Skip to main content
OpenTrials
Completed

NCT Number: NCT07842627

Smartphone-Based Cartoon Distraction During Cast Removal in Children

Cast removal can cause considerable fear and anxiety in children despite being a generally painless procedure. This randomized controlled trial evaluated whether watching a cartoon on a smartphone during circumferential upper-extremity cast removal reduces procedure-related fear and behavioral distress in children aged 4 to 12 years compared with standard care. Participants were randomly assigned in a 1:1 ratio to standard cast removal alone or standard cast removal combined with smartphone-based cartoon distraction. The primary outcome was fear assessed using the Children's Fear Scale (CFS). Secondary outcomes included behavioral distress assessed using the Observational Scale of Behavioral Distress-Revised (OSBD-R) and pulse rate measured by pulse oximetry.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Anxiety Anxiety Disorders Fear Mental Disorders

Age range

4 year–12 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ankara Atatürk Sanatorium Training and Research Hospital

Ankara, 06380, Turkey (Türkiye)

About this study

Children aged 4 to 12 years undergoing removal of a short- or long-arm circumferential cast were included in this single-center randomized controlled trial. Eligible participants were assigned to either a control group or a smartphone-based distraction group.

In the control group, children underwent the routine cast-removal procedure after they and their families were informed about the procedure and the safety of the vibrating cast saw. In the intervention group, the same standard care was provided, and children additionally watched a standardized age-appropriate cartoon on a smartphone during cast removal. The selected cartoon was "Rafadan Tayfa, Episode 91: Health Guardians." No pharmacological agents were used for anxiety management in either group.

Fear, behavioral distress, and physiological response associated with cast removal were evaluated using the Children's Fear Scale, the Observational Scale of Behavioral Distress-Revised, and pulse rate measured by pulse oximetry.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Children aged 4 to 12 years. Scheduled to undergo removal of a short- or long-arm circumferential plaster cast at the orthopedic clinic.

Exclusion criteria

Presence of a neurological disorder that could affect assessment of fear, anxiety, or behavioral responses.

Presence of a cognitive disorder that could interfere with study participation or outcome assessment.

Treatment and study plan

Smartphone-Based Cartoon Distraction

Behavioral

Participants watched a standardized age-appropriate cartoon on a smartphone during the cast-removal procedure as a passive distraction intervention.

Standard Cast Removal Care

Other

Standard cast removal was performed after the child and family had been informed about the procedure and the safety of the vibrating cast saw.

Primary outcomes

  1. Children's Fear Scale (CFS) Score

    Time frame: During the cast-removal procedure

    Fear associated with the cast-removal procedure was assessed using the Children's Fear Scale (CFS), a five-face scale ranging from 0 to 4. Higher scores indicate greater fear.

Secondary outcomes

  1. Observational Scale of Behavioral Distress-Revised (OSBD-R) Score

    Time frame: During the cast-removal procedure

    Behavioral distress during the cast-removal procedure was assessed using the Observational Scale of Behavioral Distress-Revised (OSBD-R), which evaluates observable behavioral and emotional responses during the procedure. Higher scores indicate greater behavioral distress.

  2. Peak Pulse Rate During Cast Removal

    Time frame: During the cast-removal procedure

    Peak pulse rate during the cast-removal procedure was measured noninvasively using pulse oximetry as an objective physiological indicator of procedure-related stress. Values were recorded in beats per minute.

Interested in participating?

Completed

Looking for future studies?

Notify Me

Sponsors and collaborators

Lead sponsor

Caner Oguk

Other Gov

Registry information

Official study title

Does Watching Cartoons During Circular Cast Removal Reduce Anxiety and Fear in Children?

Acronym: CAST-REMOVE

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Sep 25, 2026
Registry last updated
Sep 25, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.