الفهرس 
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Abstract
Introduction:Rheumatoid arthritis (RA) is a persistent, progressive inflammatory disease begining in the synovial membrane, leading to the deformation and destruction of articular tissues, and the damage of articulatory
function. Patient with rheumatoid arthritis experiences several somatic
problems, such as the deformation and damage of joints, chronic pain,
fatigue, weight loss and fever. Rheumatoid arthritis (RA) may cause
several physical problems such as apparent restrictions in mobility,
activities of daily living, sleep disorders, and changes in self-esteem.
Such conditions can cause disabilities and long-term changes in the patients. Depression is a significant comorbidity in patients with RA and it may occur either in a chronic or an intermittent manner. There are numerous researches in Egypt have been published regarding pain and depression and impact of them on patients with rheumatoid arthritis.
However, little research exists egarding how to manages pain and reduce depressive symptoms. Because psychiatric nursing interventions have the ability to relieve the severity of pain, reduce depression, increase quality of life, and improve physical and emotional function. Therefore, the goal of this study is to evaluate the effectiveness of psychiatric nursing intervention on pain and depression symptoms among rheumatoid arthritis patients.The aim of the study was to:Evaluate the effectiveness of psychiatric nursing intervention on pain and depressive symptoms among patients with rheumatoid arthritis.Research hypothesis The patients who will participate in psychiatric nursing intervention (study group) will have lower mean scores of pain immediately after implementation of psychiatric nursing intervention and after2 months of follow-up than the patients who don’t receive psychiatric nursing intervention (control group).
The patients who will participate in psychiatric nursing intervention (study group) will have lower mean scores of
depressive symptoms immediately after implementation of psychiatric nursing intervention and after 2 months of follow-up than the patients who don’t receive psychiatric nursing intervention (control group). Research subject:
A purposive sample of 100 patients with rheumatoid arthritis who attending at physical medicine and rehabilitation clinic of Menoufia University Hospital, who were free from any history of psychiatric illness; other chronic physical illness; neurological disorders; both sex; Age ranges between 21-55, patients of 1st and 2nd stages of
rheumatoid arthritis agree to participate on the study Research Design:Quazi experimental design, two groups was used to achieve the purpose
of the study.Research Setting:This study was conducted at clinic of physical medicine and rheumatology of Menoufia University Hospital.Tools of the Study:
Tool (1):-A structured interview questionnaire:This questionnaire was developed by the researcher to assess socio demographic characteristics of the patients as age, gender, income .......
Etc.Tool (2): Beck depression scale:
This scale was developed by Beck (1961) as a screening technique for measuring symptoms of depression.Tool (3):- Rheumatoid Arthritis Pain Scale (RAPS)
It was originally developed by Anderson (2001) to measure pain in rheumatoid arthritis patients The main findings of the study revealed the following:
There was highly statistical significant reduction of total means score of pain immediately after psychiatric nursing intervention and after 2 months follow-up in the study group compared to
control group.There was statistical significant reduction of mean score of
depressive symptoms immediately after psychiatric nursing intervention and after 2 months follow-up in the study group compared to control group.There was highly statistically significant positive correlation between total pain level and depressive symptoms before and
immediately after psychiatric nursing intervention among the study group.
•There was a highly statistically significant relation between gender
and the mean score of pain and depressive symptoms before and
immediately after psychiatric nursing intervention in study group.There was a highly statistically significant relation between educational level and the mean score of total pain level and
depressive symptoms of study group before psychiatric nursing intervention
Conclusion:Based on the result of this study: It was concluded that-Psychiatric nursing intervention has a positive effect on reducing pain and depressive symptoms among patients with rheumatoid arthritis There was significant reduction in the total mean score of pain and depressive symptoms immediately after nursing intervention program and
after 2 months follow-up among study group compared with control group.
Recommendation:1Psychiatric nursing intervention in reducing pain and depressive symptoms should become an integral part of the total management
of rheumatoid arthritis patients in rheumatology units.2- Routine screening for depression as part of the rheumatology clinic visit and referral when necessary.3-Psych educational program should be given for all patients with rheumatoid arthritis to decrease pain and depressive symptoms4-This study should be replicate using a larger probability sample from different geographical areas to help for generalization of the results