本文病人自覺乳房症狀後，因經歷家人之癌症治療經驗，影響病人疾病之接受與適應，排斥西醫遲未就醫，直到髖關節疼痛影響日常生活才勉強就醫診斷為晚期乳癌，引發筆者介入動機。病人之身心靈問題交錯，影響癌症治療及預後，於2017年3月9日至3月22日護理期間運用Orem理論進行病人整體性照護評估，筆者依病人之自我照護行為代償程度提供適切之照護措施，確立以病人重要的健康問題如身體活動障礙、否認行為不當、自我照顧能力增進的準備度為例。生理問題方向，依病人需求選用適當輔具及指導正確移位技巧，並改造居家設備為無障礙環境，增加活動效能；心理層面則以Swanson理論系統性介入關懷措施，成功引領病人渡過否認及磋商期，接受病況配合治療，提供適切的醫療資訊，引導病人發展出適當的自我照護能力因應行為，增進居家自我照護能力。本病人照護選用適切的照護理論，引領病人發展出適合癌症病人之生活模式，達到自我照護與調適之目標。

In the current case, the patient was nonadherent to her current medicine despite experiencing breast cancer-related symptoms and did not visit the doctor until her hip-joint pain disrupted her daily-living activities. On investigation, she was diagnosed as having advanced-stage breast cancer. The patient's adherence to cancer therapy was influenced by her family's poor experience with cancer therapy. The patient's condition was complex, with simultaneous physical and psychological problems, which adversely affected her cancer therapy and prognosis. She was assessed thoroughly on the basis of Orem's theory during the period of nursing care (March 9-22, 2017). The patient's physical and mental problems were intertwined, affecting her cancer treatment and prognosis. Orem's theory was used to conduct a case-wide overall care assessment during the nursing period (March 9-22, 2017). According to the self-care behavior of the patient, appropriate care measures were provided. Important health problems, such as physical activity disorders, denial of misconduct, and increased self-care ability, are examples. The patient's psychological problems resolved after systematically intervening care measures given by Swanson's theory were applied. The patient was successfully guided to pass the stages of denial and negotiation, accept the disease condition, adhere to the therapy to develop proper self-care and daily-living abilities, and provide appropriate medical information. We emphasize the promotion of the individualized nursing care theory and model to guide cancer patients in developing adequate self-care abilities.