— 心理社會完整性 · HARD · MCQ —
護理師照顧一位表達悲傷與無望感的老年病人。下列哪項提問最能有效評估自殺意念？
A nurse is caring for an older adult who expresses feelings of sadness and hopelessness. Which question is the most appropriate to assess for potential suicidal ideation?
- AWhy do you feel so sad and hopeless?你為什麼覺得這麼悲傷和絕望？
- BAre you planning to do something to harm yourself?你有計劃要做什麼來傷害自己嗎？
- CHave you ever thought about hurting yourself?你有想過要傷害自己嗎？
- DDo you feel like you want to end your life?✓ 正解你有想結束生命的感覺嗎？
— Explanation · 中文詳解 —
自殺評估應直接且具體。D 選項直接詢問「結束生命」的意圖，最能精準獲取病人是否具備自殺意念的訊息。C 選項僅詢問「傷害自己」，可能被病人解讀為自傷行為而非自殺企圖。A 選項使用「為什麼（Why）」會讓病人產生防衛心。B 選項詢問「計畫」太過具體，應先確認有無自殺意念再進一步評估計畫。
Direct questioning is the gold standard for suicide risk assessment. Option D specifically asks about ending life, which accurately identifies suicidal ideation, whereas asking 'why' (Option A) can be defensive and vague questions (Option C) may confuse self-harm with suicide.
✦ 台美臨床差異
台美皆強調自殺防範教育，但在臨床評估工具上，美國更常規使用 Columbia-Suicide Severity Rating Scale。