一位剛被診斷出癌症末期的病人對護理師說：「我知道檢驗報告一定是錯的，我感覺很好，這輩子沒這麼健康過。」該病人正在使用哪種防衛機轉？

此案例展現了典型的「否認（Denial）」防衛機轉。否認是一種心理策略，個人透過拒絕承認痛苦的現實或事實，來保護自我免受過度焦慮的威脅。在面對末期疾病的早期階段，這也是庫伯羅絲（Kübler-Ross）悲傷五階段的第一階段。病人雖然客觀上收到了檢驗報告，但心理上無法負荷如此巨大的打擊，因此直接否定事實。護理師此時的重點不應是強迫病人接受事實，而是提供支持性的環境，等待病人準備好後再進一步討論。其他選項如潛抑（Displacement）是將情緒轉移到他人身上；投射（Projection）是將自己的負面念頭歸咎於他人；合理化（Rationalization）則是為行為找藉口。

This case illustrates the classic defense mechanism of denial. Denial is a psychological strategy in which an individual refuses to acknowledge a painful reality or fact in order to protect the self from overwhelming anxiety. In the early stages of facing a terminal illness, this is also the first stage of Kübler-Ross's five stages of grief. Even though the patient has objectively received the laboratory results, the psychological impact is too great to bear, and they therefore directly deny the facts. The nurse's focus at this stage should not be to force the patient to accept reality but to provide a supportive environment and wait until the patient is ready for further discussion. Other options include displacement, which involves shifting feelings from a threatening target to a less threatening one; projection, attributing one's own unacceptable thoughts to others; and rationalization, providing logical-sounding excuses for one's behavior.

美國醫護溝通強調『誠實告知（Full disclosure）』，並尊重病人的心理進程；台灣臨床上，家屬常要求醫護人員對病人隱瞞末期診斷，這使得護理師在處理病人的否認機轉時，面臨更複雜的倫理困境。