「案主能力分析表」於聽覺障礙者適用性之探討

The applicability of the Client Ability Checklist in Hearing impaired

吳瓊華(Chung-Hua Wu)

指導教授 ： 張彧

國立臺灣大學/醫學院/職能治療研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.00459

摘要

前言：我國進行社區化就業服務時，常會使用「全國身心障礙者就業轉銜暨職業重建服務資訊管理系統資料庫」中之「案主能力分析表」來評量聽覺障礙者（簡稱聽障）之工作相關特質，再將與工作進行媒合。但聽障之就服人員反應「案主能力分析表」並不能充分反應影響聽障穩定就業的因素，且並沒有其他可使用的量表，導致提供職業重建服務之不適切。因此，本研究的目的乃是在探討「案主能力分析表」之評估項目是否能夠在涵蓋範圍及難度上，真正評量出聽覺障礙個案的工作能力，以及能否從評估結果來區分出個案是否穩定就業。
研究方法：分成兩部分：（一）以焦點團體及文獻回顧方式探討影響聽障者就業因素，並與「案主能力分析表」之評估項目做涵蓋範圍的比較。（二）從「全國身心障礙者就業轉銜暨職業重建服務資訊管理系統資料庫」中挑出全台灣領有聽障手冊，並於民國95年到96年底開案並結案之社區化就業服務者，共373位個案（男性155位、女性218位），將人口學資料及「案主能力分析表」的評估資料抄錄下來。以羅序分析進行單向度及難度的分析，以及用卡方分析和「是否穩定就業」進行交叉分析，以檢驗其區辨力。
研究結果：（一）從焦點團體及文獻回顧的結果中發現，「案主能力分析表」仍有些未涵蓋的部分，如：性向、智能、就業準備度、面試技巧、遵守職場規範、對情境錯誤理解、對自身障礙的接受、社會化經驗、助聽器的適用性/學習成效、津貼、經濟壓力、工作相關安全能力及工作相關生活技能等項目。（二）「案主能力分析表」整體來看，符合羅序模式假設（MNSQ=1.03；ZSTD=0），具有單向度性，其中只有少數幾項不符合。有超過一半的項目難度低於絕大多數人2個標準差的能力，顯示題目太過簡單，缺乏難度較高的題目。（三）區辨力的部分，除了「打字」（χ2=4.288；p=.038）、「使用一般辦公設備」（χ2=3.861；p=.049）、「職務流程」（χ2=5.272；p=.022）、「半職工作」（χ2=8.829；p=.003）、「常加班工作」（χ2=4.505；p=.034）及「是否有大學學歷」（χ2=6.573；p=.010）這幾個項目外，其他的項目在「是否穩定就業」的兩組間均沒有達到顯著差異。並且有許多項目是幾乎全數的個案都擁有此能力，或者是在項目拿到最高分，顯示「案主能力分析表」評估項目，對此族群的個案能力過於簡單，缺乏區辨能力。
結論：「案主能力分析表」評估的項目有兩個重要的問題：第一、涵蓋範圍有限；第二、在一些已評估的項目上，又有過於簡單、分級不足、定義不清楚及不適用的項目。建議未來使用「案主能力分析表」來評估聽障工作能力時，要加強其他項目的評估，或是發展專屬於聽障的工作評估量表，以增進評估的效益。

關鍵字

案主能力分析表 ； 羅序模式 ； 涵蓋範圍 ； 難度 ； 區辨力

並列摘要

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.

並列關鍵字

Client Ability Checklist ； Rasch model ； range ； item difficulty ； item discrimination

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