一名 45 歲憂鬱症患者表示：「我是一個失敗者，活著沒有意義。」護理師哪種回應最具治療性？
A 45-year-old client diagnosed with depression states, 'I am a failure and have no reason to live.' Which response by the nurse is most therapeutic?
- AThings will get better once you start your medication.一旦你開始服藥，情況會好轉的。
- BYou have a lot to live for; don't think like that.你有很多活下去的理由；不要那樣想。
- CWhy do you feel like you are a failure?你為什麼會有這種自己是失敗者的感覺？
- DTell me more about what you are feeling right now.✓ 正解告訴我你現在的感覺更多一些。
面對自殺意念或低自尊表達，首要任務是提供傾聽空間。選項 D 運用開放式問句促進個案探討內心世界，符合治療性溝通原則。A 否認個案感受並強加個人價值觀；B 使用「為什麼」會引發防衛心；D 給予虛假的保證與過度簡化問題，皆非治療性回應。
When confronted with suicidal ideation or expressions of low self-worth, the nurse's first priority is to provide a space for active listening. Option D uses an open-ended statement to encourage the client to explore their inner experience, consistent with therapeutic communication principles. Option B denies the client's feelings and imposes the nurse's personal values; option C's use of 'why' tends to provoke defensiveness; option A offers false reassurance and oversimplifies the problem. None of these are therapeutic responses.
台美在精神護理中皆重視自殺風險評估與傾聽，差別在於美國法律規定護理師須執行標準自殺風險評估工具。