— 心理社會完整性 · MEDIUM · MCQ —
一位精神分裂症病人告訴護理師：「那些聲音告訴我，妳想要在我的食物裡下毒。」何種回應最具療效？
A client with schizophrenia tells the nurse, 'The voices are telling me that you are trying to poison my food.' Which response is most therapeutic?
- AI understand that you hear voices, but I am here to help you✓ 正解我了解你聽到聲音，但我在這裡是為了幫助你
- BWhy do you think I would want to harm you?你為什麼認為我會想傷害你？
- CThere is no one else here, just you and me這裡沒有其他人，只有你和我
- DI promise that the food is safe to eat我保證食物是安全可食用的
— Explanation · 中文詳解 —
對於幻聽與妄想的病人，護理師應採取「不認同幻覺，但同理病人情緒」的態度。選項 A 承認病人有幻聽體驗，同時表達關懷與護理意圖，能有效降低病人的防衛心。A 容易使病人懷疑，B 可能引發憤怒，C 則是直接否定病人的感官經驗，皆不適當。
Therapeutic communication with a client experiencing hallucinations involves acknowledging the client's feelings without validating the delusion. Responding by stating, 'I understand that you hear voices, but I am here to help you,' validates the client's distress while maintaining reality orientation and building trust.
✦ 台美臨床差異
美台精神科護理原則皆強調治療性溝通，但在台灣臨床場域中，護理師需更多考量家屬對治療的介入與限制。