A Qualitative Study of Hospital Interior Environments during the COVID-19 Pandemic

Reviewers’ Comments

Authors’ Responses

Reviewer #1

1. More references on safety and wealth control can be mentioned in the Introduction, especially those were conducted in the context of medical facilities. 

[Pages 3-4] Thank you very much for your insight. I put a paragraph in Introduction to explain more about safety and wealth control in hospitals, especially during the COVID pandemic.

I also added one more sentence about relationship between interior environments and safety in Literature Review. Please let me know if you think the addition is not enough. Thank you!

2. The main argument / theory support has not yet been highlighted in the Introduction. If there is no literature review section, a cohesive summery of existing literature and theoretical framework / analytic framework to support research design should be provided.

[Page 4] Based on your comment, I separated Introduction and Literature Review. Please see page 4. I also specified a theoretical framework (human ecological framework) at the very beginning of Literature Review.

Thank you very much for your great insight on the manuscript.

3. The biggest weakness of this paper lies in the methodology. I believe that the study adopted a solid methodology, but it is not well illustrated in this paper, such as the sampling process, the profile of the interviewees, etc.  Also, the data analysis is vaguely mentioned. This has undermined the validity of the results and discussion.

[Pages 6-7] This is a good point. I added more information about recruitment process and profile of the interviewees.

[Page 8] In addition, the data analysis part was improved.

4. What are the differences between "general discussion" and other sections under "discussion"?

[Page 16] “6. General Discussion” on p. 16 is about the overall discussion above the points, from 1 to 5 discussion points. If the word is confusing, I can change it to “Overall Discussion”. Please let me know what you think. Thank you!

Reviewer #2

Participants: Indicate also the Age Range of participants. Is there also data on the contraction of Covid-19 by the participants? Also, it could be interesting to know if people with a long experience reported different opinions from healthcare professionals with less experience.

[Pages 6-7] Thank you very much for your great feedback. The age rage information is included. Also, work years are included. Unfortunately, this study only asked a minimum of demographic information about participants; therefore, there is no more information about participants to be reported.

Data analysis: Please, improve this section.

[Page 8] The data analysis part was improved.

Results: When reporting excerpts from their interviews, please indicate age, medical unit, and years of service. This will add richness to the reported content.

[Pages 8-16] This is also great point. Now, age, medical unit, and years of practice were indicated. Regarding the years of practice, I specified as a range (such as less than 5 years, more than 30 years) because the participants can be revealed due to the small sample size.

If you still think that exact service years should be identified, please let me know. Happy to revise it. Thank you!

Also, have you considered a results' graphic representation?

This is a great point. I thought about to add a graphic representation. However, due to the small sample size and nature of the qualitative data, I ended up including pictures to show visually what the participants tried to explain.

I hope this makes sense to you. If there is anything I can improve the manuscript, please let me know. Happy to hear your opinions.

Limitation: Add the almost total presence of the female gender.

[Page 19] Thank you for the great point. I added the gender as a limitation at the end. I appreciate your insights on the manuscript.

Reviewers’ Comments

Authors’ Responses

Reviewer #1

1. More references on safety and wealth control can be mentioned in the Introduction, especially those were conducted in the context of medical facilities. 

[Pages 3-4] Thank you very much for your insight. I put a paragraph in Introduction to explain more about safety and wealth control in hospitals, especially during the COVID pandemic.

I also added one more sentence about relationship between interior environments and safety in Literature Review. Please let me know if you think the addition is not enough. Thank you!

2. The main argument / theory support has not yet been highlighted in the Introduction. If there is no literature review section, a cohesive summery of existing literature and theoretical framework / analytic framework to support research design should be provided.

[Page 4] Based on your comment, I separated Introduction and Literature Review. Please see page 4. I also specified a theoretical framework (human ecological framework) at the very beginning of Literature Review.

Thank you very much for your great insight on the manuscript.

3. The biggest weakness of this paper lies in the methodology. I believe that the study adopted a solid methodology, but it is not well illustrated in this paper, such as the sampling process, the profile of the interviewees, etc.  Also, the data analysis is vaguely mentioned. This has undermined the validity of the results and discussion.

[Pages 6-7] This is a good point. I added more information about recruitment process and profile of the interviewees.

[Page 8] In addition, the data analysis part was improved.

4. What are the differences between "general discussion" and other sections under "discussion"?

[Page 16] “6. General Discussion” on p. 16 is about the overall discussion above the points, from 1 to 5 discussion points. If the word is confusing, I can change it to “Overall Discussion”. Please let me know what you think. Thank you!

Reviewer #2

Participants: Indicate also the Age Range of participants. Is there also data on the contraction of Covid-19 by the participants? Also, it could be interesting to know if people with a long experience reported different opinions from healthcare professionals with less experience.

[Pages 6-7] Thank you very much for your great feedback. The age rage information is included. Also, work years are included. Unfortunately, this study only asked a minimum of demographic information about participants; therefore, there is no more information about participants to be reported.

Data analysis: Please, improve this section.

[Page 8] The data analysis part was improved.

Results: When reporting excerpts from their interviews, please indicate age, medical unit, and years of service. This will add richness to the reported content.

[Pages 8-16] This is also great point. Now, age, medical unit, and years of practice were indicated. Regarding the years of practice, I specified as a range (such as less than 5 years, more than 30 years) because the participants can be revealed due to the small sample size.

If you still think that exact service years should be identified, please let me know. Happy to revise it. Thank you!

Also, have you considered a results' graphic representation?

This is a great point. I thought about to add a graphic representation. However, due to the small sample size and nature of the qualitative data, I ended up including pictures to show visually what the participants tried to explain.

I hope this makes sense to you. If there is anything I can improve the manuscript, please let me know. Happy to hear your opinions.

Limitation: Add the almost total presence of the female gender.

[Page 19] Thank you for the great point. I added the gender as a limitation at the end. I appreciate your insights on the manuscript.