Healthcare Experience of People with Acute Spinal Cord Injury: A Phenomenological Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for an important inquiry into the thoughts/reflections of people experiencing acute SCI during the acute rehabilitation phase.  A few suggestions to enhance your patient centered inquiry manuscript:

1) Understand writing in a second or third language is difficult.  A few minor translation errors detract from your manuscript.   Examples: a) Live with SCI in first sentence abstract would be either Living with SCI or Life with SCI; b) delete all or most of the 'that' not necessary and slow down the reader; c) use active voice no perfect tense such as 'have had' what does this mean? instead use action verbs such as experienced, reported; d) other than the literature review (and sometimes lit review as well) manuscripts are typically written in past tense.  The discussion can move to present.  Suggest you enlist another native english speaking colleague to review the manuscript one more time.

2) A major issue is when you discuss activities of living--very similar to activities of daily living ADL such as in line 13 abstract. Please use the full name of the Activities of Living Nursing Model (ALNM?). All of us utilize activities of daily living --making it difficult to understand when you are speaking specifically about this ALNM.

3) Design: unclear if your semi-structured interviews were piloted on individuals experiencing acute SCI? Additionally data analyses requires more detail such as did you use the constant comparative method or another structured assessment tool to arrive at your emerging themes? As currently written the details of how you 3 arrived at emerging themes is unclear.  When you ask participants to review and validate transcription it is indeed an important component of patient centered research--also called member checking--add citations as to why this component is important. Results: love your visual display 3.2.1 but the title requires work. Are you reporting--Activities of Living: Maintaining a safe Environment? Your themes include quotes which enrich the manuscript--however it seems too many quotes. Maybe less narrative and display in chart format? The verbiage is overwhelming for reader. Make it easier to review, think about, and digest. Discussion: Please consider looking at each emerged theme to see if given ability level in acute care such as ambulatory/non ambulatory categorize some of the themes.  With such a wide injury level you provide a wide experience. The data may provide specific concerns of individuals with acute SCI based upon functional level. Did education level and/or family involvement (i know covid) make a difference in voiced concerns?  This type of discussion will assist the next round of clinical inquiry. It may also prompt clinicians to think more specifically which individuals with acute SCI may struggle with given themes.  A table to present this theme analysis would be helpful.

Comments on the Quality of English Language

Please see #1 above

Author Response

Dear editor,
We have submitted the documents.

Best regards,

CSF

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

It is my pleasure to review your study but I have a lot of doubts.

General information:

-first of all, prepare the article in accordance with the journal's guidelines,

-the references should be corrected.

Introduction:

-please define acute phase of SCI in introduction,

-aim of study is missing, it should be corrected,

M&M:

-"The article was written following the COREQ guidelines." - please provide reference,

-inclusion and exclusion criteria should be precisely specified,

-"prioritizing the face-to-face interview with two researchers." - who interviewed the patients? It should be described in more detail. 

Results:

-"3.1. Participant ́s Characterization" - please provide SD to the age,

-there is a mix of informations in table 1, it should be presented better and organized to be clear to the reader,

-provide a reference for Figure 1,

-the results are poorly presented, illegible, incomprehensible. This absolutely needs to be corrected.

-no statistics, no calculations in the study,

Discussion:

-the discussion should be more correlated with the results, which are very unclear,

-the article has many limitations that are missing.

Comments on the Quality of English Language

Dear Editor,

the article is of very poor quality.

I do not recommend it for publication.

Author Response

Dear editor,
We have submitted the documents.

Best Regards

CSF

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This study investigates healthcare experience of people suffered spinal cord injury (SCI) at acute phase. 

 

The major concern is bias toward non-traumatic SCI and lack of complete SCI patients. Traumatic spinal cord injury is suddenly damage of spinal cord and loss of motor, sensory and autonomic function below injury. The acute phase of traumatic SCI is more challenge due to dramatic changes of life, which might be very different from non-traumatic SCI that develop gradually and there is no clear acute phase in many cases. 

 

The 12 activities should be quantified and arranged according to their priority. “Maintaining a safe environment” is not the most important priority. This is in a special period of time during Covid19 pandemic (2021-2022) that can not represent other time. 

Author Response

Dear editor,
We have submitted the documents.

Best Regards

CSF

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for the corrections, the manuscript looks better.

However, the limitations section should be at the end of the discussion section, not at the end of the conclusions. It needs to be moved.

Apart from that I have no further comments.

Best regards,

Author Response

Dear Editor,
We submit the changes.
Best regards

Carla Fernandes

Author Response File: Author Response.pdf