Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent symmetrical polyarthritis of large and small joints, as well as morning stiffness, which can result in physical and functional limitation. The Severity of the disease stages varies, and predicting the prognosis is challenging (Battafarano et al, 2018) RA diseases etiology so far unknown, but epidemiological studies show that genetic and environmental predisposing factors for these diseases, as well as viral or bacterial infection from etiological factors for this disease (Safiri et al., 2019). The periodontal pathogens of RA, the body’s immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining (synovial membrane) becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within joint (Battafarano et al.,2018) Pain is the most common and important symptom of this condition. Women with rheumatoid arthritis are concerned about pain, and health care providers are concerned about it as well (Saeedifar et al., 2018). RA, pain is one of the predictors of disability, along with self- esteem, exhaustion, depression, and motor restriction, which are all repercussions of pain (Chattu& Yaya, 2020) Arthritic women have higher risk of premature death and disability. HEPA (Health- Enhancing Physical Activity) could be a major aspect in minimizing this risk. Increasing health care expanses necessitate the creation and testing of novel ways of rehabilitation, such as physical activity outside of the health care system (Latifi et al, 2021) Previous studies when studying the determinants of pain reduction and control found that self-care is widely recognized as an important tool in pain control in women with rheumatoid arthritis (Ibrahim & Mohamed, 2020). Empowering women with chronic pain through the use of self-care measures is more beneficial than other approaches (Chancay et al., 2019). Considering the various methods and medications used to relieve the signs and symptoms of the disease, especially pain in women with rheumatoid arthritis, which causes side effects and costs, it is important to find a method involving a women spending less and increasing 2 the treatment that reduces stress and anxiety and increasing the potential ability of the woman (Newman et al., 2018) In recent years, as prevention and promotion of health have become more essential than treatment, the role of the nurse has shifted, with a greater emphasis on the concept of self-care (Ovayolu et al.,2012). RA self-care is a way to confirm that the educator has explained to a woman what is important and in a manner that the women understand (Michou et al,.2022) Aim of the study: The current study aimed to evaluate the effects of nursing instructions for rheumatoid arthritis self-care on pain intensity and functional status among arthritic women through the following objectives: 1- Assessing rheumatoid arthritis knowledge and their self-care practices among arthritic women. 2- Assessing pain intensity and functional ability among arthritic women. 3- Designing and implementing nursing instructions for rheumatoid arthritis self- care among arthritic women. 4- Evaluating the effects of nursing instructions for rheumatoid arthritis self-care on pain intensity and functional ability among arthritic women. Hypotheses of research: H1: The functional ability of arthritic women will be improved after implementing of nursing instructions for rheumatoid arthritis self-care. H2: pain intensity among arthritic women will be reduced after implementing of nursing instructions for rheumatoid arthritis self-care. Subjects and Methods: Research design: A quasi-experimental research design had been used to attain the study's aim. Setting: The current study was conducted at specialized rheumatology unit, Zagazig University Hospitals in Egypt's Al Sharkia governorate .The unit provides medical services in the form of admission for monitoring, diagnosis, and different types of treatment besides out-patient clinic for follow up and rehabilitation physiotherapy unit. This specialized rheumatology unit worked daily form Saturday day to Thursday, but alternative workdays were separated for male and female. The total average number of attendances for follow up about 800 patients/ month: with different rheumatic diseases . Rehabilitation & physiotherapy unit receive about 10-15 RA patients/day for receiving different physiotherapy and exercises. Subject: A purposive sample of 80 cases of women with RA who met the following criteria during the study period: age between 18 and 65 years old, Women had a definite diagnosis of RA at least one year, from 1 st 2 nd and 3 rd degree of RA. Free from severe cardiac disease (heart failure, recent myocardial infarction), pulmonary 3 disease, inflammatory or muscle disease or previous hand or arm injuries and lower extremity injuries or operation. Willing to participate in the study. Data collecting tools include: Tool (1): women assessment interview schedule; This tool developed by researchers after reviewing of relevant literature to assess women health status. It consisted of three parts as follows: Part I: Women socio-demographic characteristics: This part of the tool included age, educational level, marital status, area of residence, occupation, and income. Part II: Women clinical data: were collected from women medical record, it was included location of joints (arm/ knee) affected, duration of illness and women habits include smoking, past and present history. Part III: women knowledge regarding rheumatoid arthritis: this part of tool developed by the researchers after reviewing the relevant literature (Hinkle & Cheever 2018). It included 15 main questions in which each question had group of three or four answer, included definition of RA, causes of arthritis pain, benefits of plans in pain management and importance of joint protecting techniques. In addition, important of resting between activities. Tool (2): Women Self-care