Date of Award

Fall 2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Knobf, M. Tish

Abstract

Sleep disturbance is one of the most common and distressing symptoms in breast cancer survivors. Research has shown that sleep disturbance can adversely affect quality of life and clinical outcomes. Younger aged women with breast cancer represent a unique sub-group of survivors and combined with their developmental stage of life, their survivorship experience is distinctive from older women. Sleep health in young women with breast cancer (YWBC) has not been well studied. Cognitive appraisal of breast cancer and how a woman copes with the experience can potentially affect sleep health. Yet, there is lack of evidence on the effect of cognitive appraisal and coping on sleep health. The purpose of this dissertation, using an explanatory sequential mixed methods design, was to describe the sleep experience of YWBC, examine the relationship between contributing factors, cognitive appraisal, coping, and sleep health, and describe sleep health from the perspective of YWBC. The first manuscript, “Sleep health in young women with breast cancer: A narrative study,” synthesized the existing literature on sleep in YWBC and discussed the gap in the literature, supporting the need of further study. The second manuscript, “Factors associated with sleep health among young women after breast cancer treatment,” reports the quantitative findings, specifically, comprehensive sleep health characteristics and significant factors associated with sleep health. In the third manuscript, titled “A Qualitative Study of Sleep in Young Breast Cancer Survivors: “No Longer Able to Sleep Through Night,” I describe the qualitative findings of the sleep experience of young women and the perceived factors that were attributed to disrupted sleep, grounded in their everyday lives across the breast cancer trajectory. The dissertation provides insights for developing future interventions to improve sleep in YWBC and emphasizes the significance of sleep health assessment and management as part of oncology care.

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