Relational and contextual self-determination : qualitative and quantitative studies of adults with mild intellectual disability in Hong Kong

Abstract

Self-determination is an intrinsic need of all human beings. Its importance is universal across different cultures, though the ways of satisfying it may vary. In the past two decades, the construct of self-determination, particularly the theory development, assessment instrument, and instructional model aspects, has developed remarkably in the international intellectual disability (ID) field. However, very little research has been done in Chinese societies, including Hong Kong. Our understanding and knowledge of the exercise of self-determination by Chinese people with ID is rather scant. The present research represents an initial attempt to explore the self-determination experience of adults with mild ID in Hong Kong and their decision-making patterns and to examine the relationships between self-determination competencies, relatedness, and personal well-being.

Methodological pluralism was adopted in the present research. Two studies were conducted. Study One was a qualitative study with a focus group interview design. The purpose of this study was to examine how self-determination is perceived by local adults with mild ID and their significant others and what factors contribute to supporting or hindering the exercise of self-determination by adults with ID. Five focus groups were conducted with 13 adults with mild ID, seven parent carers, and 12 rehabilitation personnel. Phenomenological analysis was used as the data analysis approach. Five clusters with 12 categories and 18 subcategories were formed: Meaning of Self-Determination, Pursuit of Goals, Support for Self-Determination from Significant Others, Dynamic Situations in the Exercise of Self-Determination, and Who Makes the Decision?.

The roles of relational and contextual elements in the process of self-determination were the new insights discovered in Study One, and they contributed to the development of Study Two’s research questions. On the basis of these new discoveries and a hypothesis on the relationship between self-determination competencies and personal well-being, Study Two was formulated. A quantitative design was adopted in this study. The objectives of Study Two were 1) to examine the relationships among self-determination competencies, relatedness, and personal well-being in adults with mild ID in Hong Kong and 2) to explore the forms of decision-making in cases of disagreement between adults with mild ID and their significant others, and to assess the happiness levels of the adults with mild ID following decision-making in different contexts. A total of 170adults with mild ID were recruited from ID adult services in different regions of Hong Kong. The results showed that self-determination competencies positively correlate with personal well-being and the “significant-other directed” (relational) relatedness is the moderating variable of its relation. The results also revealed that agreement of opinion situations were dominant across different contexts.

The findings of the search for a dynamic equilibrium of decision-making and of the moderating model make a contribution to our knowledge of the self-determination of Chinese people with mild ID. The results suggest that the importance of self-determination to people with ID is universal across cultures. The role of relational relatedness in self-determination needs to be further explored. Implications for the self-determination construct, research, cultural, and intellectual disability service system aspects are discussed.