Master of Arts (Counselling & Guidance)

Nasopharyngeal carcinoma (NPC) patients have been shown to demonstrate worse impairment in psychosocial functioning compared to cancers of other sites. Therefore, NPC patients that undergo cancer treatment are at a higher risk of developing emotional distress (i.e. anxiety and depression), which is likely to manifest as somatic symptoms that may overlap with or worsen the side effects of Radiation Therapy (RT) treatment. Hence, it would be useful to look into the psychological aspects of somatic symptoms in RT patients with NPC, so as to provide better care for them and improve their cancer experience. The main objective for this study is to examine whether illness representations, response expectancies, and emotional distress are related to somatic symptoms of patients with NPC during and after their RT.

The study reported in this dissertation is a part of a larger study conducted at the National Cancer Centre Singapore (NCC). A sample of 43 NPC patients from the Division of Radiation Oncology at NCC was recruited over a period of 6 months. They were asked to fill-in questionnaires that measured illness representations, response expectancies, emotional distress, and somatic symptoms before (Time 1), during (Time 2 to 4) and 1 month (Time 5) after completing their RT treatment. The results highlighted a few significant correlations between the variables. The findings indicated that beliefs in negative consequences were positively correlated with anxiety and depression before treatment. In addition, pre-treatment anxiety was also found to be positively associated with beliefs in a cyclical timeline. On the other hand, depression displayed inverse associations with personal control. The findings also indicated that participants with pre-treatment anxiety had increased expectations of symptoms experienced during RT. Increased levels of depression was linked to greater severity of somatic symptoms at Time 2, while increased levels of anxiety was associated with greater severity of somatic symptoms at Time 3 and Time 5.

On the other hand, the results did not show significant correlations between illness representations and emotional distress during RT, illness representations and somatic symptoms during RT, response expectancies and somatic symptoms experienced during RT, as well as doctors’ assessment of the side effects and the participants' self-reported somatic symptoms throughout RT. The main limitation of the current study was the small sample size, especially for the longitudinal data. The many non-significant correlations in the results are probably due to a Type II error caused by the small sample size. It is likely that a much larger sample size will yield more significant results when the larger study is completed in mid-2016.