— 心理社會完整性 · EASY · MCQ —
一位病人因末期診斷而處於否認期的哀傷中。護理師應如何反應？
A client is experiencing the denial stage of grief following a terminal diagnosis. How should the nurse respond?
- ARefer the client to a psychiatrist for medication轉介個案至精神科醫師處接受藥物治療
- BConfront the client with the medical facts until they accept them用醫學事實與個案對質，直到其接受為止
- CAcknowledge the client's current state and offer presence✓ 正解肯定個案當前的狀態並提供陪伴
- DEncourage the client to start making funeral plans immediately鼓勵個案立即開始籌備後事
— Explanation · 中文詳解 —
否認是病人處理痛苦消息的保護機制。護理師不應強行打破此屏障（confront），而是尊重其調適節奏。提供陪伴（Presence）與傾聽，讓病人感到安全，當他準備好面對時，會自行跨越否認期。強行讓其處理後事（D）過於粗糙，藥物（A）則非必要。
Denial is a normal protective mechanism against trauma, so the nurse should acknowledge the client's current state and offer supportive presence without forcing acceptance. Confronting the client with facts or pushing for immediate funeral plans can disrupt their coping process, while psychiatric referral is not indicated for this normal grief response.
✦ 台美臨床差異
台美臨終護理皆強調陪伴；但美國安寧照顧（Hospice）資源較普及，心理師介入更為常態。