— 心理社會完整性 · MEDIUM · MCQ —
一位患有強迫症（OCD）的病人每天花數小時檢查門鎖。下列何項護理介入最適合？
A client with obsessive-compulsive disorder (OCD) spends several hours daily checking locks. Which nursing intervention is most appropriate for this client?
- AIgnore the behavior to discourage it through lack of reinforcement忽視此行為，以缺乏增強來使其消退
- BStructure the environment to allow for time-limited rituals initially✓ 正解建構環境，初期允許進行限時性的儀式行為
- CStrictly limit the time spent checking locks to 10 minutes嚴格限制檢查門鎖的時間為 10 分鐘
- DExplain to the client that the behavior is illogical向病人解釋此行為是不合邏輯的
— Explanation · 中文詳解 —
強迫症治療初期不宜強硬中斷儀式行為，否則會引發嚴重焦慮。應在日常生活中給予結構化的時間表，允許其進行儀式，但逐步減少時間。邏輯勸說對 OCD 無效，因病人多了解其行為不合理；忽視行為則可能造成病人更強烈的焦慮反應。
Abruptly stopping compulsive rituals can trigger severe anxiety; therefore, the nurse should initially structure the environment to allow time-limited rituals while gradually reducing the duration. This approach helps the client regain control without experiencing acute distress, whereas ignoring the behavior or logical persuasion fails to address the underlying anxiety.
✦ 台美臨床差異
美國心理衛生護理較常運用認知行為治療框架；台灣多以環境支持與藥物治療為主。