— 心理社會完整性 · MEDIUM · MCQ —
護理師照顧一位剛被診斷為末期疾病並處於否認期的病人。下列哪項護理師的回答最具治療性？
A nurse is caring for a client recently diagnosed with a terminal illness who is exhibiting signs of denial. Which statement by the nurse best reflects a therapeutic response?
- AIt is important that you accept the diagnosis to start treatment.接受診斷對於開始治療很重要。
- BThe doctors are certain about these test results, so you should face it.醫師對這些檢驗結果很有把握，所以你應該面對現實。
- CYou seem to be having a difficult time believing this diagnosis.✓ 正解你似乎很難相信這個診斷。
- DDon't worry, there are many new treatments available today.別擔心，現在有很多新的治療方法可用。
— Explanation · 中文詳解 —
否認是悲傷過程的防衛機制，具治療性的溝通應採取同理與接納。選項 C 使用了「反映（reflecting）」技巧，幫助病人表達情緒而不強迫其立即接受現實。選項 A 和 B 具有強迫性，會中斷治療關係；選項 D 是虛假的保證，會削弱病人的信任感。
Denial is a defense mechanism within the grieving process, and therapeutic communication should use empathy and acceptance. Option C uses the technique of reflecting, helping the client express their feelings without forcing immediate acceptance of reality. Options A and B are coercive and disrupt the therapeutic relationship; option D is false reassurance that undermines the client's trust.
✦ 台美臨床差異
美國強調病人自主權與心理調適，台灣臨床對末期病人往往傾向家屬隱瞞，護理師需在倫理間平衡。