This book is written primarily for occupational therapists and occupational therapy students but will be of relevance to anyone working with clients with rheumatoid disease. It is hoped that the text will communicate the challenge faced by therapists to establish management programmes appropriate to the identified needs and priorities of the individuals with whom they work, the potential to utilize a wide range of skills and the opportunity to contribute to the understanding of the many unanswered questions which remain in relation to rheumatic diseases. The aim of this book is to present an holistic approach to the management of rheumatoid disease, considering first, the ways in which rheumatoid disease can affect a person's life and then looking at the approaches and techniques used by therapists to minimize these effects. This approach has been chosen as it is fundamental to both the philosophical basis of occupational therapy and the manage ment of a chronic progressive disease. An holistic approach considers the physical, psychological, social and spiritual aspects of a person and the ways in which these have been effected by an underlying disease process. Each of the components are interrelated, illustrating the complexity of establishing appropriate management programmes and evaluating their effectiveness. The first two chapters consider the effects of rheumatoid disease on clients and their families. An holistic approach identifies the need for a diversity of skills to be available to both the therapist and client.

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Part 1 Introduction to chronic arthritides: structure of diarthroidal joints; types of chronic arthritis - osteoarthritis, the crystal related arthropathies, rheumatoid arthritis, ankylosing spondylitis. Part 2 Psychosocial aspects of rheumatoid disease: self concept; changes in role; stages in life; stress, anxiety and depression; locus of control. Part 3 An holistic approach to the management of rheumatoid disease: the multidisciplinay team; the role of the occupational therapist. Part 4 Assessment: clinical assessment; functional assessment; health status questionnaires; psychological assessment; social factors; the process of occupational therapy assessments. Part 5 Developing skills: provision of information; educational programmes; self-help groups; counselling. Part 6 Adaptive techniques: energy conservation; the use of assistive equipment; housing adaption; splinting; relaxation and pain control; personal and sexual relationships; community care.