— 心理社會完整性 · HARD · MCQ —
一位 30 歲思覺失調症個案出現聽幻覺，護理師應如何回應最合適？
A 30-year-old client with schizophrenia is experiencing auditory hallucinations. Which response by the nurse is most appropriate?
- ATell me what the voices are saying to you right now告訴我現在聲音對你說了什麼
- BI don't hear any voices, so you shouldn't either我沒聽到任何聲音，所以你也應該聽不到
- CLet's focus on an activity to distract you from the voices讓我們專注於一項活動來轉移你對聲音的注意力
- DI understand that you hear voices, but I do not hear them✓ 正解我知道你聽到聲音，但我沒有聽到
— Explanation · 中文詳解 —
處理幻覺的黃金原則是「承認現實但不認同幻覺」。護理師應明確告知個案自己並未聽到，避免對病人的幻覺表示認同或完全否定其真實感。A 容易導致衝突；C 容易強化幻覺內容，若指令具危險性會產生風險；D 應在個案情緒穩定後才進行。
The most therapeutic response validates the client’s experience without reinforcing the hallucination by stating, 'I understand that you hear voices, but I do not hear them.' This approach acknowledges the client's reality while maintaining the nurse's own perspective, which helps build trust and reduces isolation.
✦ 台美臨床差異
美台精神科護理原則一致，均強調避免與幻覺辯論，並著重於環境安全監控。