— 心理社會完整性 · EASY · MCQ —
一位強迫症病人每天花數小時進行洗手儀式。護理初期最恰當的護理措施為何？
A 30-year-old client with obsessive-compulsive disorder (OCD) spends several hours daily performing hand-washing rituals. Which nursing intervention is most appropriate for early treatment?
- AExplain that the hand-washing is irrational and unnecessary解釋洗手是不合理且不必要的
- BPrevent the client from performing the ritual to stop the habit阻止病人執行儀式以戒除習慣
- CForce the client to stop the behavior immediately強制病人立即停止該行為
- DStructure the environment to allow time for the ritual✓ 正解安排環境以允許病人進行儀式
— Explanation · 中文詳解 —
對於強迫症病人，在治療初期直接禁止強迫行為會導致極度焦慮，甚至引發暴力行為。最合適的策略是在治療計畫中安排時間讓病人完成儀式，同時建立治療性關係，再逐步進行暴露與反應預防（ERP）。對行為進行理性批判（A）並無法解決強迫意念。
In the early stages of treating OCD, abruptly preventing rituals can cause severe anxiety; therefore, structuring the environment to allow time for the ritual is appropriate. This approach facilitates the establishment of a therapeutic relationship and supports gradual behavior modification through exposure and response prevention.
✦ 台美臨床差異
在美國護理師常參與認知行為治療（CBT）的執行，而台灣護理師較常專注於情緒支持與服藥遵從性評估。