本文描述一位直腸癌併發福爾尼埃氏壞疽之64歲男性個案，經過清創術及腸造口手術治療後，除了面臨傷口疼痛造成的生理問題，更伴隨著因身體構造改變而產生的負向自我感受。筆者護理期間自2012年3月23日至2012年4月27日，藉由觀察、會談及非語言溝通的方式收集資料，運用Gordon十一項功能性健康評估工具，發現個案有組織完整性受損、營養少於身體需要、急性疼痛、身體心像紊亂及社交隔離等健康問題，本文針對急性疼痛、營養少於身體需要及身體心像紊亂之主要健康問題提出護理計畫。於護理期間，筆者透過主動關懷，傾聽個案需求及對自身疾病的感受，尊重其想法，鼓勵個案參與腸造口及傷口照護，並運用醫療團隊資源，包括醫師、營養師、社工師及直肛治療室技術師，與家屬共同討論照護模式，針對主要健康問題提供個別性的照護，如減輕術後傷口疼痛，提供營養支持，幫助個案重建正向的身體心像，增進腸造口及傷口照護認知，以提升自我肯定，並利用社會支持系統申請醫療補助，助於個案回歸正常生活。

This nursing case study is on a 64-year-old male patient with rectal cancer complicated with Fourniers Gangrene, the study illustrates this patient’s physical and psychological response due to the physical challenges after the debridement and colostomy treatment. The nursing care began on March 23, 2012, to April 27, 2012. During this period, the patients data were collected by the author only through observations and nonverbal communication interviews. Gordon 11 Function Health Patterns was adopted to evaluate patients general condition. The author had discovered the patient had multiple health problems including impaired tissue integrity, poor nutrition status, acute pain, body image disturbance and social isolation. Therefore, this case study will be focusing on the care program for patients’ primary health problems: acute pain, poor nutrition status and body image disturbance. During this nursing period, the author listened to the patients needs and feelings actively, with respect and understanding, the author encourage the patient to participate with colostomy and wound care. Doctors, dietitians, social workers and ST room technicians were also counseled in helping educate the patient’s family members to prepared themselves in individual care, consisting of obtunding of physical pain, adequate nutrition support, reconstruction of positive body image and consciousness preparation on patient’s surgical wound and colostomy care, with the application of medical aid through social support system, hoping to help the patient return to his normal stage of life.