一位 45 歲患有廣泛性焦慮症的個案至診所就診，主訴心悸與失眠。護理師應優先使用哪種治療性溝通技巧？
A 45-year-old client with a history of generalized anxiety disorder presents to the clinic reporting frequent palpitations and insomnia. Which therapeutic communication strategy should the nurse use first?
- AAsk the client why they are feeling anxious today詢問病人今天為何感到焦慮
- BChallenge the irrational beliefs causing the anxiety挑戰引起焦慮的非理性信念
- COffer broad openings to encourage the client to talk✓ 正解提供開放式引導以鼓勵病人談話
- DProvide reassurance that everything will be fine提供一切都會沒事的安慰
對於焦慮個案，開放式問句能給予個案表達感受的空間，有助於建立治療性關係並蒐集資料。提供保證（D）會否認個案的真實感受；詢問「為什麼」（A）常帶有批判性，容易使個案防衛；挑戰認知（B）屬於認知行為治療，需在建立良好關係後進行，非優先步驟。
For an anxious client, broad openings provide space for the client to express feelings and help build a therapeutic relationship while gathering data. Offering reassurance (D) denies the client's actual experience; asking 'why' (A) is often perceived as critical and tends to provoke defensiveness; and challenging cognitions (B) belongs to cognitive behavioral therapy and should be done only after a good rapport has been established, so it is not the first step.
美國護理教育極度強調治療性溝通技巧（Therapeutic Communication），台灣臨床常因忙碌而直接進入衛教或評估，溝通技巧應用較為鬆散。