本文旨在分享運用Orem自我照顧理論，協助一位因工作受傷造成多重性骨折的49歲男性，面對生、心理壓力之護理經驗。筆者於2012年5月18日至27日護理期間，透過觀察、身體評估、會談及查閱病歷等方式收集資料，確立個案有急性疼痛、身體活動功能障礙、自我照顧能力缺失、個人因應能力失調等健康問題。照護中先藉由疼痛護理解決個案急性疼痛的問題；再讓個案和家屬了解復健運動的重要性，共同訂定有效的復健計劃，協助持續執行復健運動，及監測其完整性；藉由強化家屬的支持功能、結合社工師、復健護理師等支持系統，早期介入出院準備服務，提供輔具租借服務、經濟舒緩方案，幫助個案面對疾病的生、心、社會衝擊，調適負面情緒，產生正向意念，繼而能早期激發自我照顧的意願，學習出院後的居家自我照顧與復健運動，因而個案能如期出院與適應居家自我照顧生活。冀望藉此護理經驗提供護理同仁在重大創傷病人照護與協助其自我照顧時的參考。

This paper describes the nursing experience of applying Orem’s self-care theory to a forty-nine-year-old man in facing physiological and psychological impacts resulted from multiple fractures due to an accident at work. During the nursing period from May 18 to 27 in 2012, data were collected through observations, physical assessment, and interviews. The health problems identified included acute pain, impaired physical mobility, self-care deficit, and ineffective coping. The author not only helped the patient to solve the problem of acute pain but also assisted him in understanding the importance of exercise rehabilitation and established an effective rehabilitation program to continuously monitor the integrity of implementation of exercise rehabilitation. We also strengthened the support system from family. Social workers as well as rehabilitation nurses provided early discharge planning to help the patient face the illness and stimulate their willingness to learn self-care skills. This report could provide the nursing staff with reference for similar cases.