— 心理社會完整性 · MEDIUM · MCQ —
精神科住院病人開始在交誼廳咆哮與踱步。下列何者展現了護理師對於去激化技巧的理解？
A client on an inpatient psychiatric unit begins shouting and pacing in the common area. Which action demonstrates the nurse’s understanding of de-escalation?
- AApproach the client quickly to stop the behavior快速接近病人以制止該行為
- BUse a clear, low-pitched voice to offer choices✓ 正解使用清晰、低沉的聲音提供選擇
- CFirmly state that the behavior is unacceptable and must stop堅定地表示該行為不可接受且必須停止
- DCall for immediate physical restraint of the client要求立即對病人實施肢體約束
— Explanation · 中文詳解 —
去激化（de-escalation）的關鍵在於降低個案的憤怒反應。使用低沉、冷靜且清晰的語音能避免刺激個案，給予有限的選擇權（如：去隔離室休息或在角落安靜一下）能讓個案感到仍有控制感，進而降低攻擊風險。貿然制止或威脅反而會激化衝突。
The key to de-escalation is reducing the client's anger response. Using a low-pitched, calm, and clear voice avoids further provoking the client, while offering limited choices (such as going to a quiet room to rest or sitting in a corner) helps the client retain a sense of control, thereby reducing aggression risk. Abruptly stopping the behavior or threatening the client tends to escalate the conflict.
✦ 台美臨床差異
美國非常強調去激化技巧的證照訓練（如 CPI）；台灣臨床較注重病房安全，但在去激化流程的實證護理標準化上尚在發展中。