— 心理社會完整性 · MEDIUM · MCQ —
護理師照護一位重度憂鬱症個案，下列哪項個案敘述代表其自殺風險最高？
A nurse is caring for a client who is diagnosed with major depressive disorder. Which statement by the client indicates the highest risk for self-harm?
- AI am having trouble sleeping and have no appetite.我最近睡不好也沒有食慾。
- BI have been feeling very sad and hopeless lately.我最近感到非常悲傷和絕望。
- CI am waiting for my new medications to take effect.我正在等待新藥發揮作用。
- DEverything will be much better for my family after I am gone.✓ 正解我離開後，我的家人情況會好很多。
— Explanation · 中文詳解 —
此個案表現出「賦予身後事」的徵象，將死亡視為對家人的解脫，這是自殺意念轉化為自殺計畫的危險警訊。憂鬱症患者若在療程中突然心情變好，若伴隨此種言論，表示其可能已決定結束生命，必須立即進行自殺風險評估與監控。
The statement 'Everything will be much better for my family after I am gone' indicates a plan for suicide, as it suggests the client views death as a relief for others and excludes themselves from the future. This is a critical warning sign requiring immediate suicide risk assessment and monitoring.
✦ 台美臨床差異
美國護理師在自殺風險評估上擁有更多自主權啟動安全檢查；台灣多依賴醫師開立約束或監控醫囑。