The purpose of this study was to determine the effectiveness of play activities upon the self-esteem level of the chronically ill "low" communicative patient during a therapeutic nurse-patient relationship.

A survey of the literature revealed that meaningful interpersonal relationships are an important aspect of mental health. For the emotionally disturbed person with distorted self concept, the use of nonverbal activities may be a way to establish a relationship which can help increase his feeling of personal worth and responsibility, A particularly important topic related to the study was the use of play activities in nursing.

The experimental method was used in conducting the study. Sixteen female patients identified as "low" communicators from a "chronic" unit of a 1537-bed state mental hospital were included in the sample. At the beginning and again at the end of the four-week study period, the researcher administered the Rosenberg-Guttman Scale, a pencil and paper test measuring self-esteem, to each of the participants. The experimental group of eight patients participated on an individual basis with the nurse researcher in selected play activities, in addition to the routine therapy program of the unit. The activities were simple and did not require special skills in order to perform. These included Word Cubes, Dominoes, and Parchisi. The control group of eight patients was involved in their usual activities with no other contact with the researcher.

The results obtained on the Rosenberg-Guttman Scale of Self-Esteem showed slight increase in the self-esteem level of the experimental group following therapy. The control group remained unchanged. The T-test was used to compare mean difference of the pre- and post-test scores of the two groups. The results were significant at the .01 level.

Observation data indicated changes in behavior and communication patterns of the experimental patients, The amount and quality of verbalization were particularly increased.

The findings of the study indicate that simple noncompetitive activities can be used by the nurse to involve the "low" communicative patient in order to establish a meaningful relationship and help increase his self-esteem.

LLU Discipline





Graduate School

First Advisor

Ruth Wang

Second Advisor

Maureen Maxwell

Third Advisor

Thomas Straight

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Psychiatric Nursing; Self Concept; Nurse-Patient Relations



Page Count

vii; 61

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives