Learning Objective #1: to explore the predictors of disability in rheumatoid arthritis patients.

Learning Objective #2: to prevent or postpone the risk factor of disability and decrease severity of disability in the future.

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Abstract The purpose of this study was to explore the predictors of disability in rheumatoid arthritis patients. We conducted a prospective cross- sectional study with a convenience sampling method. One hundred and fifty patients regularly visiting rheumatologic outpatient clinics at a local regional teaching hospital and a medical center in north Taiwan were recruited. The Center for epidemiological survey depression scale (CES-D), the Chinese version of the brief pain inventory (BPI-C), and the health assessment questionnaire (HAQ) were used to assess of depressive tendency, pain and disability respectively. Descriptive statistical method was carried out such as Independant t-test, one-way analysis of variance and post-hoc comparison. Correlation analysis was made by Pearson¡¦s product correlation. The multiple regression analysis was used to explore the predictors of disability. Results indicated that most patients had mild disability (average HAQ score= 0.61). Depression score was significantly and positively correlated with pain severity (r=0.39, p<0.01) and pain interference (r=0.5, p<0.01). The results of multiple regression analysis showed that anatomic stage (such as stage IV, stage III or stage II), the age level was 61~80 years old, depression tendency, the duration of disease (range of 15 through highest or 6~10 years) and the education level for elementary were significant predictors of patients¡¦ disability, explaining 81.2% of the total amount of variance in disability. These results could provide guidances for nurse staff to predict disability, develope stage-specific intervention and offer therapeutic information in depression and disability.Nurses could teach their patients to deal with the depressive mood, care joints by patients themselves and avoid joint over-use to prevent or postpone the risk factor of disability and decrease severity of disability in the future. Keywords¡GRheumatoid arthritis, chronic pain, depression, disability