— 心理社會完整性 · MEDIUM · MCQ —
一位 16 歲第一型糖尿病病人對於自我管理感到抗拒。下列哪種反應展現了治療性做法？
A 16-year-old client with type 1 diabetes is struggling with adherence. Which response indicates a therapeutic approach?
- A'I will inform your parents if you don't take your insulin.''如果你不打胰島素，我會告訴你的父母。'
- B'You need to realize that your health is at risk.''你需要體認到健康正處於危險之中。'
- C'Why are you being so careless with your treatment?''你為什麼對治療這麼粗心大意？'
- D'Tell me what aspect of managing your diabetes feels most difficult for you.'✓ 正解'告訴我，管理糖尿病的哪個部分對你來說最困難？'
— Explanation · 中文詳解 —
青少年的主要發展任務是認同感與自主性。糖尿病的管理若與其社交生活衝突，易導致抗拒。運用開放性問句探索其困難（D），能展現尊重，並與其共同尋找適合的調適策略。威脅、指責或過度教條化均會增加青少年的反抗心。
The primary developmental tasks of adolescence are identity and autonomy. If diabetes management conflicts with social life, resistance is common. Using an open-ended question to explore the client's difficulties (D) demonstrates respect and supports working together to find adaptive strategies. Threats, blame, or overly didactic approaches only intensify the adolescent's resistance.
✦ 台美臨床差異
美國設有青少年健康中心，重視青少年自主權；台灣臨床常受家長主導影響，護理師需在平衡家長期望與青少年自主間花更多心力。