| 122 it’s gone, or these capabilities are. I can imagine that would be very difficult.’ Australia, Participant 3 Limitations to meaningful engagement Whilst many were very engaged, not all participants found the photo elicitation techniques meaningful. For example, one participant did not feel it was possible to understand what someone else might experience, especially without more information about the person and their unique situation. However, through the process of engaging with the scenario, he was eventually able to see the perspective as if in “Thelma’s shoes”. Participant: ‘Well, this is a problem for me, because I do not know exactly what this dementia is associated with. If so… it could be very serious. Or it is at the beginning, for example, and something else can be done about this dementia through some mental training or some drug treatment, so I just don’t know what this diagnosis entails. And I, if I were in this lady’s shoes, I would like to know, the truth is, what is it, what can be done, can something be done, can something be done, or what they are here, I don’t know ... dementia is generally associated with something so serious (…)’ Poland, Participant 2 One participant also limited their engagement with the scenario, providing only brief, and factual responses. Interviewer: ‘If you were the person who received that diagnosis how would you feel? Or how would she be feeling?’ Participant: ‘Well, if the doctor said you had it, the doctors they know their business’. Interviewer: ‘mm-hm’ Participant: ‘I would accept what they said.’ Interviewer: ‘Ok, do you think she would have, that Thelma would have some questions at the time when her physician said that to her?’ Participant: ‘Well, I wouldn’t know. Some people accept these things, and some people don’t, so it all depends [on] whether she accepted the decision.’ Canada, Participant 5 Our analysis suggests that the inclusion of written words within the ‘thought bubbles’ as well as the nature of some of the images selected may have limited participant responses. Researchers felt that they specified a focus for
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