— 心理社會完整性 · HARD · SATA —
護理師照顧一位呈現憂鬱症狀的病人，下列哪些跡象顯示該病人有自我傷害的風險？（選所有適合的）
A nurse is caring for a patient who exhibits signs of depression. Which of the following indicate that the patient is at risk for self-harm? (Select all that apply.)
- AGiving away prized personal possessions✓ 正解分送珍貴的個人物品
- BSudden improvement in mood and energy levels✓ 正解情緒和體力突然改善
- CExpressing feelings of hopelessness✓ 正解表達絕望感
- DIncreased participation in group therapy增加參與團體治療
- EMaking a final will or funeral arrangements✓ 正解訂立最後遺囑或安排葬禮
— Explanation · 中文詳解 —
評估自殺風險時，除了口頭表達無望感外，行為指標至關重要。特別是「情緒與活力突然好轉」常暗示病人已下定決心自殺，因為他們不再為矛盾掙扎而感到沉重。交代後事與分送珍愛物品均為警訊，需立即啟動自殺防範程序。
Giving away prized possessions, making final arrangements, and expressing hopelessness are classic behavioral and verbal indicators of suicidal intent. A sudden improvement in mood or energy may signal that the patient has resolved their internal conflict and decided to proceed with the plan, representing a critical risk factor.
✦ 台美臨床差異
美國採取極度嚴格的自殺風險評估量表（如 Columbia-Suicide Severity Rating Scale）；台灣臨床亦多遵循此標準，但評估工具的使用率依醫院層級而異。