— 心理社會完整性 · MEDIUM · MCQ —
一位精神分裂症病人正在經歷聽幻覺。護理師下列哪種回應展現了有效的治療性溝通策略？
A client with schizophrenia is experiencing auditory hallucinations. Which response by the nurse demonstrates an effective therapeutic communication strategy?
- AIt must be distressing for you to hear voices that others cannot hear✓ 正解聽到他人聽不到的聲音一定讓你很痛苦
- BTell me more about what the voices are saying to you告訴我那些聲音對你說了些什麼
- CI don't hear any voices, so you should stop talking to them我沒聽到任何聲音，所以你應該停止跟它們說話
- DThe voices are not real, so you should focus on reality那些聲音不是真的，所以你應該專注於現實
— Explanation · 中文詳解 —
治療性溝通的核心是接納病人的感受，而非辯論幻覺的真實性。承認病人的痛苦能建立信任感。否定或辯論（C、D）會引發對立，深化病人與護理師的疏離感。深入探討幻覺內容（B）可能會增強幻覺的真實感，應引導病人聚焦於現實活動。
The core of therapeutic communication is to acknowledge the patient's feelings rather than debate the reality of the hallucinations. Recognizing the patient's distress builds trust. Denying or arguing (C, D) provokes conflict and deepens the patient's sense of alienation. Probing deeply into the content of the hallucinations (B) may reinforce their perceived reality; the nurse should redirect the patient toward reality-based activities.
✦ 台美臨床差異
美國強調病人中心照護與同理心；台灣臨床因工作量大，護理師常受限時間而偏向指令式溝通。