一位人格障礙症的病人在病房中展現操控行為。下列哪項護理措施最為有效？
A client with personality disorder is exhibiting manipulative behaviors on the unit. What is the most effective nursing approach to address this?
- AConfront the client about their behavior during group therapy在團體治療期間指責病患的行為
- BConsistently enforce unit rules and communicate with the interdisciplinary team✓ 正解一致地執行病房規則並與跨專業團隊溝通
- CAssign a different nurse to the client each day to prevent favoritism每天指派不同的護理師照顧該病患以防止偏袒
- DIncrease the medication dosage to reduce the client's agitation增加藥物劑量以降低病患的躁動
處理人格障礙（特別是邊緣性人格）的操控行為，關鍵在於「團隊一致性」。個案常會挑撥離間（Splitting），因此所有護理人員必須遵守相同的規範，且保持良好的溝通。A 選項在公開場合指責會導致衝突與羞愧感；C 選項頻繁換護理師會造成病人不信任；D 選項藥物非解決行為問題之首選。
The most effective approach for managing manipulative behaviors in clients with personality disorders is maintaining consistent limit-setting and interdisciplinary communication to prevent splitting. Consistency ensures that all staff enforce the same rules, reducing the client's ability to play staff members against one another. Confrontation in group settings or frequent staff rotation can damage the therapeutic alliance and increase instability.
台灣病房常有照服員介入，護理師需確保照服員也了解溝通一致性，避免病患對不同層級人員採取不同操控手段。