— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人表示「幻聽」要求他停止服用藥物。護理師應如何回應最恰當？
A client with schizophrenia expresses that the 'voices' are telling him to stop taking his medication. Which response by the nurse is most appropriate?
- ATell the client that the voices are not real告訴病人那些聲音是不真實的
- BFocus on the client's feelings and acknowledge the experience✓ 正解聚焦於病人的感受並認可其經驗
- CAsk the client what the voices are saying to them詢問病人那些聲音對他說了些什麼
- DExplain to the client that the medication is necessary for his health向病人解釋藥物對他的健康是必要的
— Explanation · 中文詳解 —
面對幻聽，應採納護理溝通技巧：承認病人對幻聽的「主觀真實感受」，但將焦點轉向病人的內心感受而非幻聽內容。否定幻聽（選項A）會引起對抗，詢問幻聽內容（選項C）可能加深病人對幻覺的關注，單純強調服藥必要性（選項D）缺乏同理心。
The nurse should validate the client's subjective experience and focus on their emotional distress without confirming the hallucination as reality. Directly challenging the voices or asking for detailed content can increase defensiveness or reinforce the delusion, while logical explanations are often ineffective during acute psychotic episodes.
✦ 台美臨床差異
美國護理教育極重視治療性溝通技巧；台灣精神科護理則常結合藥物衛教，有時較偏向指導式溝通。