一位強迫症（OCD）病人因為花了 45 分鐘摺衣服的儀式行為而早餐遲到。護理師最合適的行動是什麼？
A client with obsessive-compulsive disorder (OCD) is late for breakfast because of a 45-minute ritual of folding clothes. What is the most appropriate nursing action?
- ALock the client's room during breakfast hours to prevent the ritual在早餐期間鎖住病人的房間以防止儀式行為
- BInterrupt the ritual to ensure the client gets to breakfast on time打斷儀式行為以確保病人準時吃早餐
- CGive the client a 15-minute warning before it is time to leave for breakfast✓ 正解在離開去吃早餐前 15 分鐘給予病人警告
- DExplain to the client that the ritual is illogical and time-consuming向病人解釋該儀式行為不合邏輯且浪費時間
強迫症病人的儀式行為是為了減輕內心的極度焦慮。在治療初期，強行中斷儀式（如選項 B）會導致病人焦慮爆發，甚至產生恐慌。合適的護理策略是『預留時間』並給予提醒，這能讓病人在完成儀式後仍能參與病房活動，兼顧其焦慮緩解與功能維持。後續治療會使用暴露不反應法（ERP）逐漸限制儀式時間，但在急性期或一般管理中，尊重其節奏並給予緩衝提醒是維護心理完整性的首選。邏輯解釋（選項 D）對 OCD 無效，因為病人通常知道行為不合理但無法控制。
Providing a 15-minute warning allows the client with OCD to manage their ritual within the daily schedule, helping to mitigate extreme anxiety that could result from abrupt interruption. This approach respects the client's need for anxiety relief while ensuring participation in necessary activities like meals.
美國 NCLEX 考題常考如何平衡『儀式行為』與『病房作息』；台灣臨床環境中，若病人延誤作息，有時會採取較強硬的限制或要求家屬協助中斷，較少系統性地應用行為緩衝技巧。