— 心理社會完整性 · MEDIUM · MCQ —
一位患有思覺失調症的個案表示，電視新聞主播正在對其傳遞秘密訊息。護理師應採取何種治療性溝通回應？
A client with schizophrenia expresses the belief that the television news anchor is sending secret messages directly to them. Which response by the nurse is most therapeutic?
- AAsk the client why they believe the anchor is sending them these messages詢問病患為何認為主播正在傳遞訊息給他們
- BAcknowledge the client's perception but state that you do not share that experience✓ 正解肯定病患的感受，但表示你並未經歷同樣的情況
- CTurn off the television to eliminate the source of the delusion關掉電視以消除妄想的來源
- DExplain that the news anchor is broadcasting to millions and not targeting them解釋新聞主播是向百萬觀眾廣播，並非針對他們個人
— Explanation · 中文詳解 —
對於妄想症狀，治療性溝通強調「現實感回饋」（Reality Testing）。護理師不應爭辯或強迫個案放棄信念（D），也不應完全附和。客觀表達個人未感受到同樣的訊息，能有效區分個案的內在體驗與外在事實，有助於建立信任關係。
For delusional symptoms, therapeutic communication emphasizes reality testing. The nurse should neither argue with nor force the client to abandon the belief (D), and should not simply agree with it either. Objectively stating that the nurse does not perceive the same message effectively distinguishes the client's internal experience from external reality and helps to build a trusting relationship.
✦ 台美臨床差異
台美均強調 Reality Testing，但台灣文化中護理師有時會傾向直接給予否認，需加強溝通技巧訓練。