護理師正在面談一位剛被診斷為末期疾病的病人，病人表示：「我覺得我只是家人的負擔。」護理師採取哪種反應最恰當？
A nurse is interviewing a client recently diagnosed with a terminal illness who states, 'I feel like I am just a burden to my family.' Which response by the nurse is most appropriate?
- ATell me more about what leads you to feel this way.✓ 正解告訴我更多讓你產生這種感覺的原因
- BYou should speak with a social worker about your concerns.你應該與社工討論你的擔憂
- CDo not worry, your family loves you and will take care of you.別擔心，你的家人愛你並會照顧你
- DWhy do you feel like a burden to your family?你為什麼覺得自己是家人的負擔？
面對末期病人的情感表達，核心目標是促進治療性溝通（Therapeutic Communication）。病人表達出「負擔感」是一種深層的心理挫折，護理師應運用開放式問句（Open-ended question）來鼓勵病人傾訴內心深處的恐懼與價值觀。選項 C 使用了「請勿擔心」這類虛假的安撫（False reassurance），會中斷進一步溝通；選項 D 使用「為什麼」（Why）容易讓病人產生防衛心態；選項 B 雖然轉介是正確的，但當下應先進行初步的心理支持，直接推給社工會讓病人感到被拒絕。護理師應透過主動傾聽（Active listening）與反映情感，讓病人感受到被理解，這在心理護理中是建立信任感的第一步，也是評估病人自殺意念或憂鬱程度的關鍵契機。
The nurse should use open-ended questions to encourage the client to elaborate on their feelings, which promotes therapeutic communication and validates their emotional experience. This approach allows the client to express underlying fears and helps the nurse assess for issues such as depression or suicidal ideation without providing false reassurance or sounding judgmental.
美國護理教育高度強調治療性溝通的技巧，並將其視為評估心理狀態的工具；台灣臨床由於護病比過高，護理師較常傾向於先解決生理需求，心理支持部分往往受限於時間而容易被忽略或直接轉介社工。