Preoperative AnxietyNCT07425405
Daily Screen Exposure and Preoperative Anxiety in Children Aged 2-5 Years
An observational study of Preoperative Anxiety, run by Kanuni Sultan Suleyman Training and Research Hospital at 1 site in Turkey (Türkiye).
Trial summary
This prospective observational study aims to evaluate whether daily screen exposure duration is associated with preoperative anxiety levels in children aged 2-5 years undergoing elective surgery. Screen exposure in early childhood has been associated with emotional and behavioral outcomes, including increased anxiety. Read more about this study
- Who is it for?
- Ages 2 to 5 years
- Conditions the study is for
- Preoperative Anxiety
- How many people
- 275 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 11 Mar 2026to 30 Jan 2027
- How long will I take part?
- 1 Day
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 2 to 5 years
- All sexes
- No healthy volunteers
- Child
Study population: The study population consists of children aged 2-5 years scheduled for elective surgical procedures under general anesthesia at Kanuni Sultan Süleyman Training and Research Hospital. Participants will be enrolled prospectively after written informed consent is obtained from a parent or legal guardian. Children will be categorized based on parent-reported daily screen exposure duration. Preoperative anxiety will be assessed immediately before anesthesia induction using the Modified Yale Preoperative Anxiety Scale (mYPAS).
Who may be able to join
- Children aged 2 to 5 years
- Scheduled for elective surgical procedures under general anesthesia
- American Society of Anesthesiologists (ASA) physical status I-III
- Parent or legal guardian able to provide written informed consent
- Parent able to complete the structured questionnaire in Turkish
Who cannot join
- Premedication administered or planned prior to anxiety assessment
- Emergency surgical procedures
- Known developmental delay or neurodevelopmental disorder
- Known psychiatric disorder
- Visual or hearing impairment that may interfere with behavioral assessment
- Chronic use of sedative, antipsychotic, or antiepileptic medications
Show all 9Show fewer
- Anticipated need for postoperative intensive care
- Incomplete or unreliable questionnaire data
- Inability to perform mYPAS assessment prior to anesthesia induction
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital
Istanbul, küçükçekmece, 34303
Engin ihsan Turan, Principal investigator, 05382431114, enginihsan@hotmail.com
About this study
Official title: The Effect of Daily Screen Exposure Duration on Preoperative Anxiety in Children Aged 2-5 Years: A Prospective Observational Study
This prospective observational study aims to evaluate whether daily screen exposure duration is associated with preoperative anxiety levels in children aged 2-5 years undergoing elective surgery.
Screen exposure in early childhood has been associated with emotional and behavioral outcomes, including increased anxiety. However, its potential impact on anxiety in acute stress situations such as surgery has not been previously investigated. Preoperative anxiety in children is associated with difficult anesthetic induction, increased postoperative agitation, prolonged recovery, and behavioral disturbances.
Read more
In this study, parents will complete a structured questionnaire assessing their child's daily screen exposure duration and related factors. Children will be categorized into three groups according to reported daily screen time: less than 1 hour per day, 1-2 hours per day, and more than 2 hours per day.
Preoperative anxiety will be assessed immediately before anesthesia induction using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational tool for measuring anxiety in young children.
No additional medical interventions will be performed beyond routine clinical care. The study seeks to determine whether higher screen exposure is associated with increased preoperative anxiety levels and to identify potential risk factors contributing to anxiety in preschool children undergoing surgery.
Read the detailed description
Preoperative anxiety is a common and clinically significant problem in preschool-aged children undergoing elective surgery. Elevated anxiety levels before anesthesia induction have been associated with difficult induction, increased postoperative emergence agitation, prolonged recovery time, and long-term behavioral disturbances.
Early childhood is a critical developmental period characterized by ongoing emotional regulation maturation and increased sensitivity to environmental factors. In recent years, daily exposure to digital screens (television, tablets, smartphones) has increased substantially among children aged 2-5 years. Previous literature has linked excessive screen time with emotional dysregulation, anxiety symptoms, and behavioral problems. However, no clinical studies have investigated the relationship between daily screen exposure and preoperative anxiety in young children.
