— 心理社會完整性 · HARD · MCQ —
一位思覺失調症的個案對護理師說：「收音機在跟我說，我是天選之人，必須拯救世界。」護理師應如何回應？
A client with schizophrenia tells the nurse, 'The radio is telling me that I am the chosen one and must save the world.' Which response is most appropriate?
- AWhy would the radio choose you to save the world?為什麼收音機會選擇你去拯救世界？
- BLet's focus on reality and talk about your medication instead.讓我們專注於現實，談談你的藥物吧。
- CI do not hear the radio saying those things, but I understand it is real to you.✓ 正解我沒有聽到收音機那樣說，但我理解這對你來說是真實的。
- DThat sounds like a very important mission, but it is not true.這聽起來是一項非常重要的任務，但這不是真的。
— Explanation · 中文詳解 —
針對妄想與幻聽，護理原則是「不強化（不贊同）、不爭辯（不拆穿）、專注於感受」。護理師應界定現實與病人的主觀經驗（表達自己沒聽到），同時尊重個案的感受，避免直接質疑造成對立，這能保護護病關係並降低個案的防衛心。
The nurse should validate the client's feelings without reinforcing the delusion by stating that the experience is real to them but not shared by others. This approach maintains therapeutic communication and reduces defensiveness, whereas arguing or dismissing the client's reality can damage the nurse-client relationship.
✦ 台美臨床差異
台美針對精神病人的溝通技巧訓練內容高度一致，皆強調「Reality orientation」與「Therapeutic communication」。