本文探討一位因車禍致頸椎第五、六節脊髓損傷合併雙下肢癱瘓的加護經驗，照護期間自2017年12月11日至12月18日，運用Gordon十一項健康功能型態進行整體評估，並以觀察、身體評估、會談等方式收集資料，確立出身體活動功能障礙、自我照顧能力缺失、無力感、照顧者角色緊張、及性功能障礙等健康問題。因病人正值壯年期，突如的意外導致雙下肢癱瘓，一夕之間日常生活皆需仰賴他人協助，家屬亦背負莫大的照顧與經濟壓力，故於護理過程中，以Swanson關懷照顧理論作為照護之架構，運用同理、陪伴、主動關懷等方式，引導個案及家屬表達內心感受，給予正向支持以提升自信心，且共同擬定復健計畫，增強肌肉力量並提升自我控制感；另外會診跨團隊即早介入，提供醫院內部及外部照護資源，盡團隊力量減輕照顧者及個案之身心困擾，使其以正向積極的態度度過無力感過程，重拾信心面對未來。願此經驗分享可供護理同仁參考及運用。

This report describes the nursing experience of a patient suffered from 5th to 6th cervical spine injury with paraplegia due to a car accident. During the intervention period from December 11 to 18 in 2017, case assessment was conducted via physical examination, direct observation and interview applying Gordon's Eleven Functional Health Patterns. Problems identified included physical functional impairment, self-care deficit, powerlessness, caregiver role strain and sexual dysfunction. Because the patient was in the prime of life, he and his family members may be under a lot of pressure due to possible bed-ridden status after an unexpected accident. The author establishes a good nurse-patient relationship with empathy, active care and acceptance using the guidelines of Swanson's Caring Theory; provides positive support, accompany and encourages the patient to continue rehabilitation for better muscle strength and self-control; and utilizes communication skills to understand the feeling of powerlessness, then guides the patient and family members expressing their feelings. In addition to pressure management and building confidence, we also help family members learn how to take care of this case. Through collaborating with the medical team including physical therapists and social workers, discharge planners, etc., we provided an organized rehabilitation program with internal and external care resources. Our medical team put a lot of effort into the alleviation of the physical and mental distress of the caregiver and the patient, so that they can face the subsequent future treatment with a positive attitude. The aim of this report is to facilitate the learning and understanding of staff nurse by sharing an active care model of a patient with unexpected accident and spinal cord injury.