Patients’ experiences of the complex trust-building process within digital cardiac rehabilitation

Marjo-Riitta Anttila; Anne Söderlund; Tuulikki Sjögren

doi:10.1371/journal.pone.0247982

Peer Review History

Original SubmissionJuly 2, 2020
25 Sep 2020 Decision Letter - Celena Scheede-Bergdahl, Editor PONE-D-20-20409 Patients' experiences of the complex trust-building process within digital cardiac rehabilitation PLOS ONE Dear Dr. Anttila, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by October 10, 2020. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Interesting study. Generally well-written. The manuscript could be improved by adding a demographics tables (gender, age, race, ethnicity, SES, marital status, employment status, age at onset ect). Please include additional information on family history, medications taken and any comorbidities. Also, include information re: access to digital technology. Inclusion and exclusion criteria needs additional description "22 males and 8 females, who had undergone coronary angioplasty (25/30) or bypass 103 surgery (4/30) approximately 3 to 12 months prior to rehabilitation". ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0247982.r001
Revision 1
8 Feb 2021 Author Response Response to Reviewer PLOS ONE Dear Academic Editor Celena Scheede-Bergdahl and reviewer We want to thank you for giving us the opportunity to revise the manuscript entitled (PONE-D-20-20409) “Patients' experiences of the complex trust-building process within digital cardiac rehabilitation". The manuscript has been revised based on the comments of the reviewer and academic editor. We respond to academic editor and reviewer comments and submit one revised manuscript. We want to thank the reviewer for constructive and important comments and these comments helping us to improve our manuscript. Below we have listed all comments with a point-by-point response. Two versions of the revised manuscript are submitted: a clean final copy and a version with all changes marked. Academic Editor comments Journal Requirements: When submitting your revision, we need you to address these additional requirements 1. Please ensure that your manuscript meets PLOS ONE's style requirements Comments to the Editor: We has been taken account PLOS ONE's style requirements. 2. Please include additional information regarding the interview guides used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. Comments to the Editor: Interview guide information in the data collection and analyzing section as follows: Each focus group interview included 5-9 patients and lasted an average of 30-90 minutes. The participants were encouraged to speak openly about their experiences of the rehabilitation process. The interviewer was free to vary the questions and their content and to allow for group discussion. Example questions, are as follows: “What were your meaningful experiences with rehabilitation process?”; “How was the peer group meaningful to you?”; and “What are your experiences of how technology has been a help to you in coping with daily life and lifestyle changes?” The interviewer asked follow-up questions as needed. The interviewer observed the group dynamics and ensured that everyone had an opportunity to speak. Occasionally, there were people in the focus group who talked more and guided the session, but the interviewer provided a balanced discussion by asking the quieter participants supplementary questions. The study analyzed patients’ experiences of the rehabilitation process in accordance with principles of Glaser’s` grounded theory (open, selective coding), which guided the constant comparative model (See: Theoretical sensitivity: advances in the methodology of grounded theory. Mill Valley (Calif.): Sociology Press; 1978). We have described the analysis process in the text and figure 1. We added registered information to article text: The study is a part of a remote technology in cardiac rehabilitation study registered at the ISRCTN Registry [ISRCTN61225589]. 3. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information Comments to the Editor: Participant consent Information has been added in the methods section of the manuscript, as follows: Patients were informed verbal and written of the study prior to rehabilitation that participation was voluntary and that they could withdraw from the study at any time. Patients signed informed consent forms to participate in the study. Patients were also assured that whether they wanted to participate in the study or not, it would not have any negative impact on the rehabilitation process. (Page 5, setting section, line 118-122) The information is also in the ethical statement, The Ethics Committee of the Central Finland Health Care (2015). No minors participated in the study 4. Please clarify the sources of funding (financial or material support) for your study. List the grants or organizations that supported your study, including funding received from your institution. Comments to the Editor: Here is more information about the sources of funding, which were University of Jyväskylä and Social insurance institution of Finland (Kela). b. State what role the funders took in the study. If the funders had no role in your study, please state: “The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” Comments to the Editor: We designed the research-project, data collection and analysis and applied for funding from the Social Insurance Institution (Kela). The funder approved the research plan and provided funding to the grant for intervention, financial support for a research project. In Finland Kela carries out research on the benefit systems it operates, Kela’s internal operations, general health security and rehabilitation (https://www.kela.fi/web/en/research-projects). c. If any authors received a salary from any of your funders, please state which authors and which funders. The University of Jyväskylä is employer by researchers, Tuulikki Sjögren and Marjo-Riitta Anttila (salary). Comments to the Editor: d.If you did not receive any funding for this study, please state: “The authors received no specific funding for this work.” Comments to the Editor: The authors received no specific funding for this work (article). The funders (Kela) had no role (no salary) in decision to publish, or preparation of the manuscript by any authors. 