— 心理社會完整性 · HARD · MCQ —
一位強迫症（OCD）病人花數小時洗手。最恰當的初步護理行動為何？
A client with obsessive-compulsive disorder (OCD) spends hours washing hands. What is the most appropriate initial nursing action?
- AAllow the patient to finish the ritual, then structure time for other activities✓ 正解允許病人完成儀式，然後安排其他活動的時間
- BImmediately stop the washing to prevent skin breakdown立即停止洗手以防止皮膚破損
- CRestrict the patient's access to soap and water限制病人接觸肥皂和水
- DTell the patient that the washing is irrational告訴病人洗手行為是非理性的
— Explanation · 中文詳解 —
強迫症（Obsessive-Compulsive Disorder, OCD）病人的強迫行為（Ritual）是其緩解焦慮的唯一機制。若護理師強制中斷，會導致病人焦慮指數急劇飆升，甚至引發敵對或恐慌反應。護理照護的策略應先維持病人情緒穩定，允許其完成儀式，隨後透過結構化護理計畫（Structured Care Plan），在病人焦慮較低時，逐步減少儀式時間，並引入其他替代性活動，以達到行為修正的目的。
The most appropriate initial action is to allow the client to complete the hand-washing ritual to maintain emotional stability, as abrupt interruption can cause severe anxiety. Afterward, the nurse should structure time for other activities and gradually work toward reducing the ritual duration.