與患有妄想的病人互動時,下列哪些護理措施展現了治療性溝通技巧?(選所有適合的)
Which of the following nursing interventions demonstrate therapeutic communication when interacting with a client experiencing delusions? (Select all that apply.)
- AReinforce the client's reality by focusing on topics other than the delusion✓ 正解透過聚焦於妄想以外的話題來強化病人的現實感
- BArgue with the client about the factual basis of their delusion與病人爭辯其妄想的事實基礎
- CExpress empathy for the feelings the client experiences due to the delusion✓ 正解表達對病人因妄想所經歷感受的同理
- DRepeatedly ask the client to explain the delusion to ensure understanding反覆要求病人解釋妄想以確保理解
- EMaintain a supportive and non-judgmental demeanor✓ 正解維持支持性且非批判性的態度
核心概念:與思覺失調症(Schizophrenia)或精神疾病患者進行治療性溝通(Therapeutic Communication)。 為何正確答案對: A. 轉移對妄想(Delusion)的焦點,引導病人關注現實生活中的事物,有助於穩定其情緒並減少妄想的影響力。 C. 妄想雖是錯誤信念,但病人對此的「感受」是真實的。表達同理心(Empathy)能讓病人感到被理解與支持,建立信任關係。 E. 保持支持性(Supportive)和非批判性(Non-judgmental)的態度,避免直接否定或爭論病人的妄想內容,能營造安全的溝通環境。 為何其他選項錯: B. 直接與病人爭辯妄想的真實性,只會加劇其防禦心理,使病人更堅持其信念,並可能破壞治療關係。 D. 反覆要求病人解釋妄想內容,可能無助於理解,反而會強化其固著的思維模式,並可能讓病人感到被質疑或攻擊。 臨床思路(Psychosocial Integrity/Safety):治療性溝通的目標是建立信任,減少病人焦慮,並引導其走向現實。對於妄想病人,應避免直接挑戰其核心信念,而是透過同理、支持與現實導向的對話,逐步協助其穩定情緒與認知。
Therapeutic communication involves maintaining a supportive, non-judgmental demeanor and expressing empathy for the client's feelings without validating the delusion itself. It is also effective to gently redirect the client’s focus to reality-based topics rather than arguing against or repeatedly exploring the false beliefs.