The Chinese version of the Becker Work Adjustment Profile (BWAP-CV) for use by people with developmental disabilities. (Becker Work Adjustment Profile).

Work is considered therapeutic and essential for an individual's physical survival and psychological well-being (Dawis, 1987) and people with developmental disabilities are no exception. They are usually referred for work rehabilitation by professionals working in clinical facilities (Reed & Sanderson, 1992). An effective vocational rehabilitation program is crucial to the well-being of clients with developmental disabilities. Vocational assessment plays a significant role in optimizing rehabilitation outcomes of people with disabilities (Chan, Reid, Kaskel, Roldan, Rahimi & Mpofu, 1997). Before a vocational rehabilitation plan is formulated, therapists need to initiate the problem-solving process with selected assessment procedures. Reliable and valid assessment results provide information for the identification of vocational rehabilitation goals and services needed to accomplish the goals. A thorough and accurate assessment is important as it directs the decision and in turn influences the outcome of the rehabilitation program. In addition, vocational assessments can be used to document clients' progress and serve as outcome indicators. Hence, measuring vocational behaviors with a psychometrically sound assessment instrument is a challenge for therapists working in rehabilitation facilities.

The Minnesota Theory of Work Adjustment (Dawis, 1987) is a useful framework for implementing vocational assessment of people with disabilities (Chan et al., 1997). According to this theory, work adjustment is the ultimate goal of vocational rehabilitation. Whether an individual is successful in the process of work adjustment is influenced by two major factors: job satisfaction and job performance. Satisfactory job performance includes general employability, specific employability and placeability. Placeability is the likelihood that an individual will actually be hired for a job. It deals also with a person's ability to seek and maintain a job. In contrast to specific employability skills, general employability skills are not job specific and are required in every job. Examples of these behaviors include grooming and hygiene, attendance, punctuality, relationships with co-workers and supervisors, and production rate. An assessment of client behavior in this skill area requires the use of a situational assessment approach which is predictive of job maintenance behavior (Chan et al., 1997).

There are four major approaches in vocational assessment for people with disabilities: standardized testing, job analysis, work samples and situational assessment (Chan et al., 1997; Rubin & Roessler, 1995), however the situational assessment approach focuses on general employability skills and is able to provide valid representations of work functioning which are generalizable to a variety of settings (Bryson, Bell, Lysaker & Zito, 1997; Chan et al., 1997). The Becker Work Adjustment Profile (BWAP) is an observer rating instrument designed to assess work behaviors and related social behaviors of persons with physical, intellectual, and emotional disabilities using the situational assessment approach. The primary purpose of the BWAP is to identify deficits in clients' work and related behaviors that can be remediated in vocational rehabilitation programs (Bolton, 1992). The BWAP is simple in design, allowing rehabilitation professionals to use it competently with minimal training or simply after a review of the evaluator's manual (Gory, 1992). It takes approximately twenty minutes to administer. The BWAP consists of 63 items which when factor analyzed are distributed within four domains: Work Habits/ Attitudes (10 items), Interpersonal Relations (12 items), Cognitive Skills (19 items) and Work Performance Skills (22 items). Test items are scored by using a five-point rating scale. Each point on the scale corresponds to a recognizable or definable behavior pattern (Gory, 1992). The BWAP is a reliable and valid instrument in terms of internal consistency ([1]84 to .94), test-retest reliability (.79 to .95), inter-rater reliability (.76 to .86), content validity (reviewing relevant instruments and literature, and interviewing with practicing workshop personnel), concurrent validity (moderate to high correlation coefficients with AAMR-Adaptive Behavior Scale, Nihira, Foster, Shellhaas & Leland, 1974) and construct validity (the four factors/domains accounted for 71.08% of the total common variance) (Becker, 1989; Bolton, 1992; Gory, 1992).

