— 心理社會完整性 · MEDIUM · MCQ —
一位憂鬱症個案表示：「沒有我，我的家人會過得更好。」護理師最合宜的治療性回應為何？
A client with depression says, "My family would be better off without me." Which response by the nurse is the most therapeutic?
- AYou are feeling like a burden to your family.✓ 正解你覺得自己是家人的負擔。
- BLet's focus on positive things in your life today.讓我們專注於你今天生活中的美好事物。
- CDon't say that; you have a loving family.別這麼說，你有一個愛你的家庭。
- DWhy would you think your family feels that way?你為什麼會認為你的家人有這種感覺？
— Explanation · 中文詳解 —
此個案表現出低自我價值與可能的自殺意念。護理師應使用「反映感受（Reflecting）」技巧，確認並同理個案的負面情緒，而非反駁或給予虛假安慰。透過澄清感受，能鼓勵個案表達更多內心想法，並建立治療性溝通關係。
The client's statement suggests feelings of worthlessness and potential suicidal ideation, requiring a therapeutic response that validates their emotions. Reflecting the client's feelings acknowledges their distress without judgment, encouraging further expression and building trust. Non-therapeutic responses such as offering false reassurance, dismissing the concern, or asking 'why' can invalidate the client's experience and hinder open communication.
✦ 台美臨床差異
台美皆強調自殺防範與治療性溝通；美國護理教育更強調「自殺評估」流程，台灣則常受傳統文化影響，偏向採取勸導式回應。