本文描述一位憂鬱症合併有自殺行為個案的護理經驗，個案對自我期許高，面對工作壓力時缺乏良好因應方式，且缺乏疾病認知，使得身心壓力累積無法負擔，進而以自殺作為問題解決方式，筆者擔心未適時介入合宜措施會致憾事再次發生，故使用正念認知療法介入。護理期間自2018年2月8日至2018年4月24日，運用觀察、會談及整體性護理評估，確立個案之健康問題有潛在危險性傷害─自殺、個人因應能力失調─負向思考、健康維護能力改變─缺乏疾病認知，筆者首先與個案建立治療性護病關係，潛在危險性傷害─自殺方面，除了提供安全及支持性環境，並運用簡式健康量表評估情緒變化，適時給予提醒及教導合宜情緒發洩；個人因應能力失調─負向思考方面，教導個案運用正念練習因應及轉移壓力源，以及運用蘇格拉底法駁斥非理性信念；健康維護能力改變─缺乏疾病認知方面，教導個案認識所服用的藥物，提升服藥遵囑性，也給予疾病相關衛教，提升個案疾病認知，結果發現正念認知療法能有效改善憂鬱情緒、提升個人因應能力及增進疾病認知。建議執行初期陪著個案一起練習及引導，出院前可給予個案卡片提示說明，讓個案出院後也能持續使用，期望本護理經驗能助於推展正念認知療法於臨床之應用。

This paper describes the nursing experience of a case of depression with suicidal behavior. The patient had high self-expectations, coped poorly with work stress, and lacked disease awareness. Physical and mental stress accumulated and became unbearable, prompting suicidal behavior. The author was worried about a successful suicide attempt in the absence of appropriate and timely intervention. Mindfulness-based cognitive therapy was applied as an intervention. During the nursing period from February 8 to April 24, 2018, observation, interview, and holistic nursing assessment determined that the health problems of the patient included potentially dangerous injury-suicide behavior, negative outlook concerning personal coping, and detrimental changes in health maintenance (specifically, lack of disease awareness). The author first established a therapeutic nurse-patient relationship with the patient. To address the potentially dangerous injury-suicide behavior, a safe and supportive environment was provided, the Brief Symptom Rating Scale was adopted to evaluate emotional changes, and the patient was taught to appropriately release emotions. Concerning personal coping, the patient was taught to cope with and transfer stressors by practicing mindfulness, and to refute irrational beliefs using the Socratic method. Concerning health maintenance and the lack of disease awareness, the patient was educated to be better aware of the drugs being used, to improve compliance with the drug therapy, and to improve disease awareness. The mindfulness-based cognitive therapy effectively alleviated depression enhanced personal coping skills, and improved disease awareness. It is suggested to practice with and guide a patient at the initial stage of implementation. Providing the patient with a card with prompts and instructions before discharge for use continuously after discharge is helpful. It is hoped that this nursing experience can help promote the clinical application of mindfulness-based cognitive therapy.