護理師照護一位患有神經性厭食症的病人，下列哪項護理措施在治療初期最合適？
A nurse is caring for a client with anorexia nervosa. Which nursing intervention is most appropriate for the initial phase of treatment?
- ADiscuss the long-term effects of malnutrition討論營養不良的長期影響
- BExplore the underlying family dynamics探討潛在的家庭動力
- CEncourage the client to cook their own meals鼓勵個案自行烹飪餐點
- DEstablish a structured meal plan and monitor intake✓ 正解建立結構化的飲食計畫並監測攝取量
神經性厭食症（Anorexia Nervosa）是一種複雜的進食障礙，涉及生理、心理及社會因素。在治療初期，首要目標是穩定病人的生理狀況，防止因極度營養不良導致的危險併發症。因此，建立結構化的飲食計畫（structured meal plan）並嚴密監測其進食量（monitor intake）是關鍵。這能確保病人獲得足夠的營養，逐步恢復體重，並建立規律的進食習慣。討論長期後果（discuss long-term effects）或探索家庭動力（explore family dynamics）是重要的心理治療環節，但通常在病人生理狀況較為穩定後才開始。鼓勵病人自行烹飪（cook their own meals）則可能增加其對食物的焦慮，不適合初期治療。
Anorexia nervosa is a complex eating disorder involving physiological, psychological, and social factors. In the initial phase of treatment, the priority goal is to stabilize the client's physiologic status and prevent dangerous complications from severe malnutrition. Therefore, establishing a structured meal plan and closely monitoring intake is essential. This ensures the client receives adequate nutrition, gradually regains weight, and establishes regular eating habits. Discussing long-term effects or exploring family dynamics are important components of psychotherapy but typically begin after the client is physiologically stable. Encouraging the client to cook their own meals may increase food-related anxiety and is not suitable for early treatment.
在神經性厭食症（Anorexia Nervosa）的初期治療，美國與台灣的臨床實務都強調生理穩定與建立結構化飲食計畫。美國的治療模式可能更強調跨專業團隊合作，包括精神科醫師、心理治療師、註冊營養師（Registered Dietitian, RD）和護理師，且 RD 在飲食計畫的制定與執行中扮演更核心的角色。台灣的醫療體系也同樣有多專業團隊，但 RD 的介入程度可能因醫院資源而異。此外，美國對於飲食障礙的心理治療（如認知行為療法 CBT、辯證行為療法 DBT）有更廣泛的研究與應用，可能在初期就開始融入部分心理介入的元素，但仍以生理穩定為前提。