title: Balancing uncertainty and acceptance: understanding Chinese women's responses to an abnormal cervical smear result.
abstract: OBJECTIVE
  The aims of this study were to examine the responses of Hong Kong Chinese women receiving an abnormal smear result and to compare any differences in responses depending on the diagnosis of the abnormal smear.
  
  
  BACKGROUND
  The implementation of cervical screening programmes has resulted in an increasing number of women receiving an abnormal smear result requiring cytological surveillance or referral for colposcopy. Evidence suggests that women frequently misunderstood such results, believing that they already have cancer. However, little is known about the responses of Chinese women in this situation.
  
  
  METHODS
  An exploratory qualitative study.
  
  
  METHODS
  Face-to-face semi-structured tape-recorded interviews were undertaken with 66 women sampled opportunistically from an urban centre of a major non-governmental service provider. Amongst this sample, 22 women required cytological surveillance, 20 required treatment for vaginitis and 24 were referred for colposcopy. Thematic analysis was undertaken of the translated interviews within and across groups to identify categories and themes illustrating women's responses to an abnormal smear result.
  
  
  RESULTS
  An important difference in the comparison of the data sets was that of women's understanding of the cause of the abnormal result. Women with vaginitis understood the cause of their abnormality, whereas those in the other groups remained unclear about their abnormality, generating feelings of fear and uncertainty. Trust in practitioners influenced women's acceptance of the result.
  
  
  CONCLUSIONS
  Although responses of Chinese women are similar to those in other population groups, with those referred for colposcopy experiencing greater anxiety than those undergoing cytological surveillance, balancing feelings of uncertainty and acceptance influenced Chinese women's responses to their abnormal results and allowed them to make sense of their result in their everyday life. Trust in the practitioner was essential to the acceptance of their result.
  
  
  CONCLUSIONS
  Such findings highlight implications for nursing practice, in particular developing information-giving strategies and targeted information to help women manage feelings of uncertainty. The importance of trusting professional relationships in determining women's acceptance of an abnormal result is also highlighted. The findings suggest nurses working with Chinese women should consider the underlying influence of culture on women's beliefs and actions.
authors.affiliation: The Nethersole School of Nursing, Esther Lee Building, The Chinese University of Hong Kong, Shatin, New Territories, China. sftwinn@cuhk.edu.hk
authors.forename: Sheila
authors.initials: S
authors.lastname: Twinn
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D001294:Attitude to Health / Q000208:ethnology*; D002681:China / Q000208:ethnology; D003127:Colposcopy / Q000523:psychology; D003466:Cultural Characteristics; D004522:Educational Status; D005260:Female; D006301:Health Services Needs and Demand; D006723:Hong Kong; D006801:Humans; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D036301:Qualitative Research; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D035501:Uncertainty; D002577:Uterine Cervical Diseases / Q000208:ethnology / Q000473:pathology; D014626:Vaginal Smears / Q000523:psychology*; D014930:Women / Q000193:education / Q000523:psychology*