Association between Stressors after Hurricanes Irma and María and Psychological Distress in Patients with Active Breast and Colorectal Cancer Treatment

Abstract

Objective: This study aimed to explore the stressors faced by breast and colorectal cancer patients following Hurricanes Irma and María in Puerto Rico and to evaluate their association with post-hurricane psychological distress. Methods: A telephone-based survey was conducted with 241 cancer patients (140 with breast cancer and 101 with colorectal cancer) aged ≥40 years, diagnosed at least six months before September 2017, and undergoing treatment at the time of the hurricanes. Data on traumatic stressors (e.g., experiences directly related to life-threatening situations), non-traumatic stressors (e.g., difficulties accessing basic needs), and psychological distress (measured using the Kessler 6-item Psychological Distress Scale) were collected. Poisson regression estimated the prevalence ratio (PR, 95% CI) for psychological distress according to hurricane-related stressors, adjusting for age, cancer type, pre-hurricane preparedness, and social support. Results: Nearly 25% of participants faced traumatic stressors, 57.5% were exposed to nontraumatic stressors, and 45.6% presented elevated psychological distress. Those who faced traumatic and nontraumatic stressors demonstrated elevated psychological distress compared to their counterparts (PR=1.73, 95% CI=1.36, 2.20; PR=1.69, 95% CI=1.21, 2.35; respectively) after adjusting for age, cancer type, pre-hurricane preparedness, and social support. Conclusion: Breast and colorectal cancer patients experienced heightened psychological distress due to exposure to various hurricane-related stressors. It is crucial to prioritize an action plan that addresses disaster preparedness, response, and the mental well-being of vulnerable populations like cancer patients to enhance their overall health and resilience.