— 心理社會完整性 · MEDIUM · MCQ —
護理師正在照護一位患有憂鬱發作的雙極性情感障礙病人。病人說：「我感覺非常沒價值且充滿罪惡感。」最恰當的護理介入措施是什麼？
A nurse is caring for a client with bipolar disorder who is experiencing a depressive episode. The client states, 'I feel so worthless and guilty.' Which nursing intervention is MOST appropriate?
- ATell the client they are not worthless or guilty.告訴病人他們並非毫無價值或充滿罪惡感。
- BAcknowledge the client's feelings without validating them as fact.✓ 正解在不將其視為事實的情況下，認可病人的感受。
- CSuggest activities that require significant concentration.建議需要高度集中注意力的活動。
- DEncourage the client to focus on positive aspects of their life.鼓勵病人專注於生活中的積極面向。
— Explanation · 中文詳解 —
面對病人的無價值感和罪惡感，護理師應先同理其感受，但不直接否定。選項 B 承認病人表達的情緒，同時不將這些感受視為客觀事實，為後續的介入（如探索原因、建立價值感）留有空間。A 句否定，D 句可能因病人情緒狀態而難以實行，C 句可能增加其挫敗感。
Acknowledging the client's feelings validates their emotional experience without reinforcing the distorted thoughts as objective facts. This therapeutic approach maintains a safe distance and avoids invalidating the client, unlike direct contradiction or suggesting activities that may be too difficult during severe depression.
✦ 台美臨床差異
美台護理師在處理憂鬱症病人的無價值感時，都強調先同理病人感受。美國在心理動力學的運用上，可能更強調探索這些感受的根源。