Chinese is the first language for more than 90% of people in Hong Kong, the Mainland, and Taiwan with a population of more than 1.2 billion. However, limited reliable and valid vocational assessment instruments for assessing work behaviors of individuals with developmental disabilities using the situational assessment approach have been available in Chinese. There is a need, therefore, for an instrument such as the BWAP to be translated into Chinese. This version can then be used by Chinese speaking rehabilitation professionals and their assistants to report and communicate clients' progress in their work performance.

As the BWAP was developed and validated in the United States, some of the items may not be relevant to the Chinese culture which may in turn affect the test's validity and reliability (Sabonis-Chafee & Hussey, 1998). This article addresses this issue by reporting a three-phased validation exercise aiming at (1) selecting culturally relevant items, (2) translating the selected items into the Chinese version, and (3) assessing its psychometric properties. This research can act as a catalyst for further studies of the Chinese version including the development of local norms and evaluation of its predictive validity.

Item selection

The method of content experts was used in the process of selecting culturally relevant items from the original BWAP (Betz & Weiss, 1976; Thom & Deitz, 1989). In this method, experts were asked to assess the relevance of each item to the content addressed by the domain and their judgments were then analyzed (Waltz, Strickland & Lenz, 1984). Ten occupational therapists (six males and four females) experienced in vocational rehabilitation for people with developmental disabilities in Hong Kong were recruited to the expert panel. The panel members' mean working experience in vocational rehabilitation for people with developmental disabilities in Hong Kong was 4.58 [+ or -] 2.13 years with a range from 2.25 to 8.00 years.

A self-administered questionnaire was designed to collect the expert panelists' opinions. The first part of the questionnaire was designed to gather opinions on the degree of relevance of the 63 individual items to their corresponding domains of the BWAP by asking the expert panelists to indicate each of the items as either "relevant", "questionably relevant" or "irrelevant" to Hong Kong. The second part of the questionnaire was designed to gather opinions on the representativeness of the four domains and the 63 items in the BWAP in assessing the general employability of people with developmental disabilities in Hong Kong. Closed end questions were used. If the expert panelists indicated that the domains or items were not representative, further elaboration of the opinion was requested. The expert panelists were asked which of the items and domains should be modified or deleted (if any). They were also asked if other domains and items should be added and what the domains and items should be. In addition, the description of each item and the appropriateness of the five-point scale were examined. If the expert panelists indicated that the description was not appropriate, they were asked to make recommendations.

The questionnaires were sent to the expert panelists and collected by post within five weeks. The panel members were asked to contact the first author for any queries about the questionnaires. Background information regarding the Minnesota Theory of Work Adjustment (Dawis, 1987), definition of "general employability", and function of the panel review were explained to the panelists to aid their rating.

Data collected in the first part of the questionnaire were analyzed by the content validity ratio (CVR) (Lawshe, 1975, pp.567): CVR = (Ne - N/2) / (N/2) where Ne is the number of panelists indicating "relevant" and N is the total number of panelists. According to the method prescribed by Lawshe (1975), items with CVR value less than .62 were eliminated when the number of panelists was ten. The opinions collected in the second part of the questionnaire were reported and compared. The BWAP was revised as the Becker Work Adjustment Profile--Hong Kong Version (BWAP-HKV) according to the expert panelists' opinions (defined as at least 90% agreement).

From the data collected in the first part of the questionnaire, the CVR values of each item of the BWAP were computed. All the CVR values ranged from .80 to 1.00 except three items with CVR values lower than the minimum value for retention (.62). Those items were "Eating Habits" (CVR = .40), "Restroom Use" (.CVR = .40) and "Changes in Routine" (CVR = .60). These were dropped from the BWAP-HKV.

From the opinions collected in the second part of the questionnaire, at least 90% of the expert panelists agreed that the remaining items and domains were representative in assessing the general employability of people with developmental disabilities in Hong Kong. In addition, at least 90% of the expert panelists agreed with the appropriateness of the item and five-point scale descriptions. The only exception was that no panelist agreed with the five-point scale description of the item "Reading Level". Finally, panelists recommended that the five-point scale description be modified as in Figure 1.

