— 心理社會完整性 · MEDIUM · MCQ —
一位重度憂鬱症個案拒絕進食與洗澡已三天。護理師哪項陳述最能展現治療性溝通？
A client is diagnosed with major depressive disorder and refuses to eat or bathe for three days. Which nursing statement best demonstrates a therapeutic communication technique?
- AYou really need to eat something to get your energy back.你真的需要吃些東西來恢復體力。
- BDon't you think you would feel much better if you kept yourself clean?你不覺得如果你保持清潔會感覺好得多嗎？
- CIt's important for you to follow the unit rules regarding hygiene.遵守病房關於衛生的規定對你很重要。
- DI noticed that you have not been eating or bathing for the past three days.✓ 正解我注意到你在過去三天沒有進食或洗澡。
— Explanation · 中文詳解 —
觀察法（Observation）是治療性溝通的重要技巧，護理師應客觀敘述觀察到的事實，而非進行評價或強迫。選項 D 僅陳述事實，不僅給予病人確認感受的空間，也不會帶來評判感。其他選項皆带有說教或要求意味，容易引發抗拒。
Therapeutic communication involves stating objective observations without judgment or advice. By noting that the client has not eaten or bathed for three days, the nurse validates the behavior and opens a dialogue for the client to express feelings. This approach avoids the defensiveness often triggered by leading questions, advice-giving, or rigid rule enforcement.
✦ 台美臨床差異
台灣護理師在快節奏環境中常直接給予指示，而美國護理教育更強調對觀察結果的回饋，以促進病人自我覺察。