本文旨在描述照顧一位不遵從行為的 58 歲血液透析病人之護理經驗，護理期間 由 2012 年 5 月 1 日至 6 月 30 日。藉由會談、觀察與病歷查閱等方式蒐集資料，並 運用 Gordon 十一項健康功能型態進行評估，發現個案有體液容積過量、不遵從飲食 及服藥控制，及無望感等問題。經由加強個案瞭解體液容積過量對身體健康危害性， 並訂定水份控制計劃；說明高血磷症危害性並介紹高磷食物，及備妥磷結合劑於攜帶 型藥盒，增進服藥規則性；透過陪伴關懷與傾聽，增進社交互動來提升自我價值感來 改善個案無望感問題。經上述護理措施介入後，結果達到改善體液容積過量，有效控 制血磷值與規則服藥，並使個案能積極參與相關社交活動，達到理想的健康狀態。

This report describes the nursing experience with a 58-year-old noncompliant hemodialysis patient from May 1 to June 30 in 2012. Based on the Gordon model, the author collected information and data by interview and chart review. Excess body fluids, noncompliance with medication and diet, and hopelessness were defined as the major problems to be dealt with. As a result, the patient was educated on how excess body fluids could be dangerous to his health, and a water-content control plan put into place. In order to improve medicine compliance, the patient was educated on the health hazards of hyperphosphatemia and the types of phosphorus-rich foods. The patient was also provided with a medicine box and persuaded to carry this box with him as a reminder to take his medicines on time. Finally, to reduce his feeling of hopelessness, the author focused on listening skills and providing the patient with company to alleviate any concerns, and participating in social activities to enhance self-worth. As a result, improvement was made in the excess body fluid problem, noncompliance with medication was corrected, and hyperphosphatemia reduced. At present, the patient actively participates in relevant social activities and has achieve the ideal state of health.