— 心理社會完整性 · HARD · MCQ —
一位臨終癌症個案表達想要結束生命。護理師下列哪句話最能給予支持？
A nurse is caring for a client with terminal cancer who expresses a wish to end their life. Which statement by the nurse best supports the client at this stage?
- ALet's focus on the positive things that happened today.讓我們專注於今天發生的好事。
- BI will contact the chaplain to come talk to you about these thoughts.我會聯絡牧靈人員來與你談論這些想法。
- CI hear that you are in a lot of pain and feeling hopeless right now.✓ 正解我聽到你現在非常痛苦且感到絕望。
- DYou shouldn't feel that way; you have a lot to live for.你不應該有這種感覺；你還有許多值得活下去的理由。
— Explanation · 中文詳解 —
此題重點在於「反射性傾聽」。當面對臨終痛苦時，否認（D）或轉移（A）都是阻斷式溝通。護理師應反映其痛苦感，這能為個案提供情緒出口。直接找牧師（B）雖可參考，但應先親自探詢個案感受，建立深度支持後再進行轉介。
Reflective listening is the most therapeutic response when a terminal client expresses suffering. Naming and acknowledging the pain and hopelessness invites further sharing and validates the client's experience. Denying the feelings (D) or shifting to positives (A) shuts down communication; calling the chaplain (B) may be appropriate later but should not preempt the nurse's own presence and empathic engagement.
✦ 台美臨床差異
台灣受儒家文化影響，討論自殺意念時家屬干預較多；美國文化較強調個案自主權與專業諮商。