— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人出現聽幻覺，護理師何種反應最具治療性？
A client with schizophrenia is exhibiting auditory hallucinations. Which response by the nurse is therapeutic?
- AAcknowledge the experience and focus on the client's current feelings✓ 正解肯定病人的經驗，並聚焦於病人目前的情緒感受
- BChallenge the reality of the voices to encourage logical thinking挑戰聲音的現實性，以鼓勵邏輯思考
- CAsk the client to ignore the voices請病人忽略這些聲音
- DTell the client the voices are not real告訴病人這些聲音並非真實存在
— Explanation · 中文詳解 —
面對幻覺，護理師應持客觀態度，承認病人感受到的現實（對病人而言是真的），但強調自己並未聽到。透過轉移注意力至現實感受，能減少病人對幻覺的關注。爭辯真實性會導致防衛機制，增加病人的敵意與焦慮，對建立治療性關係無益。
Therapeutic communication with a client experiencing auditory hallucinations involves acknowledging the client's experience without reinforcing the delusion, while focusing on their current feelings. This approach validates the client's distress and helps maintain a realistic orientation, whereas challenging the hallucination or denying its existence can increase anxiety and damage trust.
✦ 台美臨床差異
台美護理教育皆強調幻覺處理應「接納感受但強調現實」，避免直接辯駁，做法一致。