefly outline the conceptualization of a prototype simulating a widower’s experience volunteering in a palliative ward, shifting the ludic focus from defeating a disease to navigating loss.