— 心理社會完整性 · MEDIUM · MCQ —
一位新診斷為思覺失調症的個案表示聽到評論他行為的聲音。下列哪種護理回應具備治療效果？
A client newly diagnosed with schizophrenia mentions hearing voices that comment on their actions. Which nursing response is therapeutic?
- ASuggest that the voices are not real建議這些聲音並非真實存在
- BAsk the client what the voices are saying to them✓ 正解詢問個案這些聲音對他說了什麼
- CEncourage the client to listen to music to drown out the sound鼓勵個案聆聽音樂以掩蓋聲音
- DTell the client that you do not hear the voices告訴個案你沒有聽到這些聲音
— Explanation · 中文詳解 —
思覺失調症個案出現幻聽（Auditory hallucinations），護理師應具備治療性溝通技巧。重點在於「評估幻聽內容」，因為指令性幻聽（Command hallucinations）可能導致病人出現攻擊行為。透過詢問幻聽內容，護理師能評估病人的安全性並建立治療性關係。否認幻聽或爭辯真實性會破壞關係。
When a client with schizophrenia experiences auditory hallucinations, the nurse should use therapeutic communication. The key is to assess the content of the hallucinations, because command hallucinations may lead the client to act aggressively. Asking what the voices are saying allows the nurse to evaluate safety and to build a therapeutic relationship. Denying the hallucinations or debating their reality damages the therapeutic alliance.