Translation into the Chinese version

The BWAP was revised as BWAP-HKV accordingly.

The BWAP-HKV was translated into Chinese by a qualified translator. Back-translation into English was independently conducted by another qualified translator. Another self-administered questionnaire was designed to collect the opinions as to whether the Becker Work Adjustment Profile--Chinese Version (BWAP-CV) was appropriately and accurately translated by comparing the BWAP-HKV, the BWAP-CV and the back-translated version. Closed end questions were used. If the expert panelists, all of whom were bilingual in English and Chinese, indicated that the translation of the BWAP-CV was not appropriate, recommendations for the appropriate Chinese translation were given.

The questionnaires were sent to the same expert panelists and were collected by post within five weeks. The panel members were asked to contact the first author for any queries about the questionnaires. The opinions collected in the questionnaire were reported and compared. A final version of the BWAP-CV was confirmed according to the expert panelists' opinions with at least 90% agreement.

All panelists agreed that the contents of 34 (out of 60) items of the BWAP-CV were appropriately translated. Nine (90%) panelists agreed that another 17 items were appropriately translated. Eight (80%) panelists agreed that the remaining nine items were appropriately translated. Of these nine items, the contents recommended for modification by 10% of the panelists were different from those being recommended to be modified by another 10% of the panelists. This meant that at least 90% agreement was reached for the validity of the Chinese translation of all the contents from the BWAP-HKV. No modification was therefore made to the BWAP-CV.

Psychometric properties of the BWAP-CV

Participants

A sample of 98 participants (58 males and 40 females) diagnosed as having mild or moderate grade mental retardation was recruited via purposive sampling (Portney & Watkins, 1993) from five sheltered workshops. The selection criteria were: (1) an adult with mental retardation, and (2) having received training in the same sheltered workshop closely observed by the same staff member continuously for at least one month. The participants' mean age was 26.41 (SD = 7.06 years) with a range from 18 to 50 years.

Procedures

Staff members who had closely observed the participants in the sheltered workshop continuously for at least one month were recruited as raters. All of the 98 participants were rated by 28 raters using the BWAP-CV for examination of its internal consistency and structural validity. The total study involved 34 raters who were provided with a briefing session on how to administer the BWAP-CV before any data collection. A randomly selected sub-sample of 37 participants was rated twice with a ten-day interval by the same six raters for purpose of assessing its test-retest reliability. Another randomly selected sub-sample of 33 was rated by paired independent raters on the same day for the purpose of studying the inter-rater reliability involving 21 raters. A copy of the Chinese translated rating guidelines summarizing the original rating guidelines from the BWAP Evaluator's Manual was given to each rater for training purpose. Readers may refer to the BWAP Evaluator's Manual (Becker, 1989) for detailed guidelines on the assessment procedures.

Internal Consistency

The first rating scores of the 98 participants were used to examine the internal consistency by computing the Cronbach's alpha coefficients. All four domains "Work Habits/Attitudes", "Interpersonal Relations", "Cognitive Skills" and "Work Performance Skills" have alpha coefficients of .79, .88, .91 and .94 respectively indicating good to excellent internal consistency. The Cronbach's alpha coefficient of the whole instrument was found to be .76 indicating good internal consistency of the four domains within the instrument.

Test-retest Reliability

The test-retest reliability was assessed by intraclass correlation coefficients between the first and second rated scores of the 37 participant sub group with a ten-day interval. Within a 95% confidence interval, the coefficient was .98 for the domain "Work Habits/Attitudes", .90 for "Interpersonal Relations", 1.00 for "Cognitive Skills", .99 for "Work Performance Skills" and .99 for the total scores. All these coefficients show stability of scores over time.

