One-minute time interval estimation as a novel potent indicator of emotional concerns in cancer patients prior to starting chemotherapy

  • Ivan Shterev DonevEmail author
  • Dragomir Svetozarov Stoyanov
  • Teodorika Vitalinova Panayotova
  • Martina Stoyanova Ivanova
  • Yavor Kostadinov Kashlov
  • Merlin Erol Efraim
  • Nikolay Vladimirov Conev


Our study explored the potential relationship between time estimation and issues that lead to distress in cancer patients prior to starting chemotherapy. Time estimation was assessed in 375 chemonaïve patients with solid tumors by evaluating each subject’s prospective estimation of how quickly one minute passed compared to the actual time. The median estimated value (40 s) was used to stratify the patients into the two categories of fast and slow time estimation. The National Comprehensive Cancer Network Distress Thermometer (DT) and Problem List (PL) were used at the beginning of treatment to evaluate levels of distress and patient concerns. A fast time estimation correlated significantly with gender and items reported in the emotional domain on the PL. Females exhibited significantly faster time estimation than males. Patients who reported fear, worry and loss of interest in usual activities estimated the one-minute interval significantly faster than patients who did not report such items. In the multivariate logistic regression model, patients who experienced fast time estimation had a higher risk of reporting items in the emotional domain. Time estimation is a novel potent indicator of emotional concerns on the PL. This test is an easily performed, time-saving, nonintrusive, ultrashort screening tool that is suitable even for patients who are not willing to reveal their emotional status via direct questionnaires.


Time estimation Problem list Screening Emotional concern Cancer 


Compliance with Ethical Standards

Ethical Approval

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

Informed Consent

For this type of study, formal informed consent documentation was not required. Verbal consent was obtained.

Conflict of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ivan Shterev Donev
    • 1
    Email author
  • Dragomir Svetozarov Stoyanov
    • 2
    • 3
  • Teodorika Vitalinova Panayotova
    • 2
    • 3
  • Martina Stoyanova Ivanova
    • 2
    • 4
  • Yavor Kostadinov Kashlov
    • 3
  • Merlin Erol Efraim
    • 5
  • Nikolay Vladimirov Conev
    • 2
    • 3
  1. 1.Clinic of Medical Oncology, MHAT “Nadezhda,”SofiaBulgaria
  2. 2.Clinic of Medical OncologyUMHAT “St. Marina,”VarnaBulgaria
  3. 3.Department of Propedeutics of Internal DiseasesMedical University of VarnaVarnaBulgaria
  4. 4.Department of Nursing CareMedical University of VarnaVarnaBulgaria
  5. 5.Department of Internal MedicineMedical University of VarnaVarnaBulgaria

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