This study aims to address this gap in the literature.
Study Objective
The primary objective of this study is to evaluate the effect of daily screen exposure duration on preoperative anxiety levels in children aged 2-5 years undergoing elective surgery.
Secondary objectives include:
Evaluating the relationship between screen-related variables (age at first exposure, content type, passive exposure, parental screen time, bedroom screen presence) and preoperative anxiety.
Assessing the influence of sociodemographic and clinical variables on anxiety levels.
Determining the prevalence of clinically significant preoperative anxiety in children with high screen exposure.
Study Design
This is a single-center, prospective observational study conducted at Kanuni Sultan Süleyman Training and Research Hospital.
After obtaining written informed consent from parents or legal guardians, a structured "Sociodemographic and Screen Use Questionnaire" will be completed in the preoperative waiting area. The questionnaire includes information on daily screen exposure duration, age at first exposure, content type, parental screen use, passive exposure, bedroom screen presence, and previous medical experiences.
Children will be categorized into three groups based on reported daily screen exposure:
<1 hour per day
1-2 hours per day
more than 2 hours per day
Anxiety Assessment
Preoperative anxiety will be assessed immediately before anesthesia induction, either upon entry into the operating room or in the induction area, prior to any pharmacologic intervention.
Anxiety will be measured using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational instrument for children aged 2-12 years. The scale evaluates five behavioral domains (activity, vocalization, emotional expressivity, state of arousal, and interaction with parents). Scores range from 23.3 to 100, with higher scores indicating higher anxiety levels.
Assessment will be performed by a trained anesthesiologist through direct observation without interfering with routine clinical workflow.
Risk and Safety Considerations
This study is non-interventional. No additional medical procedures will be performed. Data collection consists of a parent questionnaire and a single observational anxiety assessment. Therefore, no additional clinical risk is anticipated beyond standard care.
- Conditions
- Preoperative Anxiety
- Keywords
- Screen Exposure, Pediatric Anesthesia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Low Screen Exposure | Children aged 2-5 years with daily screen exposure less than 1 hour per day, as reported by parents through a structured questionnaire. | |
| Moderate Screen Exposure | Children aged 2-5 years with daily screen exposure between 1 and 2 hours per day. | |
| High Screen Exposure | Children aged 2-5 years with daily screen exposure greater than 2 hours per day. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Preoperative Anxiety Level Assessed by mYPAS Total Score
Preoperative anxiety will be measured using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational tool for children aged 2-12 years. The total score ranges from 23.3 to 100, with higher scores indicating greater anxiety. The primary analysis will compare mYPAS total scores among three daily screen exposure groups (<1 hour/day, 1-2 hours/day, >2 hours/day).
Measured: Immediately before anesthesia induction
Secondary outcomes (6)
Association Between Screen Content Type and Preoperative Anxiety (mYPAS)
Association between the predominant content type watched during screen time (educational, non-violent cartoon/entertainment, adult content, action/violent content, YouTuber videos) and mYPAS total score.
Measured: Immediately before anesthesia induction (Day of surgery)
Association Between Parental Monitoring of Screen Content and Preoperative Anxiety (mYPAS)
Association between parental supervision of viewed content (always selects content, sometimes checks, usually does not check) and mYPAS total score.
Measured: Immediately before anesthesia induction (Day of surgery)
Association Between Passive Screen Exposure and Preoperative Anxiety (mYPAS)
Association between passive screen exposure (TV on in the background for most of the day vs turned off when not watched) and mYPAS total score.
Measured: Immediately before anesthesia induction
Association Between Reasons for Providing Screen and Preoperative Anxiety (mYPAS)
Association between reported situations in which parents provide a screen (feeding difficulties, during housework, to calm tantrums, to facilitate sleep, as reward, for entertainment, never allowed) and mYPAS total score
Measured: Immediately before anesthesia induction
Association Between Parental Screen Use and Preoperative Anxiety (mYPAS)
Association between maternal and paternal daily phone/tablet use (outside work) and mYPAS total score.
