脊髓損傷併糖尿病腎病變患者，因疾病或治療所衍生合併症，如：反覆性壓瘡、自主和周邊神經病變及透析治療本身導致不適症狀，須長期忍受許多不亞於癌症患者的痛苦。本文主要探討一位脊髓損傷個案，因不良生活型態致糖尿病腎病變而接受血液透析治療，後因不堪疾病衍生的神經性疼痛及久不癒合的壓瘡傷口與透析治療所帶來不適症狀折磨，最後在病人期望及團隊溝通後，轉為接受安寧緩和照護的過程。護理期間自民國104年7月25至8月30日，筆者運用Gordon十一項健康評估並藉由觀察、會談、身體評估等方法收集主、客觀資料；結果呈現個案有皮膚完整性受損、慢性疼痛與無望感之健康問題。照護過程中，筆者除了照護病人傷口與因疾病和透析帶來不適症狀外，在醫療團隊中積極扮演協助個案接受腎病末期安寧緩和照護的角色，最後，在護理人員努力溝通下，病患得以轉為以安寧緩和共同照護接受緩和醫療照護，順利轉至安寧病房達成病人善終心願，期望此護理經驗可作為照護類似個案之參考。

Patients with spinal cord injury and diabetic nephropathy may develop long-term, long-term endurance due to recurrent pressure ulcers, autonomic and peripheral neuropathy, and comorbid conditions caused by their disease or treatment, such as recurrent pressure ulcers, Pain in cancer patients. This article focuses on a case of spinal cord injury, who has poor life quality because of the disease progression. The disease itself and its complication, including neuropathic pain and non-healing pressure ulcer, and these treatment, such as diabetic nephropathy and hemodialysis may also lead to much discomfort and torture. And finally the patient may make a request for transferal to receiving hospice palliative care. During the nursing period from July 25 to August 30, 2014, the author used Gordon's eleven health assessments and collected the objective and objective information through observation, conversation and physical evaluation. The results showed that there was a case of compromised skin integrity, chronic pain and hopelessness health problems. During caring period, in addition to providing care of patients' wounds, and supportive care for the discomfort of disease, the author plays an active role in assisting patients to accept the hospice and palliative care of nephropathy in the medical team. Finally, with much effort of the nurses, the patients would be transferred to the ward with medical care and hospice palliative care of co-care team, and the patient had fulfilled his request. We hope this nursing experience can be applied to other similar cases.