— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人告訴護理師：「那些聲音告訴我，妳想要在我的水裡下毒。」下列哪項護理反應最好？
A client with schizophrenia tells the nurse, 'The voices are telling me that you are trying to poison my water.' Which is the best nursing response?
- ALet's talk about the medicine that helps stop those voices.我們來談談有助於停止這些聲音的藥物吧。
- BWhy would you think that I would want to poison you?你為什麼認為我會想要毒害你呢？
- CI understand the voices are real to you, but I do not hear them.✓ 正解我理解這些聲音對你來說很真實，但我聽不到它們。
- DI promise that the water is perfectly safe to drink.我保證這水喝起來完全安全。
— Explanation · 中文詳解 —
思覺失調症（Schizophrenia）病人出現幻聽與被害妄想時，護理師的首要任務是「治療性溝通」。我們既不能認同幻覺的真實性（這會加強病人的妄想），也不能直接否定或爭辯（這會破壞護理關係）。正確的策略是表達「理解病人的主觀感受」，但同時「明確表明自己作為客觀觀察者並未聽到聲音」，以此建立邊界並維持信任。
The nurse should acknowledge the client’s subjective experience without validating the delusion as objective reality. Responding with empathy while stating personal observation helps maintain therapeutic trust and boundaries, whereas arguing or offering false reassurance can escalate anxiety or reinforce the delusion.