本文為討論一位骨髓增生不良症候群合併末期心衰竭之個案，照護期間為2018年4月28日至2018年5月11日，透過直接照護、身體評估、觀察及會談等方式，運用Gordon十一項功能性健康型態進行評估，發現個案主要有氣體交換障礙、活動無耐力、無望感三項健康問題。筆者運用個別性護理指導，依個案狀況安排合適的舒適臥位，並協助其進行簡易自我照顧技能，以改善氣體交換障礙及活動無耐力之護理問題；與個案建立治療性人際關係，透過傾聽、主動陪伴關懷個案，以減輕個案無望感，期盼藉此護理經驗分享，提供醫護人員未來在照顧此類病人作為參考。

Tarticle discusses of caring for a patient suffering from myelodysplastic syndrome and end-stage heart failure. The nursing period was from April 28th to May 11th, 2018. Gordon's functional health assessment tool was applied to assess the patient's condition via the data collected from clinical care. The main health problems of patient were impaired gas exchange, activity intolerance, hopelessness. Then the patient was provided with integrated nursing and individual care, and was taught effective deep-breath coughing as well as the way to maintain a comfortable lying position to maintain blood oxygen saturation. A medical team was assembled to discuss the planned activities and nursing plan in order to step by step enhance the patient’s self-care ability and establish a good nurse-patient relationship. Through listening as well as active companionship and care, the patient was given psychological support. She was assisted to take the way of life review, The nursing staff taking care of this kind of patients are likely to develop negative emotion. It is suggested that in the later days the related counselling courses of grief relief can be offered to improve the nursing quality.