— 心理社會完整性 · EASY · MCQ —
一位 45 歲患有廣泛性焦慮症的個案，主訴心悸、顫抖及強烈的瀕死感。護理師應優先使用哪種治療性溝通策略？
A 45-year-old client with a history of generalized anxiety disorder presents with reports of palpitations, tremors, and a fear of impending doom. Which therapeutic communication strategy should the nurse utilize first?
- AUse short, simple sentences and maintain a calm, quiet environment✓ 正解使用簡短、簡單的句子並保持安靜的環境
- BAdminister the prescribed PRN anxiolytic medication immediately立即給予處方之備用抗焦慮藥物
- CChallenge the client's irrational thoughts to promote reality testing挑戰個案的非理性思維以促進現實測試
- DEncourage the client to describe the precipitating event in detail鼓勵個案詳細描述誘發事件
— Explanation · 中文詳解 —
面對急性焦慮發作，首要目標是降低個案的焦慮水平。過多的資訊或分析反而會增加個案負荷。使用簡短明瞭的語句能幫助個案集中注意力，平靜的環境則有助於減少外界刺激，使神經系統冷靜下來。此時進行深度探索或挑戰認知會讓病人更焦躁。
Using short, simple sentences and reducing environmental stimuli helps lower anxiety levels by minimizing cognitive load and sensory overload during an acute panic attack. More complex interactions, such as challenging thoughts or detailed analysis, can increase defensiveness and exacerbate the client's distress.
✦ 台美臨床差異
美國護理師在心理衛生單位有更多自主處置權，台灣則多依醫師醫囑執行藥物處置。