Abstract Objective: To examine the effects of an empowerment theory-based nursing intervention on functional exercise adherence and physical symptoms in patients with rheumatoid arthritis (RA).Methods: A total of 120 RA patients were randomly assigned (using a random number table) into two groups. The control group (n=60) received usual care, while the intervention group (n=60) received the empowerment theory-based nursing intervention in addition to usual care. Both groups were followed for 8 weeks. Outcomes were assessed before and after the intervention, including self-efficacy scores, functional exercise adherence scores, physical symptoms [Disease Activity Score using 28 joints (DAS28), Visual Analog Scale (VAS) for pain, and Health Assessment Questionnaire (HAQ) index], and negative emotions [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)].Results: After the intervention, the intervention group showed significantly higher self-efficacy and functional exercise adherence scores compared to the control group (P<0.05). Additionally, the intervention group demonstrated lower DAS28,VAS scores and HAQ score than the control group (P<0.05). Scores for SAS and SDS were also significantly lower in the intervention group post-intervention (P<0.05). Conclusion: The empowerment theory-based nursing intervention can enhance functional exercise adherence, alleviate physical symptoms, and improve negative emotional states in patients with RA.、