"One More Picture:" A Mixed-Methods Examination of Caption Content in a Photo Captioning Cognitive Empathy Intervention for Dementia-Caregivers.

Empathic perspective-taking may support mental health in caregivers of people living with dementia (PLWD). A photo captioning intervention can promote perspective-taking by guiding caregivers to capture the inner voice of the PLWD. Caregivers' approaches to captioning may be an important mechanism of intervention efficacy. Using a mixed-methods design including subgroup parallel sampling and descriptive content-analysis of 310 captions from an intervention trial, we identified patterns in caregivers' photo captioning. Captions from caregivers who experienced increases in perspective-taking (1) maintained first-person, PLWD focused language, (2) highlighted engagement and intention, and (3) illustrated resilient living. Captions from caregivers who experienced little-to-no increases in perspective-taking (1) offered inconsistent, incomplete phrasing, (2) provided generic, detached descriptions, and (3) adopted a negative, critical tone. Captions from both subgroups (1) connected PLWDs' emotions to events and (2) recorded PLWDs' wonders, wants, and wishes. Results support the development and refinement of perspective-taking interventions to maximize caregiver benefits.