Alternations of body structure, physical function and appearance are extremely stressful to anyone. Without providing assistance and management in time, it will result in mental and physical damages of the the patient. This article is a case report describing the nursing process of a patient with rectal cancer and permanent colostomy. The author took care of this patient from 92-08-07 to 92-08-22. She applied Orem's theory of self-care to evaluate the patient and found out that he had some nursing problems like pain, disturbance of body image, alternation of ability in maintaining good health...etc. After applying supporting skills like active concerns, empathy and acceptance to build up a therapeutic relationship and trust, the author tried to induce patient's learning motivation, appreciate patient's ability of self-care, promote patient's adjustment in alternation of body image and self-acceptance; furthermore, to learn self-care successfully and finally return to the normal social life.