Searching for a dynamic equilibrium in decision making: the voices of adults with mild intellectual disability and their significant others in Hong Kong

Purpose The self-determination of people with intellectual disability (ID) is influenced by their interpersonal environment. This study set out to understand better the experience of Hong Kong adults with mild ID in exercising self-determination and to explore the relational and contextual dynamics of how they make decisions in conjunction with parents and paid carers. Method A qualitative study was conducted using focus groups for data collection. In total, 32 participants including people with mild ID, parents and rehabilitation personnel were recruited using purposive sampling. Five focus group discussions took place and the data were analysed using a thematic approach. Results Our findings highlight a continuum of autonomy in decision making in which participants with mild ID exercise different levels of autonomy in different contexts. In the triangular relationship with parents and rehabilitation personnel, all three parties are simultaneously looking to establish a dynamic equilibrium in decision making. Conclusions The study enriches our understanding of the relational and contextual considerations for people with ID in decision making. They may have their own priorities for all the decisions they make, but these involve a dynamic interaction between all three parties.