The purpose of this study was to clarify the effectiveness and issues of the nursing intervention to self-care by Orem-Underwood Model, by testing it on 11 patients with acting-out diagnosed borderline personality disorder who were readmitted within three months of discharge. In this study, nursing intervention to self-care by Orem-Underwood Model were offered to the subject patients mainly by psychiatric CNS, in cooperation with UNIT nurses, and the CNS journals and care records of the patients were analyzed.

  Regarding self-care requisites, two categories were extracted:［ what patients want to become able to do by themselves］ and ［what patients want others to do for them］. The patients’ self-care goals set for these requisites were:［ become able to have personal time］,［ become able to engage in their own activities intentionally］, ［become able to establish a life rhythm and structurize their weekly schedule］, ［become able to get along with their husband, mother and children］, and［ control acting-out behaviors］. To help patients achieve these goals, the following nursing interventions were offered: ［clarify the target of anger, encourage expression of anger and look for their desire under anger together］, ［encourage control of anger］, ［help patients improve activity-rest balance by making daily and weekly schedules］,［ provide positive feedback when patients can practice coping activities］,［ help patients take notice before acting-out occurs and become aware of the desire that lies behind acting-out, and discuss how to cope with it］. The results of this study indicate the effectiveness of the nursing intervention to self-care by Orem-Underwood Model in promoting successful community living for patients who are difficult to care for. However four out of eleven patients had to admit to the hospital again after three-month later. The study has also revealed some issues, including the necessity of understanding impulse and desire, and interventions in ego and personality functions.