Attitudes towards Tattoos among Spanish Health Science Students

Round 1

Reviewer 1 Report

The paper is very interesting and well written. It is acceptable for publication in the current form

It is a well-written and methodologically sound paper both in terms of research protocol and data analysis.

In addition, it includes a very up-to-date bibliography on the subject which, by the way, is very limited on an international scale.

The only additional thing I would like to propose, as an idea for further investigation, is the issue of students' knowledge of the potential risks of tattooing. The authors could e.g. to have some questions in the survey questionnaire that would measure students' knowledge regarding the possible health risks of tattooing. This knowledge coded into a knowledge index (variable) could be used as a predictor in the regression model assessing student attitudes.

Author Response

The only additional thing I would like to propose, as an idea for further investigation, is the issue of students' knowledge of the potential risks of tattooing. The authors could e.g. to have some questions in the survey questionnaire that would measure students' knowledge regarding the possible health risks of tattooing. This knowledge coded into a knowledge index (variable) could be used as a predictor in the regression model assessing student attitudes.

Unfortunately, the questionnaire used in the study does not include questions to objectively measure students' knowledge about possible health risks (the questions only include opinions for or against), which prevents us from establishing an index to be used as a variable. predictor in the regression model. However, we think it is a very interesting idea that we will take into account in a future research, which will be aimed both at finding out the incidence of new tattoos in health sciences students and other students, as well as the reasons for tattooing, including the knowledge about the risks involved, and the level of satisfaction with tattoos over time.

Reviewer 2 Report

Thank you very much for this opportunity to revise the manuscript titled "Attitudes Towards Tattoos Among Spanish Health Science Students" that was submitted to European Journal of Investigation in Health, Psychology and Education. Undoubtedly, this research can stimulate scientific interest in problems on the attitudes towards tattoos. A few questions to consider and guide minor revisions to the manuscript: 1. Background of the abstract should be summarized extremely. 2. The "Materials and Methods" should be rewritten in a more organized way. 3. If a medical and nursing students needed emotional support after completing the questionnaire was this available and indicated on the information letter? 4. There might be room for improving the Discussion in order to better highlight the impact of the manuscript within a consolidated and broader framework. 5. Conclusion should be expanded. I will be happy to review the revised manuscript.

Author Response

Please see the attachment.

Point 1. Background of the abstract should be summarized extremely.

In its current format the Background includes only 21 words.

Point 2. The "Materials and Methods" should be rewritten in a more organized way. 

The "Materials and Methods" section is structured under the following headings: Study design and participant selection / Study variables / Data collection procedure / Statistical analysis.

Point 3. If a medical and nursing students needed emotional support after completing the questionnaire was this available and indicated on the information letter?

The text of “Materials and methods” has been modified to clarify this point. During the administration of the questionnaire, a qualified person settled any queries or doubts raised and provide emotional support to students who needed it after completing the questionnaire. Students were informed of this before giving their consent. 

Point 4. There might be room for improving the Discussion in order to better highlight the impact of the manuscript within a consolidated and broader framework. Point 5. Conclusion should be expanded. I will be happy to review the revised manuscript.

We have included the following comment: It is surprising that since the practice of tattooing is widespread among young people, with the possibility of adverse health effects and also with a possible association with some risk behaviors it has so far received little interest among social and health researchers, there being little scientific evidence in this regard. This situation could lead to a lack of education among young people and favour an increasing frequency of use, without taking into account the possible negative aspects and assuming that it is a harmless practice, which must be demonstrated.

Point 5. Conclusion should be expanded. I will be happy to review the revised manuscript.

We have expanded the conclusion by pointing out aspects of interest in future research on tattoos:

In the future, new research should be carried out not only on the prevalence of this practice but also on its incidence and its temporal evolution in the coming years. It will also be of interest to evaluate this practice in young people of different origins, educational levels and different degrees, both in health sciences and in other non-health subjects. It will be necessary to delve into the reasons for tattooing, checking how the level of knowledge of the risks involved affects this practice and also to know the degree of satisfaction over time among tattoo wearers.

Author Response File: Author Response.pdf