一位精神分裂症病人站在房間中央,似乎正在聽什麼。護理師的最佳行動為何?
A client with schizophrenia is standing in the middle of the room and appears to be listening to something. What is the nurse's best action?
- ATouch the client on the shoulder to get their attention.輕拍病人肩膀以引起其注意
- BAsk, 'Are you hearing voices again?'詢問:『你又聽到聲音了嗎?』
- CSay, 'I see you are listening to something; tell me what is happening.'✓ 正解說:『我看到你在聽些什麼;請告訴我發生了什麼事。』
- DWalk away so the client can have privacy.離開以讓病人保有隱私
核心概念:與有幻聽(Auditory Hallucinations)的精神分裂症(Schizophrenia)病人互動的治療性溝通技巧。 為何正確答案對: C. 護理師觀察到病人的行為(站立、傾聽狀),並以開放式、非批判性的方式邀請病人分享其體驗(「我看到你在聽某件事;告訴我發生了什麼。」),這是承認病人當下的感知,同時鼓勵其表達,有助於評估其幻聽內容與程度,並建立信任關係。這並非直接否定或肯定病人所聽到的內容。 為何其他選項錯: A. 走開(Walk away)會讓病人感到被遺棄,破壞治療關係,且錯失了評估與介入的機會。 B. 直接詢問「你又在聽見聲音了嗎?」可能帶有質疑或不信任的意味,容易引起病人的防禦心理,不如以觀察到的行為作為開場白來得溫和與接納。 D. 觸碰病人肩膀(Touch the client on the shoulder)可能對某些病人(特別是警覺性高或有被害妄想的病人)造成驚嚇或侵犯感,應避免突然的身體接觸,除非事先獲得同意或情況緊急。 臨床思路(Psychosocial Integrity/Therapeutic Communication):與思覺失調症病人溝通的關鍵在於建立信任與安全感,同時評估病情。承認病人的感知,並以溫和、好奇的態度引導其表達,是有效的溝通策略。
This question targets therapeutic communication with a client experiencing auditory hallucinations. Acknowledging the observed behavior and inviting the client to share their experience in a nonjudgmental, open-ended way validates their perception and supports trust-building while allowing assessment of the hallucinations. Walking away, asking closed-ended questions that imply doubt, and unexpected touch are all less effective and may damage the therapeutic relationship.