— 心理社會完整性 · MEDIUM · MCQ —
一位患有強迫症（OCD）的病人因重複洗手儀式而早餐遲到。在治療初期，下列哪項護理措施最合適？
A client with obsessive-compulsive disorder (OCD) is late for breakfast because of a ritualistic hand-washing routine. Which nursing intervention is most appropriate during the early phase of treatment?
- ARestrict the client's access to the bathroom before meals限制病人在餐前使用廁所
- BExplain that the hand-washing is unnecessary and illogical解釋洗手是不必要且不合理的
- CInterrupt the ritual to ensure the client arrives at breakfast on time中斷儀式以確保病人準時享用早餐
- DAllow the client enough time to complete the ritual✓ 正解給予病人足夠時間完成儀式
— Explanation · 中文詳解 —
在強迫症治療初期，應允許病人完成其儀式行為，以降低其因焦慮而產生的痛苦。突然中斷或禁止儀式會導致嚴重的焦慮發作。雖然最終目標是減少儀式行為，但在初期應先建立信任關係，並在排程中預留儀式時間。向病人解釋其行為不合邏輯通常無效，因為病人往往已具備病識感但無法控制。
In the early phase of treatment for obsessive-compulsive disorder, allowing the client sufficient time to complete rituals helps reduce severe anxiety and builds trust. Interrupting these behaviors or explaining their illogical nature can increase distress, as clients often recognize their actions are irrational but feel unable to control them.
✦ 台美臨床差異
美國護理常結合認知行為治療（CBT）的概念執行臨床護理；台灣精神科病房則較強調生活規律的建立，有時會較早介入行為限制。