Measured: Immediately before anesthesia induction
Association Between Parental Phone Use During Parent-Child Interaction and Preoperative Anxiety (mYPAS)
Association between parental phone engagement while playing/communicating with the child (never/rarely/often) and mYPAS total score.
Measured: Immediately before anesthesia induction
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Feb 2026
- Study start11 Mar 2026
- Primary completion23 Jan 2027 (estimated)
- Study completion30 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Preoperative AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 275 participants (estimated)
- Target duration
- 1 Day
Sponsor and investigators
- Lead sponsor
- Kanuni Sultan Suleyman Training and Research Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Engin Ihsan Turan, Kanuni Sultan Suleyman Training and Research Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07425405
- Sponsor's protocol ID
- Screentime
- Status last verified
- Mar 2026
- First submitted
- 16 Feb 2026
- Last updated
- 15 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Daily Screen Exposure Duration on Preoperative Anxiety in Children Aged 2-5 Years: A Prospective Observational Study
- ClinicalTrials.gov ID
- NCT07425405
- Acronym / sponsor ID
- Screentime
- Conditions
- Preoperative Anxiety
- Keywords
- Screen Exposure, Pediatric Anesthesia
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 275 participants (estimated)
- Lead sponsor
- Kanuni Sultan Suleyman Training and Research HospitalUniversity, hospital or other
- Study start
- 11 Mar 2026 (actual)
- Primary completion
- 23 Jan 2027 (estimated)
- Study completion
- 30 Jan 2027 (estimated)
- First posted
- 20 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This prospective observational study aims to evaluate whether daily screen exposure duration is associated with preoperative anxiety levels in children aged 2-5 years undergoing elective surgery.
Screen exposure in early childhood has been associated with emotional and behavioral outcomes, including increased anxiety. However, its potential impact on anxiety in acute stress situations such as surgery has not been previously investigated. Preoperative anxiety in children is associated with difficult anesthetic induction, increased postoperative agitation, prolonged recovery, and behavioral disturbances.
In this study, parents will complete a structured questionnaire assessing their child's daily screen exposure duration and related factors. Children will be categorized into three groups according to reported daily screen time: less than 1 hour per day, 1-2 hours per day, and more than 2 hours per day.
Preoperative anxiety will be assessed immediately before anesthesia induction using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational tool for measuring anxiety in young children.
No additional medical interventions will be performed beyond routine clinical care. The study seeks to determine whether higher screen exposure is associated with increased preoperative anxiety levels and to identify potential risk factors contributing to anxiety in preschool children undergoing surgery.
Detailed description
Preoperative anxiety is a common and clinically significant problem in preschool-aged children undergoing elective surgery. Elevated anxiety levels before anesthesia induction have been associated with difficult induction, increased postoperative emergence agitation, prolonged recovery time, and long-term behavioral disturbances.
Early childhood is a critical developmental period characterized by ongoing emotional regulation maturation and increased sensitivity to environmental factors. In recent years, daily exposure to digital screens (television, tablets, smartphones) has increased substantially among children aged 2-5 years. Previous literature has linked excessive screen time with emotional dysregulation, anxiety symptoms, and behavioral problems. However, no clinical studies have investigated the relationship between daily screen exposure and preoperative anxiety in young children.
This study aims to address this gap in the literature.
Study Objective
The primary objective of this study is to evaluate the effect of daily screen exposure duration on preoperative anxiety levels in children aged 2-5 years undergoing elective surgery.
Secondary objectives include:
Evaluating the relationship between screen-related variables (age at first exposure, content type, passive exposure, parental screen time, bedroom screen presence) and preoperative anxiety.
Assessing the influence of sociodemographic and clinical variables on anxiety levels.
Determining the prevalence of clinically significant preoperative anxiety in children with high screen exposure.
Study Design
This is a single-center, prospective observational study conducted at Kanuni Sultan Süleyman Training and Research Hospital.
