Health, Exercise, and Sports Sciences ETDs

Publication Date

Winter 12-31-1974



The problem was to evaluate by means of the Berryman Instrument (1971) the patient activity programs o[ licensed nursing homes in San Antonio, Texas.


The best evaluation of the total patient activities program in nursing homes was the instrument designed by Dr. Doris L. Berryman, Recommended Standards with Evalua­tive Criteria for Recreation Services in Residential Institutions. After permission was secured from the nursing homes to evaluate their patient activities pro­grams, a personal visit was made to each institution to complete the evaluation. The patient activity director and a qualified assistant assisted in the evaluation at each institution in accordance with the directions and standards found in the evaluation instrument. Before subject data were analyzed, rater reliability was deter­mined for three randomly selected nursing homes. Follow­ing this procedure, scores were interpreted by percentages and applied to a rating scale to lend significance to the data. Tables were constructed to show strengths and to identify standards and categories where future efforts may be directed.


The results of the nursing home survey in San Antonio, Texas, indicated very little or no attention was being paid to the quality of patient activity programs. Activity directors were poorly qualified and programs emphasizing participation in the cognitive, affective, and sensory motor areas were lacking. In addition, sup­portive administrative necessities, offices, budgets, consulting personnel, and records were in most instances non-existent.

These findings were in direct conflict with the intentions of the Texas State Department of Public Wel­fare which emphasized mandatory provision of activities suited to the needs and interests of the patients.


The following conclusions were based on the find­ings of this survey and the analysis of the collected data. The conclusions were classified into two cate­gories: (1) those relating specifically to the selected San Antonio nursing homes, and (2) those pertaining to the Recommended Standards with Evaluative Criteria for Recreation Services in Residential Institutions as a survey instrument. The following conclusions are based on the findings related specifically to the patient activity programs in the nursing homes surveyed:

1. The overall rating of the selected nursing homes in San Antonio was poor. With the exception of nursing home "E, 11 all of the institutions scored below 60 percent. In addition, low scores were found in all six categories of the Berryman Instrument, including (1) Philosophy and goals, (2) Administration, (3) Person­nel, (4) Programming, (5) Areas, facilities, and equipment, and (6) Evaluation and research.

The following conclusions relating specifically to the Berryman Instrument used in this survey were made:

1. A separate form needs to be devised relating to those qualities needing to be evaluated in nursing homes. Too often questions dealt with children and applied to age constraints rather than degrees of mental alertness necessary for careful evaluation of the aged.

2. Standards for the National Therapeutic Recrea­tion Society and the American Standard Specifications for Making Buildings and Facilities Accessible to, and Use­able by, the Physically Handicapped should be located in the appendix of the Berryman Instrument.

Document Type


Level of Degree


First Committee Member (Chair)

Steve Rubio

Second Committee Member

Mary Jo Campbell

Third Committee Member

Peggy Blackwell

Fourth Committee Member

Kenneth Lersten