Sawin E M
James Madison University, Harrisonburg, Virginia, USA.
Rural Remote Health. 2010 Oct-Dec;10(4):1536. Epub 2010 Nov 19.
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.
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.
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.
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.
本文描述了农村老年女性在处于缺乏支持、有时甚至是虐待性的亲密关系中被诊断出患有乳腺癌的经历。乳腺癌主要是老年女性的疾病，在美国，与其他地理区域相比，农村地区65岁以上的女性比例更高。许多女性认为亲密伴侣是癌症诊断和康复期间重要的支持来源，但对于女性在自述困难的关系中如何应对乳腺癌却知之甚少。
对来自弗吉尼亚州西部和西弗吉尼亚州社区环境的9名农村女性进行了便利抽样的半结构化定性访谈。访谈时参与者年龄在55至84岁之间（平均69岁）。诊断时的年龄在53至71岁之间（平均59.2岁）。关系持续时间从1年到55年不等（平均28.5年）。访谈与诊断之间的时间间隔从1年到31年不等（平均9.8年）。所有参与者均处于异性恋关系。乳腺癌分期从I期到III期。采用诠释现象学分析方法对数据进行分析。
出现了几个与农村环境中缺乏支持的亲密伴侣陪伴下的乳腺癌经历相关的主题。这些主题是：开车、流言蜚语、农村环境的治疗作用以及社区支持。
在没有亲密伴侣支持的情况下，农村老年女性在接受肿瘤治疗时面临独特的挑战，特别是与距离、经济压力以及有时加剧的关系压力有关。农村女性还报告了有助于她们康复的农村优势。这些发现表明，在农村肿瘤护理环境中，需要对社交网络和亲密伴侣支持质量进行全面评估。