After obtaining written informed consent from parents or legal guardians, a structured "Sociodemographic and Screen Use Questionnaire" will be completed in the preoperative waiting area. The questionnaire includes information on daily screen exposure duration, age at first exposure, content type, parental screen use, passive exposure, bedroom screen presence, and previous medical experiences.
Children will be categorized into three groups based on reported daily screen exposure:
<1 hour per day
1-2 hours per day
more than 2 hours per day
Anxiety Assessment
Preoperative anxiety will be assessed immediately before anesthesia induction, either upon entry into the operating room or in the induction area, prior to any pharmacologic intervention.
Anxiety will be measured using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational instrument for children aged 2-12 years. The scale evaluates five behavioral domains (activity, vocalization, emotional expressivity, state of arousal, and interaction with parents). Scores range from 23.3 to 100, with higher scores indicating higher anxiety levels.
Assessment will be performed by a trained anesthesiologist through direct observation without interfering with routine clinical workflow.
Risk and Safety Considerations
This study is non-interventional. No additional medical procedures will be performed. Data collection consists of a parent questionnaire and a single observational anxiety assessment. Therefore, no additional clinical risk is anticipated beyond standard care.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 1 Day
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Low Screen Exposure | – | –Children aged 2-5 years with daily screen exposure less than 1 hour per day, as reported by parents through a structured questionnaire. |
| Moderate Screen Exposure | – | –Children aged 2-5 years with daily screen exposure between 1 and 2 hours per day. |
| High Screen Exposure | – | –Children aged 2-5 years with daily screen exposure greater than 2 hours per day. |
Who may qualify
- Ages
- 2 to 5 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
- Study population
- The study population consists of children aged 2-5 years scheduled for elective surgical procedures under general anesthesia at Kanuni Sultan Süleyman Training and Research Hospital. Participants will be enrolled prospectively after written informed consent is obtained from a parent or legal guardian. Children will be categorized based on parent-reported daily screen exposure duration. Preoperative anxiety will be assessed immediately before anesthesia induction using the Modified Yale Preoperative Anxiety Scale (mYPAS).
Key inclusion criteria (5 listed)
- Children aged 2 to 5 years
- Scheduled for elective surgical procedures under general anesthesia
- American Society of Anesthesiologists (ASA) physical status I-III
- Parent or legal guardian able to provide written informed consent
- Parent able to complete the structured questionnaire in Turkish
Key exclusion criteria (9 listed)
- Premedication administered or planned prior to anxiety assessment
- Emergency surgical procedures
- Known developmental delay or neurodevelopmental disorder
- Known psychiatric disorder
- Visual or hearing impairment that may interfere with behavioral assessment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Preoperative Anxiety Level Assessed by mYPAS Total Score
Time frame: Immediately before anesthesia induction
Preoperative anxiety will be measured using the Modified Yale Preoperative Anxiety Scale (mYPAS), a validated observational tool for children aged 2-12 years. The total score ranges from 23.3 to 100, with higher scores indicating greater anxiety. The primary analysis will compare mYPAS total scores among three daily screen exposure groups (<1 hour/day, 1-2 hours/day, >2 hours/day).
6 secondary outcomes
Association Between Screen Content Type and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction (Day of surgery)
Association Between Parental Monitoring of Screen Content and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction (Day of surgery)
Association Between Passive Screen Exposure and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction
Association Between Reasons for Providing Screen and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction
Association Between Parental Screen Use and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction
Association Between Parental Phone Use During Parent-Child Interaction and Preoperative Anxiety (mYPAS)
Time frame: Immediately before anesthesia induction
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Oct 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Health Science University İstanbul Kanuni Sultan Süleyman Education and Training Hospital
Istanbul, Turkey (Türkiye)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Preoperative Anxiety, run by Kanuni Sultan Suleyman Training and Research Hospital at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 15 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Preoperative Anxiety Level Assessed by mYPAS Total Score (time frame: Immediately before anesthesia induction). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2026.