Inter-rater Reliability

Intraclass correlation coefficients between scores of the 33 participant sub group rated by the paired independent raters were computed. With 95% confidence interval, the coefficient was .61 for the domain "Work Habits/Attitudes", .55 for "Interpersonal Relations", .66 for "Cognitive Skills", .64 for "Work Performance Skills" and .67 for the total scores. All these coefficients show moderate to good inter-rater reliability.

Structural Validity

A principal components analysis using the varimax rotation was performed on the 58 BWAP-CV items. (Five items were eliminated based on preliminary item or factor analyses.) Using the Kaiser-Guttman rule and the Cattell's scree test, a five-factor solution accounting for 57.0% of the total variance was indicated. The final rotated solution was found to be parsimonious, have good simple structure, and could be meaningfully interpreted (see the structure matrix presented in Figure 2).

Factor 1: Work Attitudes and Performance Skills. There were 26 items (see Figure 2) within this factor. The items were mainly related to work attitudes and work performance skills. (The item "Dependability" appeared twice in this factor with high factor loadings and it was included in both domains "Work Habits/ Attitudes" and "Work Performance Skills" of the BWAP.) The alpha coefficient computed for the total sample was .96 which indicated excellent internal consistency of the items constituting this factor.

Factor 2: Cognitive Skills. There were twelve items for this factor (see Figure 2). The alpha coefficient computed for the total sample was .90, indicating excellent internal consistency of the items within this factor.

Factor 3: Work-related Social Behaviors. The nine items for this factor (see Figure 2) were also consistent, with an alpha coefficient .88 indicating high internal consistency within this factor.

Factor 4: General Social Behaviors. The alpha coefficient for these eight items (see Figure 2) was computed to be .89, indicating very good internal consistency.

Factor 5: Hygiene and Clothing. There were three items (see Figure 2) within this factor. The alpha coefficient computed for the total sample was .88, indicating again a high internal consistency within this factor.

Discussion

Items of the BWAP-HKV were considered by the expert panel to be relevant and representative in assessing the general employability of people with developmental disabilities in Hong Kong. Evidence of satisfactory content validity was also shown by the high CVR of the 60 retained items of the BWAP-HKV. Since the Chinese version was appropriately translated as commented by the bilingual expert panel, the items of the BWAP-CV can also be regarded as relevant and representative. Results show that the BWAP-CV has good to excellent internal consistency (.76 to .94), a level consistent with the original version (Becker, 1989). The findings support that each set of items within the same domain measures the same trait, either "Work Habits/Attitudes", "Interpersonal Relations", "Cognitive Skills" or "Work Performance Skills". In addition, high value of Cronbach's alpha coefficient of the instrument supports that all domains of the BWAP-CV measure the same trait--general employability. Test-retest reliability is excellent, and similar to the original version (Becker, 1989). These results also imply ability of the BWAP-CV to produce stable scores at different time intervals. Inter-rater reliability (.55 to .67) indicates that the degree of relationships between the ratings of two different raters with the same individual is moderate to good. Two items were excluded by the factor analysis procedure. They are "Attendance" and "Physical Strength" (with factor loadings less than .40). Although the item "Attendance" was considered relevant to the domain "Work Habits/Attitudes", it was deleted as the ratings of this item were affected by differing organizational rules of the sheltered workshops. Similarly, the item "Physical Strength" was also deleted as it was not accurately rated based only on subjective speculation of sheltered workshop staff.

