— 心理社會完整性 · MEDIUM · MCQ —
一位病人表示：「我覺得沒人在乎我，我的生命沒有意義。」哪種反應最具有治療性？
A nurse is interviewing a client who states, 'I feel like nobody cares about me, and my life has no meaning.' What is the most appropriate therapeutic response?
- AYou have a lot to live for; let's talk about the positives.你有很多活下去的理由；讓我們來談談積極的一面。
- BYou seem to be feeling very alone right now.✓ 正解你現在似乎感到非常孤獨。
- CWhy do you feel that your life is meaningless?你為什麼覺得你的生命沒有意義？
- DAre you thinking about hurting yourself?你有傷害自己的念頭嗎？
— Explanation · 中文詳解 —
此題考驗治療性溝通技巧（反映情感）。反映情感能展現對病人感受的同理與傾聽。A 使用「為什麼」過於質詢，易導致病人防衛；A 屬於錯誤的勸慰，否定了病人的痛苦；D 雖然重要，但在建立同理連結後再進行自殺評估更為順暢，B 是最能鼓勵病人持續表達的選項。
This question tests therapeutic communication via reflection of feeling. Option B names the client's emotion and validates the experience, inviting further expression. 'Why' questions feel interrogating; false reassurance dismisses the pain; direct suicide assessment is essential but is more effective after the nurse establishes rapport and acknowledges the feelings.
✦ 台美臨床差異
美國護理教育極度強調治療性溝通技巧（Therapeutic communication）；台灣臨床受限於時間，溝通模式較偏向事務性。