一位邊緣型人格障礙的病人，護理師應採取何種最恰當的方法？
A nurse is caring for a client with borderline personality disorder. What is the most appropriate approach for the nurse to take?
- AMaintain consistent and clear boundaries✓ 正解維持一致且明確的界線
- BBe flexible with established rules to build rapport對既定規則保持彈性以建立良好關係
- CAssign multiple staff members to avoid splitting指派多名護理人員以避免分裂行為
- DFocus on the client's past childhood trauma聚焦於個案的過去童年創傷
邊緣型人格障礙（Borderline Personality Disorder, BPD）的病人常因情緒不穩定、衝動行為、人際關係緊張及自我形象紊亂等特徵，在臨床照護上極具挑戰。護理的核心目標是為病人提供一個安全、可預測且結構化的環境，以協助他們發展更健康的應對機制並穩定情緒。 維持一致且明確的界線是至關重要的護理策略，這有助於病人理解行為的限制，減少操弄或分裂行為（splitting）的發生，並從中建立信任感。當護理師能堅定且溫和地執行規則，病人將逐漸學習內化這些界線，進而改善人際互動模式和情緒調節能力。這項策略不僅關乎病人的安全，也確保了治療團隊的穩定性，是長期治療成功的基石。
Clients with borderline personality disorder (BPD) are clinically challenging to care for due to emotional instability, impulsive behavior, interpersonal tension, and disturbances in self-image. The core nursing goal is to provide a safe, predictable, and structured environment that helps the client develop healthier coping mechanisms and stabilize emotions. Maintaining consistent and clear boundaries is a critical nursing strategy. It helps clients understand behavioral limits, reduces manipulative behaviors and splitting, and fosters trust. When the nurse enforces rules firmly yet gently, the client gradually learns to internalize these boundaries, thereby improving interpersonal patterns and emotional regulation. This strategy not only relates to client safety but also ensures the stability of the treatment team and is foundational to successful long-term treatment.
在美國，精神科護理師在處理邊緣型人格障礙病人時，特別強調團隊合作與界線一致性，常會召開團隊會議討論病人的行為模式與應對策略。台灣的護理環境在精神科照護上，對界線的強調程度與美國相似，但團隊協調的頻率和正式性可能因醫院規模和人力配置而異。此外，美國更重視病人的自我決定權，即使在精神疾病的脈絡下，仍會盡力讓病人參與治療計畫的討論。