By Beatrice H. Hill (Mrs. Hill is the NRA consultant on hospital recreation.)

This is a brief report of a research project, conducted from December 1954 to July 1955, on the effect of recreation on 139 chronically ill patients in Bergen Pines Hospital, Paramus, New Jersey.

The team of people making the study was under the supervision of Dr. Roscoe Brown, a professor in the research department of the School of Education, New York University. Dr. Brown’s report follows.

“Patients on two floors of the hospital participated in the project. These were chronically sick people, about half of whom had been hospitalized for over one year. There were sixty-eight patients, half of them men, on Floor A during the period of the study. Their average age was sixty-four, and most of them were hospitalized because of a neurological condition. On Floor B there were seventy-one female patients with an average age of seventy-two and a half years. All of these were suffering from general chronic diseases of old age such as cardiac ailments, arthritis, diabetes, cancer.

“From a modest beginning, the program at the end of the six-month period included the following activities: parties, movies, photo-tinting, bingo, social games, music, newspaper, dramatics, library, gardening, and grooming.

“The following aspects of patient’s behavior were studied:
1. State of health as measured by: (a) Medical Rating Scale, rated by the attending physician; and (b) Self-Rating of Health, the patient’s rating.
2. 2. Adjustment in the hospital as measured by; (a) Nurse’s Rating Scale, rating of patient’s general cooperation and adherence to hospital routine, and (b) Patient’s Adjustment Scale, the patient’s evaluation of hospital services, routine, and personnel.
3. Personality pattern as measured by: (a) projective personality tests such as the Thematic Appreciation Test and the Sentence Completion Test; and (b) psychological interview.

“The results were all rated on a five-point scale ranging from 1 for excellent to 5 for very poor.

“Complete data were available for twenty-two patients on Floor A and for seventeen patients on Floor B. It was not possible to collect complete data on all patients, some having died or been discharged during the project.

“The data obtained were analyzed through the use of appropriate statistical tests, to determine the statistical significance of any differences (i.e. the extent to which any differences may be chance differences).

“Although the measures of patient behavior presented above did not reveal statistically significant differences, there were some patients who showed particular improvement in the personality scale. This was not true of the group as a whole, however.”

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The amazing thing was that the research showed no change in the patients’ behavior, mental and health testing. Nevertheless, individual notes kept by the recreation worker, Miss Judith Fields, showed a change in the personality and morale of many of the patients. People who had previously sat and stared at the walls came to watch the movies and play passive games. Stroke cases, who had not smiled in months, beamed happily at the music that was brought to them consistently. Several patients who had been completely depressed became interested in the art of photo-tinting. For those who had seen the ward before recreation came to it, and then afterwards, it is almost incomprehensible to realize that in the actual research no changes were noted. The most amazing finis to our six-month research was that, on the day we withdrew our recreation worker from the hospital, the administrator told me that we would wait perhaps a year before engaging another—this time on the hospital’s budget. Exactly three days passed when he phoned me that the patients who had been a part of the research were so upset about the sudden withdrawal of their activities program, that they had created every nuisance possible with their relatives and friends, and were demanding that a recreation worker be hired. The worker was engaged, the hospital is thriving recreationally, and to quote the superintendent, Dr. Rufus Little, “My hospital was once just a place to treat the diseases and symptoms of my patients. Today, thanks to recreation, we feel we are a thriving community.”

As Doctor Brown states further, “It is of interest to note the impact of recreation at Bergen Pines on the community in which it serves. Where there were few volunteers at the beginning of the program, now there are many. The recreation department is now a regular part of the hospital program, with the enthusiastic support of the community and by the literal demand of the patients.

The results of this project indicate that the impact of a hospital recreation program seems to transcend the effect on the patients alone. The recreation program appears to have a social function in the acceptance of a hospital by the community and on the way in which a community thinks of its sick. This project has raised many interesting questions which are challenges to the recreation profession as well as to the psychological and medical fields. It appears that further explorations of this type should be conducted by the universities and hospitals of the nation.”

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I wish I knew the answer to this question: Are the tools available today for adequately testing the value of recreation, or is it, perhaps, impossible to test the morale and spirit of a person? Only much more research will give us the answer. I certainly would be interested in comments from our readers.