— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症患者正經歷聽幻覺，護理師下列哪種回應最具治療性？
A client with schizophrenia is experiencing auditory hallucinations. Which response by the nurse is most therapeutic?
- AI don't hear any voices, but I understand they are real to you.✓ 正解我沒有聽到任何聲音，但我理解這對你來說很真實。
- BIt's just the illness talking, you should ignore them.那只是疾病在說話，你應該忽略它們。
- CTell those voices to leave you alone right now.告訴那些聲音現在立刻離開你。
- DWhat are the voices saying to you exactly?那些聲音到底在跟你說什麼？
— Explanation · 中文詳解 —
面對幻覺，護理師應採取「呈現現實」但「肯定感受」的態度。明確表達自己未聽見幻聽（現實感），同時接納病人主觀感受的真實性（治療性溝通），這能建立信任感並協助病人將焦點回歸現實環境，避免與幻覺內容辯論或直接要求其忽視。
The most therapeutic response acknowledges the client's experience without reinforcing the hallucination. By stating that the nurse does not hear the voices but understands they are real to the client, the nurse maintains reality orientation while building trust.
✦ 台美臨床差異
台美兩地在精神科護理訓練中皆極度強調此類治療性溝通技巧，差異不大。