— 心理社會完整性 · MEDIUM · MCQ —
一位 45 歲個案被診斷為 HIV，個案表示：「我覺得我的人生完了，我一定做了什麼壞事才得到這種報應。」護理師最佳的初步回應為何？
A 45-year-old client is admitted with a new diagnosis of HIV. The client states, 'I feel like my life is over and I have done something terrible to deserve this.' What is the nurse's best initial response?
- AIt is important to understand that HIV is a medical condition, not a punishment.了解 HIV 是一種醫療狀況，而非懲罰，這很重要。
- BYou seem to be feeling very overwhelmed and guilty about your diagnosis.✓ 正解您似乎對自己的診斷感到極度不知所措和內疚。
- CWould you like to speak with a chaplain or social worker?您想與牧師或社會工作者談話嗎？
- DMany people live long lives with HIV thanks to modern treatment.多虧了現代治療，許多 HIV 患者都能長壽。
— Explanation · 中文詳解 —
治療性溝通首重「反映感受」（Reflecting feelings），護理師應先同理個案的內疚與絕望，建立信任關係，而非急於進行說教或轉介。B 選項精準捕捉了個案情緒的核心，鼓勵個案進一步表達，能有效促進心理支持。
Therapeutic communication places primary importance on reflecting feelings. The nurse should first empathize with the client's guilt and despair to build trust, rather than rushing to lecture or make referrals. Option B precisely captures the core of the client's emotions and encourages further expression, providing effective psychological support.
✦ 台美臨床差異
美國護理師強調心理支持與諮商角色；台灣護理師常因工作繁忙，心理支持多轉介社工或精神科。