— 心理社會完整性 · HARD · MCQ —
一位病人因轉化症（Conversion disorder）入院。最恰當的初步護理管理為何？
A client is admitted with conversion disorder. What is the most appropriate initial nursing management?
- AFocusing on the physical symptoms rather than the underlying stress專注於身體症狀而非潛在壓力
- BConfronting the patient about the lack of physical basis for symptoms與病人對峙，指出症狀缺乏生理基礎
- CMinimizing attention to the physical symptoms while providing support✓ 正解減少對身體症狀的關注，同時提供支持
- DIgnoring the patient until the symptoms subside忽視病人，直到症狀緩解
— Explanation · 中文詳解 —
轉化症（轉換障礙）是將心理壓力轉化為身體症狀。護理應「降低對症狀的關注」（Secondary gain control），避免讓身體症狀成為獲得關注的唯一管道，同時提供心理支持。若過度關注症狀會增強此機制；對抗（B）則會造成病人防衛。
For clients with conversion disorder, the nurse should minimize attention to physical symptoms to prevent reinforcement through secondary gain while providing emotional support. Focusing excessively on symptoms may strengthen the behavior, whereas confrontation can increase defensiveness and worsen symptoms. Ignoring the client is unprofessional and fails to address their psychological distress.
✦ 台美臨床差異
此類疾患在美國精神醫學評估中很常見；台灣臨床常因轉化症狀易被誤認為器質性病變，建議護理師需具備敏銳的心理評估能力。