| 128 Conclusions and implications for research, policy and practice Our experiences within this study suggest that word associations and researcher-driven photo elicitation techniques can be useful to support involvement and lessen some of the demands imposed by more direct questioning approaches for people with dementia. They were also useful to promote meaningful engagement with the topic, with photo elicitation especially highlighting the deeply personal aspects of being diagnosed and the complex and strong emotions associated with the diagnostic experience. In response, medical practitioners involved in diagnosing dementia should be mindful to recommend psychological support services that can promote wellbeing and psychosocial adjustment to a diagnosis, whilst dementia policy makers should also ensure psychological supports services are readily available for those recently diagnosed (61). Finally, the study has implications for research training practices, highlighting the need for research students to be exposed to a wider variety of innovative methods which may enhance the voice of people with dementia in health services research and evaluation (13). However, despite some utility, the techniques were not a ‘cure all’, and the importance of research support, careful preparation, and co-design of research approaches was highlighted. Our findings reinforced the need to match approaches to the individual circumstances and preferences of people with dementia. Future research should build on this work by exploring the value of other projective and enabling techniques to grow the evidence needed to understand what works for whom and in what context. We also join with other researchers in the call for further research which places a greater emphasis on co-design, co-delivery and co-evaluation strategies to support interpretation of research data (50). These efforts will enhance the toolkit of dementia researchers and improve the engagement of people with dementia within an interview and focus group context.
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