— 心理社會完整性 · MEDIUM · MCQ —
一位強迫症（OCD）病人因為反覆洗手的儀式行為導致早餐遲到。護理師應採取哪項行動？
A client with obsessive-compulsive disorder (OCD) is late for breakfast because of a repetitive hand-washing ritual. Which action should the nurse take?
- AExplain that the ritual is a way to avoid dealing with anxiety.解釋該儀式是避免處理焦慮的方式
- BInterrupt the ritual and insist that the client go to the dining room.打斷儀式並堅持病人前往餐廳
- CAllow the client to complete the ritual and provide a late meal.✓ 正解允許病人完成儀式並提供延遲的餐點
- DTell the client that hand washing is unnecessary and limit access to the sink.告訴病人洗手是不必要的並限制使用水槽
— Explanation · 中文詳解 —
在 OCD 治療初期，護理師應允許病人完成儀式行為，因為強行停止會引發極度焦慮甚至恐慌。護理目標應是逐漸減少儀式時間，而非立即禁止。應提供結構化的環境，並在非壓力時間討論替代方案。B、D 會加劇焦慮；A 雖然正確但對當下行為改變無助。
In the early stages of OCD treatment, the nurse should allow the client to complete rituals to prevent overwhelming anxiety or panic that may result from forced interruption. The goal is to gradually reduce ritual time within a structured environment rather than immediately prohibiting the behavior.
✦ 台美臨床差異
美國更強調 CBT 與 Exposure and Response Prevention (ERP) 的應用；台灣臨床則常輔以較大劑量的藥物控制。