Measuring cancer patients' psychological distress and well-being: a factor analytic assessment of the Mental Health Inventory

This study examined the psychometric structure of the Mental Health Inventory (MHI) in 433 cancer patients. Using structural equation modeling, confirmatory factor analyses (CFAs) were conducted. Next, exploratory factor analysis (EFA) was used to explore an alternative MHI factor structure with a randomly chosen subsample. Finally, CFAs were conducted on 6 MHI models with the second subsample. Convergent validity was examined by administering the Positive and Negative Affect Schedule (PANAS) and the Dyadic Adjustment Scale (DAS). The CFAs with the original MHI factor structure indicated inadequate fit, supporting the need to conduct an EFA. Results of the EFA indicated support for a 5-factor solution but numerous differences in item factor loadings. The CFA indicated that the 5-factor correlated model was the best fitting model. Correlations between the PANAS and the DAS with the MHI provided preliminary support for the convergent validity of the MHI. Together, these results indicate that the original MHI factor structure may require modification for use in patients with cancer.