護理師照護一位剛得知癌症末期診斷的病人。病人表示：「我不相信檢查結果是對的，我感覺很好。」病人正在使用哪種心理防衛機轉？
A nurse is caring for a client who just received a diagnosis of terminal cancer. The client states, 'I don't believe the test results are correct. I feel fine.' Which defense mechanism is the client using?
- ARationalization合理化（Rationalization）
- BProjection投射（Projection）
- CDisplacement轉移（Displacement）
- DDenial✓ 正解否認（Denial）
當個體面對無法承受的痛苦或威脅時，心理防衛機轉（Defense mechanisms）會自動啟動，以保護自我免受焦慮和壓力。否認（Denial）是其中一種常見且原始的防衛機轉，它涉及拒絕承認現實中令人痛苦或難以接受的事實、想法或感受。這種機轉能暫時提供心理上的緩衝，讓個體有時間逐漸適應創傷性或威脅性情境。然而，長期或過度使用否認可能阻礙個體面對問題並尋求適當的解決方案。護理師在照護此類病人時，應理解其行為背後的心理需求，提供支持性的環境，並逐步引導病人面對現實，而非直接挑戰其否認。
When confronted with overwhelming pain or threat, an individual's psychological defense mechanisms are automatically activated to protect the self from anxiety and stress. Denial is one of the most common and primitive defense mechanisms, involving refusal to acknowledge painful or unacceptable realities, thoughts, or feelings. It can provide temporary psychological cushioning, giving the individual time to gradually adapt to a traumatic or threatening situation. However, prolonged or excessive use of denial may prevent the individual from confronting the problem and seeking appropriate solutions. When caring for such clients, the nurse should understand the underlying psychological need driving the behavior, provide a supportive environment, and gradually guide the client toward facing reality rather than directly challenging the denial.
心理防衛機轉的概念，包括否認、投射、轉移和合理化，是心理學和精神醫學的普世理論，在美國和台灣的臨床實務中均被廣泛應用。護理師在兩地照護病人時，都會學習辨識這些機轉，以更好地理解病人的行為和情緒反應，並提供適當的心理支持。對於末期病人的否認，兩地的護理目標都是提供同理心，不強迫病人立即接受現實，而是給予時間和空間，並在適當時機提供資訊和支持，引導其逐步面對和處理悲傷過程。