[{"data":1,"prerenderedAt":76},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-023":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":47,"lastmod":75},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-022",22,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-024",24,"psychiatric-community",{"id":13,"webId":14,"year":15,"session":16,"subject":4,"number":17,"stem":18,"scenario":19,"carryOver":19,"options":20,"answer":25,"answerNote":19,"images":26,"explanation":27,"explanationDeep":28,"topics":29,"freq":32,"concepts":43},"nurse-108-1-精神科與社區衛生護理學-023","nurse-108-1-psychiatric-community-023",108,1,23,"魏小姐，32 歲，憂鬱症，第 2 次入院，今早護理人員與家屬會談時，家屬無奈表示，對於魏小姐的病很不能諒解，認為她是不願承受壓力，逃避壓力才會裝病，整天無病呻吟，全家人為了照顧她，都搞得生活大亂，護理人員對於家屬的抱怨，下列何種回應較適當？",null,{"A":21,"B":22,"C":23,"D":24},"她的病需要被照顧，等她病好了，你們家就會恢復正常了","了解做為家屬的負擔，但也需要持續她的治療","這次醫師已經幫她改藥了，病情應該可以控制住","這是憂鬱症的症狀，不要給她壓力，症狀很快就緩解了","B",[],"本題考點是面對家屬負向情緒時的治療性回應——先同理照顧負荷、再導向治療計畫的雙軌原則。依家庭護理與治療性溝通原則，家屬的抱怨反映的是照顧者負荷（caregiver burden）與對疾病的認知落差，護理人員應先承接情緒使其被理解，再提供正確方向，故選 B「了解做為家屬的負擔，但也需要持續她的治療」，前半句同理、後半句衛教，兩者兼顧。A 把家庭恢復正常寄託於個案痊癒，等於強化「都是她害的」歸因，且憂鬱症屬易復發疾病，此保證不實。C 只談改藥並保證「病情應該可以控制住」，是虛假保證且未回應家屬感受。D 直接說「症狀很快就緩解」同樣違反憂鬱症病程事實，且未同理家屬負荷。","此類題型的判準是「同理 + 事實」兩個成分是否同時出現。只有同理沒有方向＝空轉；只有衛教沒有同理＝家屬防衛升高；給時間保證（「很快」「就會」）＝虛假保證，是治療性溝通的明確禁忌，因為憂鬱症的自然病程與復發率並不支持這種承諾。\n\n家屬說「她是裝病、無病呻吟」，背後其實是疾病汙名化與對憂鬱症生物性基礎的不理解。憂鬱症涉及血清素、正腎上腺素、多巴胺等單胺神經傳導物質失調與 HPA 軸過度活化，並非意志力問題——這是後續衛教的知識基礎，但在會談當下不宜先講道理，順序仍是先情緒後認知。\n\n記憶口訣：「先接情緒，再給資訊；不承諾時間，不歸咎個人。」四個選項可按此篩：A 歸咎個人、C 與 D 承諾時間，只剩 B。\n\n可延伸複習：照顧者負荷評估、心理教育（psychoeducation）家族介入模式、Expressed Emotion（EE）高低與復發率的關係——高情緒表露家庭（批評、敵意、過度涉入）與精神疾病復發率上升有關，本題家屬的言詞正是高批評性的典型表現。",[30,33,36,39,41],{"term":31,"count":32},"治療性溝通",48,{"term":34,"count":35},"照顧者負荷",5,{"term":37,"count":38},"虛假保證",2,{"term":40,"count":16},"情緒表露(EE)",{"term":42,"count":16},"家屬心理教育",[44],{"id":45,"name":46},"therapeutic-communication","治療性溝通技巧",[48,50,54,59,64,69],{"webId":9,"stem":49,"number":10,"year":15,"session":16},"游先生，雙相情緒障礙症病人，在病房看到一位思覺失調症病人因手抖而掉藥物到地上，游先生認為這是病友的拒藥行為，大聲要求護理人員處理此病友的拒藥行為。針對此情況，護理人員最適宜的處理為下列何者？",{"webId":51,"stem":52,"number":53,"year":15,"session":38},"nurse-108-2-psychiatric-community-040","住院病人辜太太，長期於反覆的家暴中受盡折磨，辜太太表示夫妻爭吵是難免，不斷要求出院回家，請問在護理師首次接案時，下列輔導技巧何者較適切？①耐心面對辜太太的防禦心，傾聽訴說 ②應明顯立即面質辜太太的防禦心 ③護理師將焦點放在支持與增加資源的聯結 ④覺察辜太太之矛盾與壓力",40,{"webId":55,"stem":56,"number":57,"year":58,"session":16},"nurse-109-1-psychiatric-community-054","經過社區健康營造之後，某社區居民提升口腔癌與檳榔使用的認知，也願意改變以種植檳榔維生的方式。這是屬於何種評價？",54,109,{"webId":60,"stem":61,"number":62,"year":63,"session":38},"nurse-110-2-psychiatric-community-012","有關 Benzodiazepine（BZD）的護理指導，下列何者最適當？",12,110,{"webId":65,"stem":66,"number":67,"year":68,"session":38},"nurse-111-2-psychiatric-community-056","政府為提升嚴重特殊傳染性肺炎（COVID-19）疫苗接種率，透過里幹事協助老人預約鄰近的診所，並發通知單提醒接種時間與地點。此方式是應用健康信念模式的那些要素？①增加行動線索 ②降低行動障礙認知 ③增進疾病嚴重度的認知 ④提升自我效能",56,111,{"webId":70,"stem":71,"number":72,"year":73,"session":74},"nurse-112-3-psychiatric-community-010","有關認知障礙症病人的特性，下列敘述何者正確？",10,112,3,"2026-09-29",1790672290766]