Intervening to reduce anxiety for women with mild dyskaryosis: do we know what works and why?

In the United Kingdom women are encouraged to attend their general practice for cervical smear testing. Those who subsequently receive a mildly dyskaryotic result are placed under surveillance for 6 months before a further test is carried out. Receipt of a mildly abnormal result has been found to create anxiety in some women although it is suggested that this may be relieved by a specifically designed educational intervention. The qualitative investigation reported here explored the interaction which occurred during 10 nurse-patient consultations during which a practice nurse presented an educational intervention designed to relieve anxiety delivered as part of a randomized controlled trial. The investigation highlights factors relating to aspects of the intervention perceived by patients and nurses as successful and as unsuccessful. Implications for the management of women with mildly dyskaryotic results and for future nurse-led educational interventions are proposed. The need for appropriate training for practice nurses is underlined. It is suggested that training should aim to assist the nurse to identify the patient's needs in order that interventions can be individually tailored and delivered effectively without creating anxiety with regard to other aspects of health.