護理師照護一位出現日落症候群的長者。哪項介入措施最有效？
A nurse is caring for an older adult experiencing sundowning syndrome. Which intervention is most effective?
- AAdminister sedatives before sunset日落前給予鎮靜劑
- BUse physical restraints to ensure safety使用身體約束以確保安全
- CKeep the room dark to promote sleep保持房間黑暗以促進睡眠
- DMaintain a regular, structured daily routine✓ 正解維持規律、結構化的日常作息
日落症候群（Sundowning syndrome）常發生在患有認知障礙的長者身上，表現為傍晚時分的混亂、焦慮與行為改變。規律的作息（D）能給予病人高度的預測感，減少對環境的不安。保持適度照明以減少陰影、減少傍晚時分過多的刺激、維持作息規律均為非藥物介入的黃金原則。約束（B）會引發病人抵抗與譫妄， sedatives（A）則可能導致跌倒與認知惡化，皆非首選。
Sundowning syndrome often occurs in older adults with cognitive impairment, manifesting as evening-time confusion, anxiety, and behavioral changes. A regular routine (D) provides predictability and reduces environmental uneasiness. Maintaining appropriate lighting to reduce shadows, reducing excessive evening stimulation, and keeping a regular routine are golden principles of non-pharmacologic intervention. Restraints (B) cause resistance and delirium, and sedatives (A) may cause falls and worsen cognition; neither is first-line.