Occupational Therapy

Melville-Nelson Evaluation System

The Melville-Nelson Self-Identified Goals Assessment (SIGA) and the Melville-Nelson Self-Care Assessment (SCA) are new occupational therapy tools for use in subacute rehabilitation and nursing homes. The SIGA is designed to help patients identify meaningful goals for therapy and make judgments as to progress toward those goals. The SCA is designed for the objective analysis of self-care by the occupational therapist, in accordance with Medicare guidelines. The SIGA and SCA can be used in conjunction with each other, or separately. Whether or not the SIGA and SCA are used, therapists working in subacute rehabilitation and nursing homes are urged to listen carefully to patients' goals (as in the SIGA) and to conduct objective assessments (as in the SCA).

Principles applied in the development of these instruments include:

(a) consistency with the Conceptual Framework for Therapeutic Occupation and with traditional principles of occupational therapy (American Occupational Therapy Association;

(b) principles of measurement validity; and

(c) practicality within the regulatory and administrative constraints of United States' settings for subacute rehabilitation, which include assigned subacute beds in skilled nursing facilities (SNF's) and hospitals. For references, please see:

Melville, L. L., Baltic, T. A., Bettcher, T., & Nelson, D. L. (2002). Patients' perspectives on the Self-Identified Goals Assessment. American Journal of Occupational Therapy, 56, 650-659.

Nelson, D. L., Melville, L. L., Wilkerson, J. D., Magness, R. A., Grech, J. L., & Rosenberg, J. A. (2002). Interrater reliability, concurrent validity, responsiveness, and predictive validity of the Melville-Nelson Self-Care Assessment. American Journal of Occupational Therapy, 56, 51-59.

Occupational therapists are free to download and use the SIGA and the SCA as called for in their protocols, as long as the copyright is acknowledged.

The SIGA is presented here in the following links:

The SIGA protocol
The SIGA visual aid
First alternative for recording the SIGA 
Second alternative for recording (on the bottom left hand corner, Section 2, of the larger Melville-Nelson Evaluation System, which is available from the authors)
Abstract from a published validity study of the SIGA (cited above). 

The SCA is presented here in the following links:

The SCA protocol
Form for recording the SCA (on the right hand side, Section 3, of the larger Melville-Nelson Evaluation System, which is available from the authors) 
Abstract from a published reliability/validity study of the SCA

Wehope the assessments are useful, and we are always interested in finding out how they are used. If you wish, please contact me at lisa.melville@utoledo.edu.

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Last Updated: 3/23/15