— 心理社會完整性 · HARD · MCQ —
一位病人因創傷後壓力症候群（PTSD）表現出症狀。下列哪項護理介入對預防二次創傷是必要的？
A client presents with symptoms of post-traumatic stress disorder (PTSD). Which nursing intervention is essential to prevent re-traumatization?
- AAsking the client to describe the trauma in detail to speed up healing要求病人詳細描述創傷經過以加速康復
- BProviding a safe, predictable environment and informing the client before procedures✓ 正解提供安全且可預測的環境，並在進行處置前告知病人
- CEncouraging the client to watch graphic news coverage of trauma鼓勵病人觀看具衝擊性的創傷新聞報導
- DKeeping the environment busy and unpredictable維持環境忙碌且不可預測
— Explanation · 中文詳解 —
PTSD 患者對環境的掌控感與可預測性極為敏感。為了預防二次創傷，護理師需提供安全、 predictable 的環境，並且在執行任何操作前詳細說明（B）。強迫回憶創傷細節（A）或暴露於不確定環境（D、C）均會誘發驚嚇與症狀惡化。
Clients with PTSD are extremely sensitive to environmental control and predictability. To prevent re-traumatization, the nurse must provide a safe, predictable environment and give a detailed explanation before any procedure is performed (B). Forcing the client to recall traumatic details (A) or exposing them to unpredictable environments (D, C) can trigger startle responses and worsen symptoms.
✦ 台美臨床差異
兩地對於創傷知情護理（Trauma-informed care）的關注度日益提高；美國此類護理準則較為制度化。