Comparison of the Effects of Personal Versus Hospital-Provided Dolls on Preoperative Anxiety and Postoperative Delirium in Preschool Children
Conditions: Preoperative Anxiety, Emergence Delirium in Pediatric Anesthesia
Sponsor: Ankara City Hospital Bilkent

 
 
 
Comparison of the Effects of Personal Versus 
Hospital-Provided Dolls on Preoperative Anxiety 
and Postoperative Delirium in Preschool Children 
   
 
 
 
 
 
 
 
 
 
 
Document Type: Study Protocol 
Ethics Committee Approval Date: 14 January 2026 
 

Brief Description 
The goal of this study is to evaluate the effects of personal versus hospital-provided dolls 
on preoperative anxiety and postoperative delirium in preschool children aged 3–7 years 
undergoing elective adenoidectomy and/or tonsillectomy. 
Study Design 
This study is designed as a prospective observational study. 
Study Population 
Female children aged 3–7 years scheduled for elective adenoidectomy and/or tonsillectomy 
under general anesthesia. 
Eligibility Criteria 
Inclusion Criteria:  Female children aged 3–7 years• Scheduled for elective adenoidectomy 
and/or tonsillectomy under general anesthesia• Able to communicate verbally• ASA 
physical status I or II, according to the American Society of Anesthesiologists 
classification• Written informed consent obtained from a parent or legal guardian 
Exclusion Criteria: Presence of psychiatric, neurological, or developmental disorders• 
Presence of chronic pain or ongoing medical treatment that may affect anxiety levels• 
Refusal to participate despite repeated encouragement by the investigators• Use of 
additional anxiety-reducing methods or medications outside the study protocol prior to 
intervention• Previous surgical experience 
Study Procedures 
Eligible participants will be observed during the routine perioperative period and 
categorized into one of three groups based on doll use: hospital-provided doll, personal 
doll, or no doll. Preoperative anxiety levels will be assessed at predefined time points using 
standardized anxiety scales. Serum cortisol levels will be measured from an additional 
blood sample obtained during routine intravenous cannulation without requiring any extra 
invasive procedures. Postoperative emergence delirium will be evaluated in the post-
anesthesia care unit using a validated pediatric delirium scale. 
Outcome Measures 
Preoperative anxiety will be assessed using the Modified Yale Preoperative Anxiety Scale 
(m-YPAS) and Visual Analog Scale for Anxiety (VAS-A). Postoperative emergence 
delirium will be assessed using the Pediatric Anesthesia Emergence Delirium (PAED) 
scale. 
Timing of Assessments 
Preoperative assessments: waiting area, before transfer, during transfer, before anesthesia 
induction. 
Postoperative assessments: immediately after extubation, upon admission to the post-
anesthesia care unit, and 30 minutes after admission. 

 
Statistical Analysis 
Descriptive statistics will be used. Between-group comparisons will be performed using 
appropriate parametric or non-parametric tests based on data distribution. A p-value < 0.05 
will be considered significant. 
Ethics 
The study will be conducted in accordance with the Declaration of Helsinki. Ethics 
committee approval and written informed consent from parents/legal guardians will be 
obtained.