— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症個案說：「收音機在傳送關於我的秘密暗號。」護理師應如何回應？
A client with schizophrenia mentions, 'The radio is sending secret codes about me.' How should the nurse respond?
- ASuggest that the client turn off the radio to get some rest建議病人關掉收音機以獲得休息
- BAsk the client what the codes are saying about them詢問病人暗號說了關於他的什麼內容
- CAcknowledge the client's experience but validate your own reality✓ 正解肯定病人的經驗，但驗證你自己的現實
- DTell the client that the radio cannot send secret codes告訴病人收音機無法傳送秘密暗號
— Explanation · 中文詳解 —
護理師應採用肯定事實的原則，承認病人的體驗（這對他而言是真實的），但同時表達自己並未觀察到相同的現象。直接否認會破壞治療性關係，過度詢問內容可能增強幻聽。重點是轉移關注點至個案的感受，而非幻聽內容本身。
The nurse should adopt the principle of validating reality, acknowledging the client's experience (it feels real to him) while also expressing that the nurse does not observe the same phenomenon. Directly denying the experience would damage the therapeutic relationship, while over-questioning the content may reinforce the hallucination. The focus should be on the client's feelings rather than the content of the hallucination itself.
✦ 台美臨床差異
台美護理教育均強調不與妄想辯論，但美國更強調個案自主權與參與治療計畫；台灣臨床仍偶有過度依賴強制用藥的情形。