— 心理社會完整性 · MEDIUM · MCQ —
一位患有思覺失調症且有聽幻覺的病人說：「聲音告訴我，妳要在我的食物裡下毒。」護理師應如何回應？
A client with schizophrenia who is experiencing auditory hallucinations says, 'The voices are telling me that you are trying to poison my food.' How should the nurse respond?
- AThere is no one else here, and the food is perfectly safe.這裡沒有其他人，食物非常安全。
- BI understand the voices are real to you, but I do not hear them.✓ 正解我理解這些聲音對你來說很真實，但我聽不到它們。
- CLet's talk about something else to take your mind off the voices.我們來談談別的吧，讓你轉移對聲音的注意力。
- DWhy would you think that I would want to harm you?你為什麼認為我會想傷害你呢？
— Explanation · 中文詳解 —
面對有幻覺的病人，護理師應採取「現實導向」的態度，承認病人的主觀經驗（聲音對他而言是真實的），同時明確表達護理師無法聽到該聲音的客觀事實。這種回應方式既不認同其妄想，也不強行辯駁，能有效建立治療性信任關係。
When caring for a client experiencing hallucinations, the nurse should use a reality-oriented approach by acknowledging the client's subjective experience (the voices are real to the client) while clearly stating the objective fact that the nurse does not hear them. This response neither validates the delusion nor argues against it, and it effectively builds a therapeutic, trusting relationship.
✦ 台美臨床差異
台灣文化中家屬常會過度介入解釋，護理師需特別教導家屬維持中立的溝通技巧。