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. 2024 Sep 24;21(10):1267.
doi: 10.3390/ijerph21101267.

Investigation of Psychometric Properties and Correlation with Psychological Distress after Hurricane Hazards in Puerto Rico

Ruthmarie Hernández-Torres  1 , Mary Rodríguez-Rabassa  2   3 , Lianel P Rosario  2   3 , Cristina Peña-Vargas  2   3 , Zindie Rodríguez-Castro  3 , Idhaliz Flores  3   4 , Francisco Cartujano-Barrera  5 , Rosario Costas-Muñíz  1 , Nelmit Tollinchi-Natali  2   3 , Estefania Torres-Marrero  2 , Ernesto Rosario-Hernández  2 , Heather Jim  6 , Guillermo N Armaiz-Pena  4 , Eida M Castro-Figueroa  2   3
Affiliations

Investigation of Psychometric Properties and Correlation with Psychological Distress after Hurricane Hazards in Puerto Rico

Ruthmarie Hernández-Torres et al. Int J Environ Res Public Health. .

Abstract

Background: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: cancer; hurricanes; natural disasters; psychological distress; psychometric.

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Conflict of interest statement

The authors declare no conflicts of interest. The results abstract was published in the Mental Health 2024 SBM Annual Meeting Abstracts Supplement, Annals of Behavioral Medicine, Volume 58, Issue Supplement_1, April 2024, Pages S1–S705. The abstract is available at https://doi.org/10.1093/abm/kaae014.

Figures

Figure 1
Figure 1
Study methodology.
Figure 2
Figure 2
SEM model.
See this image and copyright information in PMC

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