The five-factor solution of the final 58 retained items resulting from the exploratory factor analysis retains similarities to the four-factor model of the original version, despite some differences. All of the items have factor loadings of at least .40 in one of the five factors to which they belong and have very little overlapping with other factors. The total percentage of variance being explained by the five factors is very high (57.0%). Factor 1 (Work Attitudes and Performance Skills) basically equals "Work Performance Skills" of the original version. But some items from the original "Work Habits/Attitudes" domain are now grouped under this factor as well. Factor 2 (Cognitive Skills) is very similar to the "Cognitive Skills" domain of the original version. A further exploration of factor reveals that the items are functionally related to skills essential to community living. Factor 3 (Work-related Social Behaviors) and factor 4 (General Social Behaviors) is somewhat similar to the "Interpersonal Relations" domain of the original version. The breaking down of social behaviors into general and work-related is in line with similar studies among individuals with mental illness (Tsang & Ip, 2000; Tsang & Pearson, 1996). The distinction of two sets of social skills, general and work-related, has significant implications to rehabilitation programming beyond assessment. In the field of psychiatric rehabilitation, social skills training geared towards job securing and retaining have been developed and found to be successful in enhancing vocational outcomes of individuals with mental illness (Tsang, Kopelowicz & Liberman, 2001; Wallace, Tauber & Wilde, 1999). This has also implications for the kind of follow-along support needed in supported employment program (Becker & Drake, 1993). The recent developments in the field of psychiatric rehabilitation have potential implications to people with developmental disabilities as well. Finally, some of the items from the original "Work Habits/Attitudes" domain become factor 5 (Hygiene and Clothing) of the Chinese version. However, the above can only be regarded as preliminary results as the number of cases are limited. This may pose stability problems for the factor structure of the Chinese version. Similar studies need to be conducted with more representative and larger sample in the future.

Conclusion

The BWAP-CV is easy to use as the items are culturally relevant and easy to understand. The administration time of approximately twenty minutes is reasonable given the heavy caseloads of rehabilitation professionals in Hong Kong. The assessment results of the BWAP-CV can be interpreted by vocational rehabilitation professionals to identify clients' strengths and limitations and develop effective vocational rehabilitation plans. Therapists may also use the BWAP-CV as one of the outcome or performance indicators in vocational rehabilitation units. If clients show improvement in their general employability, this is reflected in the scores of the BWAP-CV which provides objective monitoring of clients' progress. The Chinese version also promotes better communication among rehabilitation professionals and caregivers about clients' progress.

This study showed that the BWAP-CV has satisfactory content validity, good to excellent internal consistency, excellent test-retest reliability, moderate to good inter-rater reliability and satisfactory structural validity in assessing the general employability of people with developmental disabilities in Hong Kong. As the BWAP-CV is easy to use and administer, the instrument has potential to be widely used in Hong Kong and other Chinese societies. Further research in developing local norms and examining its psychometric properties is recommended. Since the participants selected in this study involved only clients with developmental disabilities working in sheltered workshops, further study involving larger sample size with different diagnoses of developmental disabilities chosen from different kinds of vocational rehabilitation units is recommended.

Figure 1
Revised five-point scale description of the item "Reading Level"

Description    Non-     Reads      Reads     Reads          Reads
              reader   various    Primary   Primary         above
                       survival     3-5       6 to        Secondary 2
                        signs      levels   Secondary 2      level
                                              levels

