[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-112-2-psychiatric-community-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":63},"精神科與社區衛生護理學","psychiatric-community",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-112-2-精神科與社區衛生護理學-024","nurse-112-2-psychiatric-community-024",112,2,24,"有關病人以身體症狀帶來附帶收穫（secondary gain）的敘述，下列何者最適切？",{"A":14,"B":15,"C":16,"D":17},"病人能增加病識感及服藥意願","滿足病人依賴的需求，減輕需負的責任","病人的記憶力與定向感下降","病人能增加社會互動的意願","B",null,[],"本題考點是身體症狀的附帶收穫（secondary gain）之定義。依精神動力學概念，初級收穫（primary gain）是症狀本身可降低內在焦慮，附帶收穫則是因為生病而從環境獲得的外部好處，例如被照顧、免除工作或責任、滿足被依賴的需求，故正解為 B。A 錯，增加病識感與服藥意願屬治療成效，與利用症狀換取好處無關。C 錯，記憶力與定向感下降是認知功能障礙（如譫妄、失智）的表現，並非附帶收穫的概念。D 錯，附帶收穫多使病人退縮、依賴且逃避責任，而非主動增加社會互動意願，反而常導致社交功能退化。考點在於辨識附帶收穫的核心是「藉症狀獲得外部利益、減輕應負責任」。","附帶收穫常見於身體症狀障礙症、轉化症與部分焦慮相關疾患。primary gain 對內（潛抑衝突、降低焦慮），secondary gain 對外（免責、獲得關注、經濟補償）。臨床照護上若過度給予特別關注，可能不自覺強化症狀，故護理重點在於同理感受但不強化生病角色，並協助以健康方式滿足依賴需求。記憶對比：primary＝解決內在焦慮，secondary＝獲得外在好處。可延伸連結「疾病獲益」與逃避型因應機轉、次級增強的概念。",[24,27,30,32],{"term":25,"count":26},"身體症狀障礙症",5,{"term":28,"count":29},"附帶收穫 secondary gain",1,{"term":31,"count":29},"初級收穫 primary gain",{"term":33,"count":29},"生病角色",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-112-2-psychiatric-community-025","陳先生，近三個月多次忽然間感到胸痛、心悸、發抖、透不過氣，失去現實感等症狀，可在幾分鐘後緩解，經各項身體檢查顯示並無生理疾病，但之後陳先生仍持續擔心症狀會再度發作並死亡。下列敘述何者為陳先生最可能的診斷？",25,{"webId":40,"stem":41,"number":42,"year":9,"session":43},"nurse-112-3-psychiatric-community-041","下列何種家庭評估工具，最適合用來評估獨居老人的外在連結和資源？",41,3,{"webId":45,"stem":46,"number":47,"year":48,"session":10},"nurse-113-2-psychiatric-community-035","有關生命統計之敘述，下列何者錯誤？",35,113,{"webId":50,"stem":51,"number":52,"year":53,"session":43},"nurse-114-3-psychiatric-community-033","調查社區民眾自費支付 SARS-COV-2 病毒核酸檢驗的能力，是評估服務資源的那一項屬性？",33,114,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-106-2-psychiatric-community-007","記憶力分為許多層次，關於其各種檢測評估方法的敘述，下列何者正確？",7,106,{"webId":60,"stem":61,"number":42,"year":62,"session":10},"nurse-107-2-psychiatric-community-041","臺灣某縣市 15 歲以上的性比小於 100，代表的意義為何？",107,"2026-09-04",1788510748888]