— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人出現聽幻覺，護理師以下何種回應最為恰當？
A client with schizophrenia is experiencing auditory hallucinations. Which response by the nurse is most appropriate?
- AIt sounds like you are hearing something that is causing you distress✓ 正解聽起來你聽到了一些讓你感到困擾的聲音
- BI don't hear any voices, so you should stop listening to them我沒有聽到任何聲音，所以你應該停止聆聽
- CWhy are you listening to the voices instead of me?你為什麼要聽那些聲音而不聽我說的話？
- DYou need to focus on your reality, not the voices你需要專注於你的現實，而不是那些聲音
— Explanation · 中文詳解 —
護理照護幻覺病人的核心原則是「確認現實但表達同理」，不應挑戰幻覺內容（因為對病人而言那是真實的）。回應焦點應放在病人因幻覺產生的情緒反應。B會造成對立，C的詢問方式具有指責意味，D過於強硬，無法建立治療性人際關係。
The most appropriate nursing response validates the client's distress without challenging the reality of their hallucinations, which helps maintain a therapeutic relationship. Acknowledging that the voices are causing distress demonstrates empathy and builds trust. Denying the hallucinations, asking 'why,' or demanding the client focus on reality can increase agitation and undermine the nurse-client rapport.
✦ 台美臨床差異
台美均強調同理心與療效關係，但台灣臨床在資源限制下，有時會過度強調藥物控制而縮短會談時間。