— 心理社會完整性 · MEDIUM · MCQ —
精神科病房的病人對他人吼叫並在走廊踱步，行為正在升級。護理師最合適的處置為何？
A client in the psychiatric unit has been shouting at others and pacing the hallway. The client's behavior is escalating. Which is the most appropriate action for the nurse to take?
- AAsk other clients to help restrain the individual要求其他病人協助約束該名個體
- BMaintain a calm demeanor and provide a quiet, safe environment✓ 正解保持鎮定的態度並提供安靜、安全的环境
- CTell the client to stop shouting or they will be restrained告訴病人停止吼叫，否則將予以約束
- DApproach the client quickly and place them in seclusion快速接近病人並將他們安置於隔離室
— Explanation · 中文詳解 —
面對行為升級的病人，護理師應先採取「去升級化」（de-escalation）技巧。保持冷靜的態度可以降低現場張力，並提供安靜的空間以減少環境刺激，幫助病人降低激越行為。過度威脅或直接採取強制手段（如隔離、約束）若非必要且未經過評估程序，可能導致暴力事件升級。
When a client's behavior escalates, the nurse should maintain a calm demeanor and provide a quiet, safe environment to facilitate de-escalation. Reducing environmental stimuli and using non-threatening communication helps lower agitation without resorting to restrictive measures.
✦ 台美臨床差異
美國法規對 seclusion/restraint 的使用有極嚴格的文書與監測要求；台灣在實務上對暴力控制的標準與執行流程相似。