— 心理社會完整性 · MEDIUM · MCQ —
一位思覺失調症病人告訴護理師：「聲音跟我說你試圖在我的食物裡下毒。」護理師應如何回應？
A client with schizophrenia tells the nurse, 'The voices are telling me that you are trying to poison my food.' How should the nurse respond?
- AAsk the client why the voices are saying such mean things詢問病人為什麼聲音會說這麼難聽的話
- BTell the client that there are no voices and the food is safe告訴病人沒有聲音，而且食物是安全的
- CRemove the food tray and bring a new one from the kitchen移除餐盤並從廚房端來新的食物
- DAcknowledge the client's feelings while stating that you do not hear the voices✓ 正解肯定病人的感受，同時表示你聽不到那些聲音
— Explanation · 中文詳解 —
面對幻聽的病人，護理師應採「現實導向」的態度，即承認病人的感受，但不認同幻覺的存在。直接否定病人的感官經驗會引發衝突，而順應幻覺（如更換食物）則會強化其妄想。應將重點放在病人的情感回應上，建立穩定信任的關係。
The nurse should acknowledge the client's fear and validate their feelings without confirming the delusion or arguing about the reality of the voices. This approach maintains a therapeutic relationship and ensures safety without reinforcing the paranoid ideation.
✦ 台美臨床差異
美國護理教育極度強調不強化幻覺；台灣臨床環境有時為了安撫病人會採取妥協性措施，需注意護理指導的一致性。