— 照護管理 · MEDIUM · MCQ —
一位病患不遵守治療計畫，護理師的首要行動為何？
A nurse is caring for a client who is non-compliant with their treatment plan. What is the nurse's first action?
- ADocument the non-compliance in the chart在病歷中記錄不配合情形
- BDischarge the client against medical advice讓病人自動出院
- CNotify the physician immediately立即通知醫師
- DDetermine the reasons for the client's non-compliance✓ 正解確定病人不配合的原因
— Explanation · 中文詳解 —
護理程序的首要步驟是評估（Assessment）。當病患表現出不遵守治療計畫（Non-compliance）的行為時，護理師不應預設病患是惡意拒絕，而應採取治療性溝通（Therapeutic communication）來探究背後原因。原因可能包括經濟困難、藥物副作用、對疾病認知不足或文化信仰衝突。僅有在釐清原因後，才能針對性地調整護理介入措施。
The first action must be to assess the underlying reasons for the client's non-compliance, as this is the initial step of the nursing process. Understanding factors such as financial constraints, side effects, or lack of knowledge allows the nurse to implement targeted interventions rather than prematurely documenting or notifying the physician.
✦ 台美臨床差異
在美國臨床環境中，非常強調「以病患為中心」的護理，護理師需展現高度的文化敏感度與倡導者角色，積極主動排除病患順從治療的障礙。