Time estimation is associated with the levels of distress in patients prior to starting radiotherapy

Purpose or objective: The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy.

Materials and methods: In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress.

Results: The time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75- 0.85, p < 0.001) and with a sensitivity of 77.8 % and specificity of 73.3 %. In a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress (OR 0.136; 95 % CI, 0.072---0.256, p < 0.001).

Conclusion: Time estimation is a novel potent indicator of high levels of distress in cancer patients prior starting of radiotherapy.