Point           0         1          2          3               4

Figure 2
Factor structure and factor loadings of the BWAP-CV items

                                                  FACTOR

FACTOR/ITEM                           1      2      3      4      5

Factor 1: Work Attitudes &
          Performance Skills
  Punctuality                         .47   -.17    .05    .45    .07
  Motivation                          .40   -.05    .64    .25    .00
  Dependability                       .67    .20    .32    .21    .22
  Work Posture                        .47   -.20    .25    .19    .40
  Memory                              .65    .20    .21    .12    .05
  Discrimination Skills               .61    .34    .12    .14   -.01
  Following Verbal Instructions       .71    .24    .04    .23    .04
  Knowledge of Work                   .66    .31    .19    .15   -.18
  Transfer of Skills                  .66    .40    .06    .17   -.03
  Learning Job Task                   .80    .18    .13    .14    .18
  Judgment                            .69    .35    .11    .11    .11
  Correcting Errors                   .65    .17    .18    .12   -.05
  Quality of Work                     .76    .12    .24    .11    .21
  Initiating Task                     .65   -.09    .39   -.01    .11
  Quantity of Work                    .68    .17    .28    .08    .32
  Dependability                       .75    .17    .20    .11    .22
  Independent Functioning             .81    .06    .22    .05    .08
  Attending to Task                   .51   -.12    .53    .24    .18
  Work Steadiness                     .62   -.03    .18    .20    .28
  Care of Equipment                   .65    .16    .20    .14    .10
  Safety Practice                     .44    .29    .09    .40    .05
  Physical Stamina                    .41   -.14    .46    .34    .22
  Fine Motor Skill                    .69    .19    .05    .18   -.01
  Manual Skill                        .69    .11    .02    .29    .09
  Gross Motor Skill                   .62    .05    .05    .29   -.06
  Work Station                        .45   -.23   -.07    .46    .25

Factor 2: Cognitive Skills
  Numbers                             .09    .76    .06   -.09    .17
  Communication Mode                  .16    .46    .29    .18   -.11
  Reading Level                       .02    .59   -.04   -.03    .28
  Time Concept                        .13    .78    .21    .07    .10
  Writing                             .15    .72    .03   -.05    .15
  Telling Time                        .28    .74    .00   -.07    .17
  Telephone                           .11    .76    .14    .03   -.01
  Measuring                           .22    .56   -.07   -.04   -.08
  Managing Money                      .20    .72    .19   -.19    .03
  Solving Problems                    .41    .42    .34    .27   -.02
  Independent Travel                  .06    .67    .14    .04   -.10
  Time Clock                          .24    .42    .37    .09   -.05

Factor 3: Work-related
          Social Behaviors
  Concern for Others                  .00    .15    .68    .29   -.12
  Social Participation               -.05    .13    .54    .33   -.16
  Helping Others                      .07    .06    .75    .28   -.14
  Communicating Basic Needs           .05    .40    .52    .09   -.09
  Asking for Materials                .41    .03    .73    .05    .06
  Requests Help When Needed           .41    .32    .66    .01   -.06
  Tool Return                         .32    .15    .69    .03    .13
  Maintaining Work Area               .30    .08    .64    .02    .24
  Communicating Problems              .26    .28    .59    .04    .02

Factor 4: General Social Behaviors
  Personal Relations                  .10    .09    .30    .77    .07
  Group Acceptance                    .16    .04    .19    .70    .04
  Cooperation - Supervisors           .22   -.18    .33    .72    .11
  Trustworthy                         .32   -.09    .13    .72   -.10
  Cooperation - Co-workers            .22    .00    .09    .78    .17
  Accepting Correction                .20   -.10    .26    .67    .09
  Emotional Stability                 .09    .06   -.13    .68    .16
  Major Disruptive Behavior           .07    .01    .08    .47    .20

Factor 5: Hygiene & Clothing
  Personal Hygiene                    .09    .15    .02    .20    .79
  Appropriate Clothing                .23    .28   -.14    .19    .73
  Personal Appearance                 .27    .12    .05    .21    .77

Acknowledgments

The authors gratefully acknowledge the contributions of the many people whose efforts have made this paper possible. In particular we thank Dr. Ralph L. Becker, Director of the Research and Tests Department of Elbern Publications, for granting us per mission to translate the BWAP into Chinese. We thank Ms. Elaine Wong, the Social Service Executive Secretary of Stewards Limited, and Ms. Samantha Ko, Senior Adult Services Supervisor of Hong Chi Association, for approving this research to be conducted in the sheltered workshops. Special thanks go to staff of Stewards Yiu On Workshop, Stewards Yiu Tsuen Workshop, Hong Chi Kwong Fuk Wai Yin Workshop, Hong Chi Ma Tau Kok Workshop and The Jockey Club Hong Chi Siu Sai Wan Workshop for their help in data collection. Last but not least, we would like to thank all the research participants and their guardians for their agreement to participate in this study.

