| Summary: | 碩士 === 國立臺灣大學 === 職能治療研究所 === 97 === Introductions: In Taiwan, we usually used the Client Ability Checklist to assess the work-related abilities in Community-Based Employment Service of the hearing impaired, and matched the results with the jobs. But there are some employment specialists claimed that the checklist didn’t reflect the influencing factors of the hearing impaired well, in their employment situations. And there were no other assessment tools for them to use, so led to some failures in the service. The purposes of this research are to examine if the Client Ability Checklist was an appropriate assessment tool for the hearing impaired by checking the range, item difficulty, and item discrimination.
Methods: We divided the purposes into two parts: 1. We used two focus groups and literature review to find out what were the influencing factors of the hearing impaired in their working world, and to discuss the assessment range by comparing the factors with the items of the Client Ability Checklist. 2. We selected hearing impaired clients from “National wide information management database of transition and vocational rehabilitation service of Disabled Citizens”, who started a Community-Based Employment Service and ended it between 2006~2007. There are 373 clients consisted of 155 males and 218 females. We downloaded their basic information and their results of the Client Ability Checklist from the database to be our analyzing data. The data was analyzed by Rasch analysis to test the unidimentionality and item difficulty, and analyzed by Chi-square tests to examine whether the items could discriminate the stable-worker group and the umemployment group.
Results: 1. We found out that the testing range of the Client Ability Checklist are short in testing aptitude, intelligence, work readiness, interviewing skills, obeying the rules, misunderstanding of some situations, whether they embrace their own disabilities, socialization experiences, fitness of their hearing aids, allowance, economic pressure, and job-related skills (including job-related ADL), compared with the findings of the focus groups and literature review. 2. The result of Rasch analysis indicated that the Client Ability Checklist fit the model(MNSQ=1.03；ZSTD=0), that is, the checklist encompass a unidimentional construct. And there are only a few items didn’t fit the model. Rasch analysis can also test item difficulty, and we found 34 items’difficulty (more than half of the checklist) were below 2 SDs of the client’s ability. The results indicated that the checklist needs some harder items. When it comes to item discrimination, there are only 6 items that can discriminate the stable-worker from the umemployment. They are “key-in”(χ2=4.288；p=.038), “common office devices use”(χ2=3.861；p=.049), “whether they had the ability to execute consecutive job functions”(χ2=5.272；p=.022), “willing to get a part-time job”(χ2=8.829；p=.003), “willing to work overtime often”(χ2=4.505；p=.034) and “if they had a college diploma or not”(χ2=6.573；p=.010). And there are ceiling-effect in most of the items, it means the Client Ability Checklist is too easy for the client, and it couldn’t discriminate the two group.
Conclutions: There are two important problems of the Client Ability Checklist which have to change in the future when assessing the hearing impaired. First, the range of the checklist is limited. Second, some items are too easy, don’t have enough grading levels, don’t have clear definitions, or items that are not suitable for the hearing impaired. For future assessment, when using the Client Ability Checklist to assess the working abilities of the hearing impaired, the assessors have to wide the assessment range, or develop a hearing impaired focused assessment.
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