— 心理社會完整性 · MEDIUM · MCQ —
一位患有強迫症（OCD）的個案藉由儀式行為來處理焦慮。在照護初期，最合適的護理介入為何？
A client with obsessive-compulsive disorder (OCD) performs rituals to manage anxiety. What is the most appropriate nursing intervention in the early stages of care?
- AAllow the client to complete the rituals to prevent increased anxiety✓ 正解允許病人完成儀式行為以防止焦慮增加
- BConfront the client about the irrationality of the rituals對質病人儀式行為的非理性
- CIncrease the medication dosage to block the obsessions增加藥物劑量以阻斷強迫觀念
- DImmediately stop the rituals to break the cycle立即停止儀式行為以打破循環
— Explanation · 中文詳解 —
對於初期治療的 OCD 個案，不應強行中斷儀式行為，因為這會引發極度焦慮與恐慌。護理原則是先允許儀式進行以維持情緒穩定，隨後在治療關係建立後，再透過逐步減少時間（反應阻斷法）的方式進行干預。直接強迫停止或批判該行為是無效且具破壞性的。
In the early stages of treating Obsessive-Compulsive Disorder, allowing the client to perform rituals helps prevent excessive anxiety while building therapeutic rapport. Forcing the cessation of rituals immediately can cause panic and damage the nurse-client relationship. Intervention should focus on gradual reduction of ritual time once trust is established.
✦ 台美臨床差異
美國臨床更強調暴露與反應預防 (ERP) 的專業行為治療；台灣臨床多採取藥物合併認知行為引導，較少由一般護理師執行 ERP。