護理師正為一位厭食症病人辦理入院。護理師應優先採取哪項初步干預措施以建立治療性關係？
The nurse is admitting a client with anorexia nervosa. Which initial intervention should the nurse prioritize to establish a therapeutic relationship?
- AEncourage the client to express feelings about their body image and control.✓ 正解鼓勵案主表達對身體形象和控制感的感受
- BExplain the strict rules regarding meal times and weight monitoring.說明關於用餐時間和體重監測的嚴格規定
- CFormulate a contract with the client regarding daily caloric intake goals.與案主制定關於每日熱量攝取目標的契約
- DAssure the client that they will not be forced to eat anything they dislike.向案主保證不會強迫其吃不喜歡的食物
厭食症病人的核心問題通常與控制感、自我價值和身體意象扭曲有關。建立治療性關係的首要步驟是展現同理心並提供一個安全空間讓病人表達內心感受。選項 A 聚焦於病人的內在衝突（控制感與心理壓力），這比單純的體重管理更能觸及疾病根源。選項 B 是必要的臨床規範，但若在入院初期就以此為重點，會讓病人感到受威脅且失去控制，不利於關係建立。選項 C 雖然在治療計畫中很重要，但它屬於協商階段，應在初步信任建立後進行。選項 D 是不切實際的保證，因為在醫療介入下，有時必須為了生命安全而強制給予營養。
The core issues for clients with anorexia nervosa typically involve control, self-worth, and distorted body image. The first step in establishing a therapeutic relationship is to demonstrate empathy and provide a safe space in which the client can express their inner feelings. Option A focuses on the client's internal conflicts (sense of control and psychological pressure) and reaches the root of the disorder more effectively than weight management alone. Option B represents a necessary clinical rule, but emphasizing it at admission can make the client feel threatened and out of control, hindering rapport. Although option C is important in the overall treatment plan, it belongs to the negotiation stage and should follow the establishment of initial trust. Option D is an unrealistic promise, because medical intervention sometimes requires forced nutrition for safety reasons.
美國的飲食障礙治療中心非常強調病人的自主參與和「控制感」的轉移；台灣在處理這類病人時，有時會由家屬高度介入決定權，護理師需在病人、家屬與醫療團隊間進行更複雜的協調，但 NCLEX 仍以病人的心理動力為核心。