一位強迫症（OCD）個案因頻繁洗手導致手部皮膚破皮。護理計畫中應包含哪些護理措施？（選所有適合的）
A client with obsessive-compulsive disorder (OCD) frequently washes their hands until they are raw. Which nursing intervention is most appropriate to include in the plan of care? (Select all that apply.)
- AAllow time for the ritual to prevent extreme anxiety✓ 正解允許時間讓其執行儀式，以防止極度焦慮
- BEstablish a schedule to gradually limit the time for handwashing✓ 正解建立計畫以逐漸限制洗手的時間
- CConfront the client about the irrationality of the behavior直接指責病人行為的不合理性
- DProvide positive reinforcement for non-ritualistic behaviors✓ 正解針對非儀式性的行為給予正向增強
- EInterrupt the ritual immediately to stop the skin damage立即中斷儀式以停止皮膚損傷
對於強迫行為，護理目標是逐步減少而非瞬間阻斷，以防焦慮激增。初期應允許儀式行為以維持焦慮穩定（A），隨後制定結構化減少洗手時間表（B），並對替代行為給予正向增強（D）。直接對抗（C）無效，強制中斷（E）會造成個案強烈恐慌甚至攻擊行為。
For compulsive behaviors, the nursing goal is gradual reduction rather than abrupt cessation, in order to avoid an anxiety surge. In the early phase the ritual should be permitted to maintain stable anxiety levels (A), followed by a structured schedule that gradually limits the time spent handwashing (B), with positive reinforcement provided for alternative behaviors (D). Direct confrontation (C) is ineffective, and forcibly interrupting the ritual (E) may provoke severe panic or aggressive behavior.
台美兩地在處理強迫症時均遵循認知行為原則，但台灣因病房人力限制，對於強迫行為的行為治療計畫執行力較易中斷。