practices questionnaire sheet: This tool was developed by the researchers after reviewing the relevant literature (Ahmed et al.,2019) and(Abdelmowla et al., 2017). Self-care practices questionnaire sheet which included A) Medical regimen for treatment (5 questions) , B) correct diet patterns for RA (7 questions) , C) Joint protection technique and Exercises (10 questions ) D) Pain controls practices (8 questions). . Tool (3): Numerical analog scale for pain: This tool developed by Hjermstad (2011) to assess pain intensity. This scale contains standardized linear range from 0- 10. The woman was asked to place a mark indicating where the current pain lies on the line. As 0 in “no pain”, 1-3 represents “mild pain”, 4-7 represents “ moderate pain”, 8-9 represents “ sever pain” and 10 is the “worst possible pain” Tool (4): - Functional ability of arthritis women: Two instruments were used for measuring functional ability . A) Katz Activities of Daily Living (Katz ADL). This tool was developed by Mary et al., (1999) and it was adopted by the researcher. This tool is used for the assessment of the functional ability of arthritic women by measuring the basic activities of daily living. Katz ADL index measured ability to conduct self-care. It consisted of a six-item instrument, which assessed the independence or dependence in the activities of bathing, dressing, toileting, transferring, continence and feeding. B) The Lawton Instrumental Activities of Daily Living Scale developed by Lawton (2000) to assess independent functional ability as well as declines and improvements over time. The test measures eight realms of functions through self- report which to attempt to assess everyday functional competence in arthritic women 4 which included telephoning, shopping, food preparation, housekeeping, laundering, use of transportation, use of medication and financial behavior. Pilot study: A pilot study was carried out on 10% of the total studied subjects (8 women) to ascertain the clarity, feasibility, and applicability of the developed tools, then the necessary modifications were done. Arthritic Women included in the pilot study were excluded from the total number of study subjects. Results: The main results of the study revealed that: - Three quarter of the studied women( 75%) aged ≥ 40 years and married Regarding the educational level, 33.8% of them were able to read and write, 30% of them had diploma. Regarding residences areas, 61.3% of them live in urban areas. Also 55% of the study sample have not health insurance. - Near to half ( 48.7% ) of the studied sample had RA from more than five years, 53.8% of them have medical history of chronic diseases and 31.3% of them had family history of RA. Regarding type of arthralgia complain 82.5% of them wrist joint followed by 72.5% elbow joint, and 71.3% ankle joint. - The total score knowledge of the studied women had improved from 27.4 % before the implementation of nursing instruction to 58.3 % after one month, and 91.3 % after three months . The majority of studied women were not done RA self-care practices in all items. More than half of studied women were done RA self-care practices after one month of nursing instruction implementation. While after three months from nursing instruction RA self-care implementation most of them were done RA self-care practice. significant difference in all items of RA self-care practices among studied women throughout phases of the study. - The total score of the studied women self-care practices. pre nursing instruction 83.3% of studied women had low RA self-care practices, 36. 1% of them had moderate self-care practices after one month from nursing instruction implementation, and 76% of them had high self-care practices after three months from nursing instruction implementation. - Near to half (48.8%) of studied women had worst possible pain followed 37.5% had severe pain before implementation nursing instruction RA self-care. After three from implementation nursing instruction RA self-care 55% of the studied women had mild pain followed 20% of them had moderate pain. - There were highly statistical differences improvement were noticed among studied women related to overall performance of activities of daily living in pre and instruction for RA self-care implementation phases. As well as positive effect for nursing instruction for RA self-care on independency for activities of daily living activities among studied subject. And there were highly statistical differences 5 improvement were noticed among studied women related to overall performance instrumental of activities of daily living in pre and nursing instruction for RA self- care implementation phases. Conclusion: Based on the findings of the present study, it can be concluded that, more than three quarters of the studied women with RA had unsatisfied knowledge about RA disease and most of them had a low self-care practice. After implementing nursing instructions for self-care practices for RA, the women improved in knowledge and related self-care practices (correct eating pattern, joint exercises, physical activity, adherence to medication, and pain control strategies). This result confirmed hypothesizes, which is that high level of RA self-care practices leading to reduce in pain intensity and improvement in functional ability. Recommendation: The following recommendations are made based on the findings of this study : 1- Replication of the current study on a larger probability sample is recommended to achieve generalization of the results and wider utilization of the designed implementation. 2- Hold continuous educational and orientation program for rheumatoid arthritis patients to upgrade their knowledge about rheumatoid arthritis’s disease and its management and encourage them for high level of self-care, health status, follow up. 3- Instructional guidelines should be applied on a wide range through different social media.