— 心理社會完整性 · EASY · MCQ —
精神科病房的個案表示：「我是全世界的總統，有秘密特務在跟蹤我。」護理師哪種回應最具治療性？
A client in the psychiatric unit states, 'I am the president of the world, and I have secret agents following me.' Which response by the nurse is therapeutic?
- ATell me more about these secret agents.告訴我更多關於這些秘密特務的事。
- BThat sounds very frightening for you.✓ 正解這聽起來讓你感到很害怕。
- CYou are not the president; you are a patient here.你不是總統；你是這裡的病人。
- DWhy do you feel like you are the president?你為什麼覺得自己是總統？
— Explanation · 中文詳解 —
面對患有妄想（Delusion）的個案，護理師應採取「不爭辯、不強化」的原則。爭辯妄想內容（如選項C）會導致醫病關係對立，使病人產生防衛心；而過度關注妄想細節（如選項A、D）則會變相「餵養」妄想系統。治療性溝通的核心在於「同理感受」，而非「驗證事實」。當病人表達恐懼或焦慮時，護理師應針對情緒進行回饋，這能幫助病人感受到被接納與理解，進而促進治療性關係的建立。
Therapeutic communication with a client experiencing delusions involves validating their feelings without reinforcing the false belief. Acknowledging the emotion, such as fear, builds trust and rapport without engaging in a debate about reality. Challenging the delusion directly or focusing on its details can increase defensiveness or strengthen the pathological thought process.