— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人出現聽幻覺。護理師下列哪句話展示了有效的治療性溝通技巧？
A client with schizophrenia is experiencing auditory hallucinations. Which statement by the nurse demonstrates an effective therapeutic communication strategy?
- AI know you hear voices, but there is no one else in the room✓ 正解我知道你聽到聲音了，但房間裡沒有其他人
- BWhy do you think the voices are choosing to speak to you?你認為這些聲音為什麼選擇跟你說話？
- CTell me more about what the voices are saying to you告訴我這些聲音對你說了什麼
- DYou should try to ignore the voices and focus on this activity你應該試著忽略這些聲音，並專注於這項活動
— Explanation · 中文詳解 —
與幻覺病人溝通的原則是：肯定病人的感受（幻覺對他是真實的），但同時陳述客觀事實以建立現實感。不要挑戰病人的幻覺，也不要過度深入討論幻覺內容（可能加重病症）。選擇 A 正確地劃分了病人的感覺與現實狀況，有助於現實導向訓練。
Therapeutic communication with a client experiencing hallucinations involves acknowledging their experience while gently orienting them to reality. Stating that the nurse does not hear the voices helps distinguish subjective perception from objective fact without challenging the client's feelings or reinforcing the delusion.
✦ 台美臨床差異
美國教學強調「現實導向」，台灣臨床受限於病房節奏，護理師有時會直接打斷病人討論幻覺以節省時間。