一位患有廣泛性焦慮症的 45 歲客戶告訴護理師：「每次走進擁擠的雜貨店，我都覺得自己快要死掉了。」護理師初步的治療性回應為何？
A 45-year-old client with generalized anxiety disorder tells the nurse, 'I feel like I am going to die every time I walk into a crowded grocery store.' Which initial response by the nurse is therapeutic?
- ATell me more about what you experience physically when you are in the store.✓ 正解告訴我你在店內時身體的感受。
- BYou should try to avoid going to crowded places for a while.你應該試著暫時避免去擁擠的地方。
- CWhy do you feel that way when you are in a crowded place?為什麼你在擁擠的地方會有那種感覺？
- DDon't worry, many people feel the same way about crowds.別擔心，很多人對人群都有同樣的感覺。
治療性溝通的核心在於鼓勵客戶描述經驗，而非提供建議或評判。當客戶提到瀕死感時，這通常是恐慌發作的症狀。護理師應運用『開放式問句』與『探詢』技術，引導病人具體化描述身體感受，這有助於後續區分是生理問題還是心理焦慮。為何不選 C？『為什麼』開頭的問句容易帶有責備暗示，會讓病人產生防禦心。B 選項是錯誤的輔導建議，鼓勵逃避行為會強化病人的恐懼症。D 選項則是輕描淡寫的安慰，會讓病人覺得自己的痛苦被忽視。專業護理師應建立信任關係，透過傾聽與探詢，協助病人察覺情緒與生理反應的連結，這是心理健康護理的基石。
Therapeutic communication involves using open-ended questions to encourage the client to describe their experiences without judgment. Asking about physical sensations helps validate the client's feelings and gathers essential data for assessment, whereas asking 'why' may induce defensiveness.
美國護理教育極度強調『治療性溝通技巧』與『非批判性態度』，強調護理師不應給予建議；台灣醫療環境較為繁忙，護理師常習慣以『給予建議』或『安撫』的方式快速結束對話，較少運用深度探詢技巧。