護理師正在照顧一位最近失去相處 40 年配偶的病人。病人表示：「我簡直不敢相信他走了，我一直覺得他會像平常一樣走進家門。」根據庫伯勒-羅斯（Kübler-Ross）的理論，此病人最可能處於悲傷的哪個階段？

本題的核心概念是庫伯勒-羅斯的悲傷五階段模型（DABDA）。病人描述「不敢相信」以及「期待對方出現」，是典型的否認階段（Denial）特徵。這是一種心理防禦機制，用來緩衝突如其來的巨大衝擊。在護理臨床思路中，首要任務是評估病人的應對能力與支持系統。正確答案 C 是因為病人表現出對現實的拒絕與不信。憤怒（A）通常表現為對醫護、命運或家屬的責備；討價還價（D）則常見於病人試圖與神明或命運達成協議以延緩結局；憂鬱（B）則涉及深刻的哀傷與撤退。護理師應提供支持性的傾聽，而非強迫病人立即接受現實，安全優先原則在於監測病人是否有自我傷害的風險，但在否認初期通常以情感支持為主。

The core concept of this question is the Kübler-Ross five-stage model of grief (DABDA). The patient's description of "not being able to believe it" and "expecting the deceased to return" is characteristic of the denial stage. Denial is a psychological defense mechanism used to buffer the patient from a sudden, overwhelming impact. In nursing clinical reasoning, the first task is to assess the patient's coping ability and support system. Option C is correct because the patient is demonstrating rejection of and disbelief in reality. Anger (A) is typically expressed as blame toward the medical staff, fate, or family; bargaining (D) is commonly seen when the patient tries to make a deal with God or fate to delay the outcome; depression (B) involves deep sorrow and withdrawal. The nurse should provide supportive listening rather than forcing the patient to immediately accept reality. The safety principle requires monitoring the patient for risk of self-harm, but during the early denial phase, emotional support is generally the primary focus.

在美國，悲傷輔導常由護理師與專業諮商師、社工共同組成團隊；台灣臨床上則較多由家屬主導照顧，護理師需特別注意家族動力，且台灣文化中較常出現壓抑悲傷的情形，護理師需主動引導表達。