一位患有強迫症（OCD）的病人每天早晨花兩小時排列床頭櫃上的物品，導致其無法參加晨間團體治療。護理師應採取哪項措施最合適？
A client with obsessive-compulsive disorder (OCD) spends two hours each morning arranging objects on a bedside table. This behavior interferes with the client's ability to attend morning groups. Which nursing action is most appropriate?
- AExplain to the client that the rituals are irrational and a waste of time.向病人解釋這些儀式是非理性的，且浪費時間。
- BLock the client out of the room during the morning to prevent the ritual.在早晨將病人鎖在房間外，以阻止該儀式。
- CGradually limit the amount of time the client is allowed to spend on the ritual.✓ 正解逐漸限制病人被允許進行儀式的時間。
- DPhysically move the objects to show the client that nothing bad will happen.物理性地移動物品，以向病人展示不會發生壞事。
強迫行為（rituals）是病人用來緩解強迫思考所引發焦慮的一種防衛機制。護理計畫的核心在於「逐步減少」強迫行為的時間，而非立即禁止。突然禁止（如 D 和 B）會引發病人爆發性的極度焦慮，甚至導致恐慌發作，這不具備治療意義。選項 C 採用行為療法中的暴露與反應預防原則，透過逐步限制時間，讓病人學習在減少強迫行為的情況下處理焦慮。選項 A 雖然事實正確，但強迫症病人通常知道行為不合理，只是無法控制，這種說法只會增加其挫折感。臨床思路上，必須兼顧病人的焦慮緩解與功能恢復，採取漸進式的目標設定。
Compulsive behaviors (rituals) are a defense mechanism the client uses to relieve the anxiety produced by obsessive thoughts. The core of nursing care is to 'gradually reduce' the time spent on the ritual rather than prohibiting it outright. Abrupt prohibition (as in Options D and B) provokes overwhelming anxiety and may trigger a panic attack, providing no therapeutic benefit. Option C applies the exposure and response prevention principle from behavioral therapy, gradually limiting time so the client can learn to tolerate anxiety while engaging in the ritual less. Option A may be factually true, but clients with OCD typically already recognize that their behavior is irrational and simply cannot control it; this kind of statement only increases frustration. Clinically, the nurse must balance anxiety relief with restoration of function, using a gradual goal-setting approach.
美國心理治療高度整合認知行為治療（CBT），護理師在病房中常需配合執行細緻的行為契約（Behavioral Contract）；台灣則多仰賴藥物治療，病房端的行為介入有時較缺乏結構化的執行與追蹤。