The Utility of Researcher-Driven Projective and Enabling Techniques to Support Engagement in Research About Dementia Diagnosis and Post-Diagnostic Support

Research involving people with dementia has highlighted the need to improve engagement in the conduct of interviews and focus groups. Projective and enabling techniques may be useful and avoid some of the drawbacks associated with direct questioning. However, researcher-driven projective techniques have not been extensively tested in research with people with dementia. In 2019, researchers in Australia, Canada, the Netherlands and Poland received training and trialled projective and enabling techniques to collect data about dementia diagnostic and early post-diagnostic experiences. The techniques were used with a total of thirty people with dementia (aged 67-97 years) in online and face-to-face individual and dyadic interviews and a focus group. Word association activities supported brainstorming about the concepts of 'dementia' and 'support'. A researcher-driven photo elicitation technique was utilised to seek responses concerning a hypothetical couple at four time points: during a diagnostic conversation, and at 1, 6 and 12-month post-diagnosis. Discussions were audio recorded and transcribed and interviewers created 'meta' mind maps of word associations and made reflective notes regarding participant engagement. Deductive content analysis was used to assess the value of the techniques to support a manageable, comprehensible and meaningful research experience. Word associations supported free-flowing conversations around the key research concepts. Photo elicitation techniques promoted empathy and supported personal reflections on the probable experiences and needs of the hypothetical couple. The techniques were also useful in eliciting reflections on personal experiences, societal responses to dementia, and recommendations for improving the diagnostic conversation and supports for the post-diagnostic period. Overall, the techniques appeared to lessen some of the demands of direct questioning but were not manageable or meaningful for all participants. Further research should explore the vast array of projective techniques and engage in greater co-design and tailoring of research approaches to enhance the toolkit of dementia researchers.