— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人告訴護理師：「這些聲音告訴我食物裡有毒。」護理師採取哪種回應最具治療性？
A client with schizophrenia tells the nurse, 'The voices are telling me that the food is poisoned.' Which response by the nurse is most therapeutic?
- AI understand that you hear voices, but I do not hear them.✓ 正解我了解你聽到聲音，但我沒有聽到。
- BI don't hear any voices, and the food is safe to eat.我沒有聽到任何聲音，而且食物是安全可食用的。
- CWhy do you think someone would want to poison you?你認為為什麼有人想毒害你？
- DDon't worry, the hospital staff checks all the food.別擔心，醫院員工會檢查所有食物。
— Explanation · 中文詳解 —
處理幻聽個案的核心原則是「承認個案的知覺經驗，同時堅持客觀現實」。不與其爭辯幻聽是否存在，也不直接認同。B 會引起防衛；C 詢問原因會強化妄想系統；D 是虛假的保證。B 呈現了護理師的同理心且界線清晰。
The nurse should acknowledge the client's subjective experience without validating the delusion, which helps build trust and rapport. By stating that the nurse does not hear the voices, the response maintains a boundary between reality and the client's perception while avoiding confrontation that could increase defensiveness.
✦ 台美臨床差異
台灣精神科護理強調減少對病人的挑戰性溝通，護理模式與國際準則趨於一致。