一位被診斷為末期癌症的病人拒絕說話且整天盯著牆壁。護理師採取哪種回應最具治療性？
A nurse is caring for a patient who was recently diagnosed with terminal cancer. The patient refuses to speak and stares at the wall. Which response by the nurse is most therapeutic?
- AI will sit here with you for a while; you don't have to talk.✓ 正解我會在這裡陪你一陣子；你不需要說話。
- BWould you like me to call the chaplain to come talk with you?你想要我召喚牧師來和你談談嗎？
- CIt is important for you to share your feelings so you can heal.分享你的感受對你很重要，這樣你才能康復。
- DI know how you feel; it is normal to be upset.我了解你的感受；感到難過是正常的。
面對哀傷或抗拒溝通的病人，提供「存在感」（therapeutic presence）是最有效的支持。強迫病人發言或預設其感受（如選項D）會造成壓力。透過陪伴，護理師傳遞的是包容與不批判的態度，讓病人能在感到準備好時表達需求，而非強加任何建議。
When caring for a client who is grieving or resistant to communication, providing therapeutic presence is the most effective form of support. Forcing the client to speak or making assumptions about their feelings (as in option D) increases pressure. By staying with the client, the nurse conveys acceptance and a nonjudgmental attitude, allowing the client to express their needs when ready, rather than imposing any advice.
美國護理教育極度強調「存在感」的治療價值，台灣臨床工作繁重，護理師較少有時間執行長時間的靜默陪伴。