一位高齡個案近期被診斷出末期癌症，他對護理師說：「我這輩子活得很精彩，我不再害怕死亡了。」請問個案正處於哪一個悲傷階段？
A nurse is caring for an older adult who was recently diagnosed with terminal cancer. The client says, 'I have lived a full life, and I am not afraid of death anymore.' Which stage of grief is the client demonstrating?
- ABargaining討價還價
- BAcceptance接受正確答案
- CAnger憤怒
- DDepression憂鬱
- B接受
庫布勒-羅絲（Kübler-Ross）的悲傷五階段理論包含：否認、憤怒、討價還價、憂鬱與接受。個案能坦然面對生命總結，且表達對死亡的釋懷，這是典型的「接受」（Acceptance）階段特徵。在此階段，個案不再對抗命運，情緒趨於平靜。憤怒（C）通常表現為對周遭人員的排斥；討價還價（A）多涉及對宗教或奇蹟的期盼；憂鬱（D）則伴隨深刻的哀傷與退縮。護理目標在於尊重個案的選擇，並維持其舒適感與尊嚴。臨床上，辨識個案的心理狀態對執行安寧護理規劃至關重要，接受階段的個案往往更傾向於討論遺願清單或生命末期計畫，護理師應給予正向的回饋與支持，而非誤以為這是病情的惡化，反而是心理成熟與整合的表現。
- A討價還價
討價還價是為了尋求延長壽命，常伴隨著『如果我再做什麼什麼，是否能多活一陣子』的語句，並非接受結局。
- B · 正確答案接受
接受代表個案已整合過往經歷，對生命結局抱持平和態度，這是靈性安寧的最高展現，護理師應給予最大的尊重與陪伴。
- C憤怒
憤怒階段通常包含指責醫療團隊、家人或自我，表現出憤世嫉俗的態度，與個案平靜接受生命盡頭的態度明顯不同。
- D憂鬱
憂鬱階段是個案意識到失去的真實性而產生的哀痛，表現為無力感與悲傷，而非個案所言的『精彩人生』之釋懷。
美國安寧護理極度重視『生命意義評估』，護理師常主導這類評估；台灣臨床多由社工師或諮商心理師協助進行靈性評估，護理師若發現此類情緒變化，通常會轉介給安寧照護團隊，較少由單一護理師完成全套心理諮商。
English explanation
Kubler-Ross's five stages of grief include denial, anger, bargaining, depression, and acceptance. A client who calmly faces life closure and expresses peace about death exhibits the typical features of the 'acceptance' stage. At this stage, the client no longer fights fate, and emotions become calm. Anger (C) is usually expressed as rejection of those around them; bargaining (A) often involves pleas to religion or for a miracle; depression (D) is accompanied by deep sorrow and withdrawal. The nursing goal is to respect the client's choices and maintain their comfort and dignity. Clinically, recognizing the client's psychological state is crucial for end-of-life care planning. Clients in the acceptance stage are often more inclined to discuss bucket-list items or end-of-life plans, and the nurse should offer positive feedback and support rather than mistaking this for clinical deterioration; it is in fact a manifestation of psychological maturity and integration.
最近修訂：2026-09-29