title: 'My husband would not help me, so I was driving over there': older rural women experiencing breast cancer with a non-supportive intimate partner.
abstract: BACKGROUND
  This article describes the experiences of older rural women diagnosed with breast cancer while in a non-supportive, and sometimes abusive, intimate relationship. Breast cancer is primarily a disease of older women, and in the USA, a higher percentage of rural women are more than 65 years of age compared with other geographical areas. Many women identify their intimate partner as an important source of support during cancer diagnosis and recovery, but little is known about how women deal with breast cancer while in a relationship self-described as difficult.
  
  
  METHODS
  Semi-structured qualitative interviews were conducted with a convenience sample of nine rural women from community settings in western Virginia and West Virginia. Participants ranged in age from 55 to 84 years at the time of interview (mean 69 years). Age at diagnosis ranged from 53 to 71 years (mean 59.2). Relationship length ranged from 1 to 55 years (mean 28.5). Time between interview and diagnosis ranged from 1 to 31 years (mean 9.8). All were in heterosexual relationships. Breast cancer stage ranged from I to III. Data were analyzed using hermeneutic phenomenological analysis.
  
  
  RESULTS
  Several themes emerged related to the experience of breast cancer with a non-supportive intimate partner in a rural setting. The themes were: driving, gossip, rural location as therapeutic, and community support.
  
  
  CONCLUSIONS
  Older rural women operating without the support of their intimate partner present to oncology treatment with unique challenges, particularly related to distance, financial stress, and sometimes heightened relationship stress. Rural women also reported rural strengths that aided them in their recovery. These findings indicate a need for complete assessments of social network and quality of intimate partner support in the rural oncology care setting.
authors.affiliation: James Madison University, Harrisonburg, Virginia, USA. sawinem@jmu.edu
authors.forename: E M
authors.initials: EM
authors.lastname: Sawin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics / Q000523:psychology* / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D012423:Rural Health; D012747:Sexual Partners / Q000523:psychology*; D012934:Social Isolation / Q000523:psychology; D012944:Social Support; D013179:Spouse Abuse / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D014186:Transportation; D014768:Virginia; D014903:West Virginia