一位思覺失調症病患聲稱：「電視正傳遞秘密訊息叫我不要進食。」下列何者為最具治療性的回應？
A nurse is caring for a client with schizophrenia who claims, 'The television is sending me secret messages to stop eating.' What is the most therapeutic response?
- AI don't hear any messages coming from the television.我沒有聽到電視傳來任何訊息。
- BYou need to ignore those messages so you can stay healthy.你需要忽略那些訊息，這樣才能保持健康。
- CWhy would the television want you to stop eating?為什麼電視會想要讓你停止進食呢？
- DThat sounds like a scary thought, but I don't see any messages.✓ 正解這聽起來很嚇人，但我沒看到任何訊息。
護理原則為認同病人感到的恐懼情緒，但同時堅持客觀現實，不與幻覺爭辯也不予支持。D 選項既回應了病人的感受，又委婉點出護理師客觀觀察到的現實，有助於建立治療性關係。A 選項較為冷漠；C 選項詢問動機易陷入幻覺內容；B 選項則帶有說教意味，病人可能無法聽進。
The nursing principle is to acknowledge the client's emotional fear while still adhering to objective reality, neither arguing with nor supporting the hallucination. Option D both acknowledges the client's feelings and gently states the nurse's objective perception of reality, helping to build a therapeutic relationship. Option A is rather cold; option C, by asking about motivation, risks engaging with the content of the delusion; option B has a preachy tone and is unlikely to be effective for the client.
兩地護理教育皆強調「Validation therapy」與現實導向，惟台灣臨床溝通中有時傾向於過度安撫而缺乏現實連結。