Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
School of Behavioral & Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico.
Int J Environ Res Public Health. 2024 Sep 24;21(10):1267. doi: 10.3390/ijerph21101267.
Puerto Rico (PR) is highly vulnerable to hurricanes, which severely impact cancer survivors by causing healthcare disruptions and increasing stress. This study investigates the reliability and factor structure of the Hurricane Hazards Inventory (HHI) and its relationship with psychological distress among cancer survivors and non-cancer controls in PR.
Using secondary data from a longitudinal study following Hurricane Maria (HM), the baseline assessment included sociodemographic data from participants, HHI, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7). Statistical analyses involved descriptive statistics, Exploratory Factor Analysis (EFA), and Partial Least Squares Structural Equation Modeling (PLS-SEM).
Among 260 participants, 78.7% were women, with a median age of 58.0 years. EFA reduced the HHI to 17 items grouped into three factors explaining 62.6% of the variance with excellent reliability (Cronbach's alpha 0.91). The three factors also showed good to excellent reliability (alpha 0.81 to 0.92). The median HHI score was 11.0 (range 4.0-26.5) out of 68. PLS-SEM revealed a direct effect of being a cancer survivor and tertiary hazards on depression and anxiety.
The HHI is a valid and reliable tool for assessing mental health impact in cancer survivors after hurricanes. However, the study had limitations, including its small sample size and lack of control for all confounding variables. Future research with larger and more diverse samples is needed to further validate the HHI and examine its generalizability.
波多黎各（PR）极易受到飓风的影响，飓风会导致医疗保健中断和压力增加，从而严重影响癌症幸存者。本研究旨在调查飓风危害清单（HHI）在 PR 地区癌症幸存者和非癌症对照人群中的可靠性和因子结构，以及其与心理困扰之间的关系。
利用一项跟踪飓风玛丽亚（HM）影响的纵向研究的二手数据，基线评估包括参与者的社会人口统计学数据、HHI、患者健康问卷（PHQ-8）和广泛性焦虑障碍（GAD-7）。统计分析包括描述性统计、探索性因子分析（EFA）和偏最小二乘结构方程建模（PLS-SEM）。
在 260 名参与者中，78.7%为女性，中位年龄为 58.0 岁。EFA 将 HHI 简化为 17 个项目，分为三个因子，解释了 62.6%的方差，具有极好的可靠性（Cronbach's alpha 0.91）。这三个因子也具有良好到极好的可靠性（alpha 0.81 到 0.92）。HHI 的中位数得分为 11.0（范围 4.0-26.5），满分为 68。PLS-SEM 显示癌症幸存者和三级危害对抑郁和焦虑有直接影响。
HHI 是一种评估癌症幸存者在飓风后心理健康影响的有效且可靠的工具。然而，该研究存在一些局限性，包括样本量小且无法控制所有混杂变量。未来需要进行更大、更多样化样本的研究，以进一步验证 HHI 的有效性，并检验其普遍性。
