護理師照護一位末期癌症個案,個案處於哀傷五階段中的「憤怒期」。護理師預期會觀察到什麼行為?
A nurse is caring for a client with terminal cancer who is in the anger stage of grief. Which behavior should the nurse expect?
- AThe client expresses a desire to try experimental treatments.病人表達嘗試實驗性治療的意願
- BThe client refuses to believe the diagnosis.病人拒絕相信診斷結果
- CThe client withdraws from all family interaction.病人退出所有家庭互動
- DThe client makes frequent complaints about nursing care.✓ 正解病人頻繁抱怨護理照護
病人在面對末期疾病時,常經歷「哀傷五階段」(Kubler-Ross model):否認(Denial)、憤怒(Anger)、討價還價(Bargaining)、憂鬱(Depression)、接受(Acceptance)。此題的病人處於憤怒期,這種情緒反應是病人應對死亡威脅的一種機制。 在憤怒期,病人常會將內心的恐懼、無助感和對疾病的不公平感,轉嫁到周圍的人事物上。因此,護理師最可能預期到的是病人對照護品質、醫護人員、家屬,甚至對上帝表達不滿或抱怨(D)。這是一種將痛苦外化的表現,並非針對個人,而是對無法掌控的局面所產生的情緒宣洩。 選項 B(否認診斷)是哀傷的早期階段。選項 A(嘗試實驗性治療)可能出現在討價還價階段,病人試圖透過尋求新療法來爭取時間或治癒的可能性。選項 C(退出社交)更像是憂鬱期的表現,病人因絕望而退縮。 臨床思路(Psychosocial Integrity / Grief and Loss):理解病人哀傷階段的行為特徵,是提供有效情感支持與心理照護的基礎。護理師應保持同理心,不將病人的憤怒視為針對個人,而是協助其度過這個階段。
When facing terminal illness, patients commonly go through the 'five stages of grief' (Kubler-Ross model): denial, anger, bargaining, depression, and acceptance. The patient in this scenario is in the anger stage, an emotional response that is a coping mechanism for the threat of death. In the anger stage, patients often displace their inner fear, helplessness, and sense of unfairness about the illness onto the people and things around them. Therefore, the nurse should most expect the patient to voice dissatisfaction or complaints about the quality of care, healthcare providers, family members, or even God (D). This externalization of suffering is not directed at any individual but is an emotional release in response to a situation the patient cannot control. Option B (denying the diagnosis) is an early stage of grief. Option A (trying experimental treatment) may appear during the bargaining stage, as the patient seeks new therapies to gain time or the possibility of cure. Option C (social withdrawal) is more characteristic of the depression stage, in which the patient withdraws because of despair. Clinical reasoning (Psychosocial Integrity / Grief and Loss): Understanding the behavioral characteristics of each grief stage is the foundation for providing effective emotional support and psychosocial care. The nurse should remain empathetic, not take the patient's anger personally, and help the patient work through this stage.