PURPOSE: A major trend in research has focused on identification of couple characteristics and dynamics against the backdrop of life-threatening or chronic illness. Awareness of these factors may lead to identification of couples at high risk for severe relationship distress. The researchers obtained an emic perspective of the impact of a breast cancer diagnosis on womens' couple relationships and the response by healthcare providers to such psychosocial issues. DATA SOURCES: This was a phenomenological study of the lived experience of breast cancer patients using a purposive sample of seven women in individual psychotherapy with a history of breast cancer and a focus group of five women from a breast cancer support group. Data analysis was conducted following Colaizzi's framework with five emergent themes identified. Interrater reliability was achieved with data analysis by two other researchers. CONCLUSIONS: Results confirmed that breast cancer may have a profound impact on the couple relationship from diagnosis through survivorship. Relationships with healthcare providers disclosed significant disparities in identification and response to couple distress. IMPLICATIONS FOR PRACTICE: Healthcare providers need to be sensitive to the "silent suffering" that exists for some breast cancer patients and incorporate consistent methods to identify and respond to couple distress.
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