Validation of the UCSD Performance-Based Skills Assessment (UPSA) for functional evaluation of people with severe mental illness in Hong Kong

Abstract

Background/hypothesis: This study aims to translate and adapt the University of California San Diego Performance-Based Skills Assessment Extended Range (UPSA-2-ER) to Chinese for assessing independent living skills of people with severe mental illness in Hong Kong. Study design: An expert panel was conducted to evaluate the translation, content validity, and cultural relevance. The UPSA-2ER (HK) was administered to 30 Hong Kong Chinese with severe mental illness (SMI) to examine the inter-rater reliability and 210 more to examine the internal consistency, structural validity and predictive validity. Sixty-six participants also completed the Chinese Functional Needs Assessment (CFNA) for concurrent validity. Study results: Good content validity was established with modifications of items to address cultural relevance. Both inter-rater reliability (ICC ranged from 0.98 to 0.99) and internal consistency (Cronbach's α = 0.97) of total score were excellent, while internal consistency of sub-domains ranged from fair to excellent (Cronbach's α ranged from 0.76 to 0.96). In Rasch analysis, raw variance explained by measures ≥40% was interpreted as good in terms of unidimensionality (Sumintono & Widhiarso, 2015), study results provided modest evidence that the UPSA-2ER(HK) has a unidimensional structure, as the variance explained by the items was 43.5% and the unexplained variance in the 1st contrast was 4.4%. Classification & regression tree analysis showed that the UPSA-2ER(HK) correctly classified 78.5% of the 210 participants into their residential status of independent living, halfway house or long stay care home. For concurrent validity, the UPSA-2ER(HK) demonstrated high correlation with the local golden standard, CFNA (r = 0.82). Conclusions: The results showed that the instrument has satisfactory psychometric properties for assessing capacity to perform community living tasks.