— 心理社會完整性 · EASY · MCQ —
一名末期癌症病人表現出明顯退縮行為，哪項護理措施展現有效的治療性溝通？
A client is diagnosed with terminal cancer and displays severe withdrawal. Which nursing action demonstrates effective therapeutic communication?
- ASitting quietly with the client to convey presence✓ 正解安靜地坐在病人旁邊以傳達陪伴
- BTelling the client everything will be fine soon告訴病人一切很快就會好轉
- CAsking the client why they are being so quiet詢問病人為什麼如此沉默
- DEncouraging the client to join a support group鼓勵病人參加支持團體
— Explanation · 中文詳解 —
面對末期病人的退縮，專業的治療性溝通核心在於「陪伴」。詢問「為什麼」可能造成病人防禦心理。保持安靜的陪伴能讓病人感受到支持與安全感，無需強迫對話，給予病人掌控自己情緒進度的空間，是處理悲傷過程中的關鍵技巧。
Therapeutic communication with a withdrawn, terminally ill client emphasizes silent presence, which conveys support without demanding interaction. False reassurance or asking 'why' questions can increase defensiveness or dismiss the client's feelings. Allowing the client space to process emotions is more effective than encouraging social activities like support groups during acute withdrawal.
✦ 台美臨床差異
美國護理重視陪伴與靈性照護（Spiritual care）；台灣文化常傾向以家屬為重心，護理師較少有時間進行純粹的靜默陪伴。