— 心理社會完整性 · EASY · MCQ —
一位精神分裂症病人告訴護理師：「耳邊的聲音告訴我食物有毒。」護理師最適當的反應為何？
A client with schizophrenia tells the nurse, 'The voices are telling me that the food is poisoned.' What is the nurse's best response?
- AOffer to go to the kitchen to see how the food is prepared主動去廚房查看食物的準備過程
- BFocus on the client's feelings and provide a reality-based statement✓ 正解聚焦於病人的感受並提供基於現實的陳述
- CAsk the voices why they want you to starve詢問那些聲音為什麼想讓你挨餓
- DExplain that the hospital food is safe and prepared by staff解釋醫院的食物是安全的且由員工準備
— Explanation · 中文詳解 —
面對幻聽導致的被害妄想，護理師應採用「呈現現實」(Presenting reality) 的溝通技巧。護理師不應直接反駁幻覺（辯論無效），亦不應參與幻覺討論。透過承認病人的感受並將焦點轉回現實，能減輕焦慮並維持治療性關係。
The nurse should use presenting reality techniques by acknowledging the client's feelings without validating the delusion or engaging in logical debate. This approach helps reduce anxiety and maintains a therapeutic relationship while gently orienting the client to reality.
✦ 台美臨床差異
美台精神科護理皆遵循治療性溝通原則，但美國法規對強迫行為的認定更為嚴謹，強調減少干預。