References

Becker, D. R., & Drake, R. E. (1993). A working life: The individual placement and support (IPS) program. New Hampshire: Dartmouth Psychiatric Research Center.

Becker, R. L. (1989). Becker work adjustment profile evaluator's manual. Ohio: Elbern Publications.

Betz, N. E., & Weiss, D. J. (1976). Validity. In B. Bolton (Ed.). Handbook of measurement and evaluation in rehabilitation (pp. 39-60). Baltimore: University Park.

Bolton, B. (1992). Review of the Becker work adjustment profile. In J. J. Kramer & J. C. Conoley (Eds.). The eleventh mental measurements yearbook (pp. 83-84). Nebraska: Buros Institute of Mental Measurements.

Bryson, G., Bell, M. D., Lysaker, P., & Zito, W. (1997). The work behavior inventory: A scale for the assessment of work behavior for people with severe mental illness. Psychiatric Rehabilitation Journal, 20(4), 47-55.

Chan, F., Reid, C., Kaskel, L. M., Roldan, G., Rahimi, M., & Mpofu, E. (1997). Vocational assessment and evaluation of people with disabilities. Vocational Rehabilitation, 8(2), 311-325.

Dawis, R. (1987). A theory of work adjustment. In B. Bolton (Ed.). Handbook on the measurement and evaluation in rehabilitation (2nd ed.) (pp. 207-217). Baltimore: Paul H. Brooks.

Gory, E. L. (1992). Review of the Becker work adjustment profile. In J. J. Kramer & J. C. Conoley (Eds.). The eleventh mental measurements yearbook (pp. 84-86). Nebraska: Buros Institute of Mental Measurements.

Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28, 563-575.

Nihira, K., Foster, R., Shellhaas, M., & Leland, H. (1974). AAMD adaptive behavior scale (Rev. ed.). Washington, DC: American Association on Mental Deficiency.

Portney, L. G., & Watkins, M. P. (1993). Foundations of clinical research: Applications to practice. Connecticut: Appleton & Lange.

Reed, K. L., & Sanderson, S. N. (1992). Concepts of occupational therapy (3rd ed.). Maryland: Williams & Wilkins.

Rubin, S. E., & Roessler, R. T. (1995). Foundations of vocational rehabilitation process. Austin: Pro-ed.

Sabonis-Chafee, B., & Hussey, S. M. (1998). Introduction to occupational therapy (2nd ed.). St. Louis: Mosby.

Thorn, D. W., & Deitz, J. C. (1989). Examining content validity through the use of content experts. The Occupational Therapy Journal of Research, 9(6), 334-346.

Tsang, H. W. H., & IP, Y. C. (2000). Development and validation of the workshop behavior checklist: A scale for assessing work performance of people with severe mental illness. International Journal of Social Psychiatry, 46 (2), 110-121.

Tsang, H. W. H., Kopelowizc, A., & Liberman, R. P. (2001). Social skills training for finding and keeping a job with the mentally ill. Psychiatric Services, 52 (7), 891-894.

Tsang, H. W. H., & Pearson, V. (1996). A conceptual framework on work-related social skills for psychiatric rehabilitation. Journal of Rehabilitation, 62 (3), 61-67.

Wallace, C. J., Tauber, R., & Wilde, J. (1999). Teaching fundamental workplace skills to persons with serious mental illness. Psychiatric Services, 50 (9), 1147-1153.

Waltz, C. F., Strickland, O. L., & Lenz, E. R. (1984). Measurement in nursing research. Philadelphia: F. A. Davis.

Rebecca S. Y. Li
Hector W. H. Tsang

The Hong Kong Polytechnic University

Rebecca S. Y. Li, Occupational Therapy Unit, TWGHs Jockey Club Rehabilitation Complex, 4 Welfare Road, Aberdeen, Hong Kong. E-mail: [e-mail]