— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症個案說：「電視正在傳送政府給我的祕密代碼。」護理師應如何回應？
A client diagnosed with schizophrenia says, 'The television is sending me secret codes from the government.' How should the nurse respond?
- AAsk the client why the government would do that詢問病人為什麼政府要這樣做
- BSuggest that the client turns off the television建議病人關掉電視
- CTell the client that this is not true告訴病人這不是真的
- DAcknowledge the client's feelings and move on to a neutral topic✓ 正解認可病人的感受並轉移至中性話題
— Explanation · 中文詳解 —
面對思覺失調症（Schizophrenia）的妄想症狀，護理師的原則是「不爭辯、不認同」。直接否定個案的妄想內容會破壞護病關係，導致個案防衛性增強；認同妄想則會強化其錯覺。正確做法是表達對個案感受的理解（如：「聽起來這讓你很不安」），並將話題轉向現實生活中的中性主題，以建立現實感（Reality orientation）。
The nurse should acknowledge the client's feelings without validating the delusion to maintain a therapeutic relationship and avoid reinforcing pathological thoughts. Directly challenging the delusion or exploring its logic can increase defensiveness, whereas shifting to a neutral topic helps ground the client in reality.