— 心理社會完整性 · MEDIUM · MCQ —
一位患有精神分裂症的病人告訴護理師：「聲音說你們打算在我的食物裡下毒。」護理師應如何回應最恰當？
A client with schizophrenia tells the nurse, 'The voices are telling me that you are trying to poison my food.' Which response by the nurse is most appropriate?
- AAsk the nurse to taste the food in front of the patient請護理師在病人面前品嚐食物
- BAcknowledge that the voices are real to them but deny the content✓ 正解承認幻聽對他們而言是真實的，但否認其內容
- CExplain that no one is trying to poison them解釋沒有人企圖毒害他們
- DIgnore the comment and continue with the medication administration忽略該評論並繼續給藥
— Explanation · 中文詳解 —
面對妄想或幻聽，治療性溝通應採取「認同病人的主觀體驗，但不認同妄想內容」的態度。直接否認（C）會破壞醫病信任關係；嘗試證明（A）會強化妄想，因為病人會認為護理師在演戲；忽視（D）會讓病人感到不安全。正確做法是將焦點放在病人的焦慮感，而非幻聽的內容。
Therapeutic communication with a client experiencing delusions involves validating their feelings without reinforcing the false belief. By acknowledging that the voices feel real to the client while denying the content, the nurse maintains trust and avoids engaging with the delusion, which could otherwise reinforce it.
✦ 台美臨床差異
美國精神科護理較強調認知行為取向與情緒同理；台灣精神醫療傾向藥物控制為主，互動多偏向安撫與規範。