1. Reviewer Reviewer #1: Interesting study. Generally well-written. The manuscript could be improved by adding a demographics tables (gender, age, race, ethnicity, SES, marital status, employment status, age at onset ect). Please include additional information on family history, medications taken and any comorbidities. Also, include information re: access to digital technology. Inclusion and exclusion criteria needs additional description "22 males and 8 females, who had undergone coronary angioplasty (25/30) or bypass 103 surgery (4/30) approximately 3 to 12 months prior to rehabilitation". Author response We thank the reviewer #1 for these comments and comments related to the research topic have been taken into account as follows. 1.2 Reviewer comments to the author The manuscript could be improved by adding a demographics tables (gender, age, race, ethnicity, SES, marital status, employment status, age at onset ect). Author response/action: We agree with the reviewer. We were improved the manuscript by adding a demographics table (gender, mean age, marital status, education, employment status, operation, time of operation) (Page 6, setting section, line 126-139). 1.3 Reviewer comments to the author Please include additional information on family history, medications taken and any comorbidities. Author response/action: We agree with the reviewer. We appreciate the concerns of the reviewer and it would have been interesting to have this information, but unfortunately, we didn`t collected additional information (family history, medications taken and any comorbidities) during this qualitative study. 1.4 Reviewer comments to the author Also, include information re: access to digital technology. Inclusion and exclusion criteria needs additional description "22 males and 8 females, who had undergone coronary angioplasty (25/30) or bypass 103 surgery (4/30) approximately 3 to 12 months prior to rehabilitation". Author response/action: We agree with the reviewer. We have restructured the sections and added to the text inclusion and exclusion criteria as follows (Page 5-6, setting section, line 108-118): Semistructured interviews were conducted with cardiac patients (mean ages 55.46), including 22 males and 8 females, who had undergone coronary angioplasty (25/30) or bypass surgery (4/30) approximately 3 to 12 months prior to rehabilitation is presented. In table 1 demographic information and operation description at baseline. The participants were recruited from rehabilitation groups (n=4) that utilized digital health tools for traditional cardiac rehabilitation in Finland. The participants were recruited among adult patients with coronary artery disease (CAD) and attended the cardiac rehabilitation courses that utilized digital health tools for traditional cardiac rehabilitation (Peurunka rehabilitation centre, Finland). The inclusion criteria for participation were adults (18 years or older) who had cardiovascular risk factors or angina pectoris with physical working capacity limitation or myocardial infarction or coronary artery bypass graft surgery (CABG) or coronary angioplasty (PTCA). Participants were excluded if they had musculoskeletal problems, cognitive or memory impairment, or if they were unable to use independently computer and remote technology application. Participation in the study intervention also required the participant to have internet at home or be able to use a computer of family members or friends. Participants in the study received an activity tracker accelerometer (Fitbit Charge HR®, USA) and remote coaching tool software (m-coach Movendos, Finland), which was free to download on computers, tablets and smart phones. Kind regards, Marjo-Riitta Anttila Corresponding Author: Marjo-Riitta Anttila, MSc Faculty of Sport and Health Sciences University of Jyväskylä P. O. Box 35 Jyväskylä, FI-40014 Finland Phone:+358408054648 Fax: 358142602011 Email: marjo-riitta.m-r.anttila@jyu.fi Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0247982.r002
18 Feb 2021 Decision Letter - Celena Scheede-Bergdahl, Editor Patients' experiences of the complex trust-building process within digital cardiac rehabilitation PONE-D-20-20409R1 Dear Dr. Marjo-Riitta Anttila, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Celena Scheede-Bergdahl Academic Editor PLOS ONE Additional Editor Comments (optional): Comments sufficiently addressed. Reviewers' comments: https://doi.org/10.1371/journal.pone.0247982.r003
Formally Accepted
25 Feb 2021 Acceptance Letter - Celena Scheede-Bergdahl, Editor PONE-D-20-20409R1 Patients' experiences of the complex trust-building process within digital cardiac rehabilitation Dear Dr. Anttila: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Celena Scheede-Bergdahl Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0247982.r004

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