本文旨在運用歐倫理論協助一位近端股骨骨折老年患者自我照顧之護理經驗。因個案過去自 我照顧及跌倒的挫敗經驗，加上患肢疼痛、活動受限等身體不適，造成個案焦慮於未知的治療結 果與疾病預後。返家後家屬僅可提供有限協助，藉此契機，於照護期間2014 年9 月24 日至10 月 12 日激發個案自我照顧動機並促進自我照顧能力。經由觀察、會談、身體評估及病歷查閱等技巧 收集資料，確認主要健康問題有三項，包括：一、急性疼痛/ 與右腿創傷及缺乏疼痛處理技巧有關； 二、自我照顧能力缺失/ 與欠缺自我照顧動機和技能有關；三、焦慮/ 與術前對手術或未來健康狀 況不明有關。運用Orem 自我照顧理論及專業團隊人員合作，以增進個案各層面健康之自我照顧 能力，包括緩解其疼痛、焦慮及降低活動障礙，激發個案對復健、預後及合併症預防之動機與增 強信心，協助達成自我照顧知識與技能。本文提供醫護人員日後照護類似案例之參考，建議針對 骨科老年患者自我照顧能力評估與護理宜早期介入，藉此促進老人患者自我照顧並提升患者術後 照護品質。

The case report describes the nursing experiences of promoting self-care of an elderly with a proximal femoral fracture by applying Orem’s theory. The patient, who had a history of falling, suffered from lower limb pain, limited mobility, and anxiety about her treatment outcome and prognosis after surgery. Her family could offer only limited assistance once she returned home. By taking this opportunity, the authors were excited to trigger the motivation of the self-care and to promote the selfcare ability of this case during the period of nursing care (from September 24, 2014 to October 12, 2014). Observation, interviews, physical assessment, and medical record reviews were used to gather information. Several health problems were identified, including acute pain, self-care deficits, and anxiety. For the three major health problems, the authors applied Orem’s self-care nursing theory and professional staff team collaboration to enhance the patient’s self-care ability at all health levels, including strategies to ease pain, anxiety, and interventions to minimize movement disabilities. The authors also worked with her to improve both her motivation to achieve rehabilitation and her confidence regarding her selfcare abilities. The authors hope that this study may be used as a reference in similar conditions. Early assessment for self-care skills of elderly orthopedic patients can lead to improve self-care and enhance the quality of postoperative care of patients.