— 心理社會完整性 · EASY · MCQ —
一位新診斷為末期癌症的病人哭泣說：「我不敢相信這發生在我身上。我的人生結束了。」護理師最合適的治療性回應為何？
A client with a new diagnosis of terminal cancer is crying and stating, 'I cannot believe this is happening to me. My life is over.' Which response by the nurse is most therapeutic?
- AEverything is going to be okay, stay positive.一切都會沒事的，保持樂觀。
- BYou should not cry because it will make you more tired.你不應該哭，因為這會讓你更累。
- CDo you want to speak with the hospital chaplain?你想跟醫院牧師談話嗎？
- DTell me more about what you are feeling right now.✓ 正解告訴我你現在的感覺。
— Explanation · 中文詳解 —
面對哀傷與否認階段，護理師應運用開放式問句鼓勵病人表達內在情感。D 選項展現主動傾聽與同理，提供病人安全空間釋放情緒。A 屬於虛假的安慰，否認了病人的苦痛；C 為過早進行轉介，未先處理當下情緒；B 則是拒絕接納病人的情緒反應。
The most therapeutic response is to use open-ended questions to encourage the client to express their feelings, validating their grief and providing a safe space for emotional release. False reassurance or telling the client not to cry dismisses their pain, while referring to a chaplain prematurely bypasses the immediate need for emotional support.
✦ 台美臨床差異
美國護理教育極度強調「治療性溝通」，台灣臨床護理師常因工作量繁重，較傾向於直接給予醫療資訊或轉介心理諮商。