一位強迫症個案花費數小時洗手，護理師採取下列何種介入最具治療性？
A client with obsessive-compulsive disorder (OCD) spends hours washing hands. Which nursing approach is most therapeutic?
- AExplain the irrationality of the behavior to the client向個案解釋該行為的非理性
- BRequire the client to stop the behavior before receiving meals要求個案在用餐前停止該行為
- CAccept the behavior while setting limits on the time allotted✓ 正解接納該行為，但對 allotted 的時間設定限制
- DImmediately stop the behavior to prevent skin breakdown立即制止該行為以防止皮膚破損
對於強迫症病人，直接制止行為（D）會引發極度焦慮，甚至導致攻擊行為。採取「接受行為但給予結構化限制」的策略，能讓個案建立安全感，同時逐步減少強迫行為。解釋理性（A）對強迫症無效，因為病人已知行為不合理但無法克制。以吃飯為要脅（B）會破壞治療同盟，並增加個案的防衛心理。
For clients with OCD, directly stopping the behavior (D) provokes extreme anxiety and may even trigger aggression. Accepting the behavior while setting structured limits gives the client a sense of safety while gradually reducing compulsive behavior. Explaining rationality (A) is ineffective in OCD because the client already knows the behavior is irrational but cannot stop it. Using meals as leverage (B) damages the therapeutic alliance and increases defensiveness.
美國強調 ERP（暴露與反應預防）治療；台灣多採藥物輔助，護理互動有時會比較急於矯正行為。