PONE-D-22-33585Exploring family functioning and - hardiness in families’ experiencing adult intensive care – A cross-sectional study.PLOS ONE

Dear Dr. Ahlberg,

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.

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Wudneh Simegn Belay, MSc

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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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. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear authors,

thank you very much for the opportunity to review the submitted manuscript. The manuscript includes a very fine study about the hardiness of families of former ICU patients.

I am appreciating this work and have got some minor and serious concerns.

SERIOUS CONCERNS

Statistics: The GFS score is the mean of all 12 items, with a range between 1 and 4, correct? If the mean GFS was 1.5 (0.6), the result may not be normal distributed. Please check your data for distribution. In general, normal distributed data are reported as mean and standard deviation, and for metrical data tests such as t-tests etc can be used. Non-normal distributed data are reported as median and Interquartil Range (IQR), and other tests should be used for metrical data, such as Mann-Whitney U Test or other. Please, check the data for distribution and use appropriate tests. Please add this information to section data analysis, and – if needed- revise the results.

Same to FHI.

Tables: where are the tables???

MINOR CONCERNS

Section abstract is well written. Interestingly, it contains relevant information without reporting numbers (except for patients). Unusual, but fine.

Page 3, Line 49: The references are numbered, but “SIR, 2022” not. Please check.

Section background is fine. Main concepts are defined and referenced.

P4, L88 I wonder if the setting is correct? Maybe you recruited patients in this setting, but patients and families were surveyed at home, right?

P5, L93 to be clear “the participants” were former ICU patients? Patients were not recruited while being cared on an ICU, following the inclusion criteria, but recruited from a data base of former patients. If correct, you should revise add a term similar to “from a database including former patients”, or else.

Very good: these persons are not patients anymore, and you use the term “participants”. Excellent!

P5, L95: is that all inclusion criteria? Alive, ≥96h ICU, and ≥19y? What about cognitive capability to fill in a questionnaire, understand language, and others? Or having a family? What happened to those without family?

P5, L99: why 390 patients (patients or participants?)?

P5, L103: okay, to be clear: when persons (humans) are treated in hospital or go to the GP, they are becoming “patients”, including contracts, dependency, treatments etc etc etc. But after discharge, the contract is finished, and they are … persons, participants, citizens, men, women, humans again. With respect to the dignity of the persons and their families, and the non-ICU setting, these attributes should be clearly used. Please revise throughout the manuscript.

Section methods: I am impressed by the clear reports of the questionnaires. Well done.

P7, L160 “104”? What does it mean? Reference?

P10, L228 in the first paragraph in section discussion, the design and main results are reported, without adding new results, or references. Just a short overview for fast readers. Please revise.

Limits: you may shorten the section limitations to the core meaning.

Conclusions: conclusions are based on methods, results, discussion, and limitations. Conclusions are generalizable information, based on this study. Not on the “results” (line 303)

Line 303: check the grammar, the sentence seems not to be complete.

Reviewer #2: This study paper covers a significant and pertinent topic. An important and relevant topic is covered in this research work. Here are some comments to strength the research work.

Abstract:

Where is the study period?

Which type of software is used for analysis?

Regression results should be appeared in the result section

Introduction

What is the difference between introduction and background? Why you want to include both?

Method

Data collection tool and method

How many sample size you have?

How you select 60 families

You used a consecutive sampling and recruiting 390 patients that fulfill the inclusion criteria and they receive the request to participate by means of an invitation letter but in in your abstract section you write 60 patients and 85 families with a total of 145 participants.

Data analysis

How you calculate the power of your study? How it can be 104? How you calculate the power based on previous study? You should to calculate the power of your study?

Which type off software u used to calculate the power?

Results

In total you include 145 participants. Is this from 390 patients or not please clarify it and provide the response rate?

In your data analysis section you write as you perform an inferential statistics (t-test and ANOVA) but I haven’t seen any result of t-test and ANOVA?

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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.

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Reviewer #1: No

Reviewer #2: Yes: Wondim Ayenew

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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.

PONE-D-22-33585R1Exploring family functioning and - hardiness in families’ experiencing adult intensive care – A cross-sectional study.PLOS ONE

Dear Dr. Ahlberg,

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 Jun 25 2023 11:59PM. 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.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Wudneh Simegn Belay, MSc

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

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

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: No

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4. 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. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear authors,

Thank you very much for the revised version of the manuscript. All concerns have been addressed, and you submitted a very fine manuscript. Well done, and thank you!

Reviewer #2: Thank you for considering my comments to strengthen your manuscript.

Comments

1. Better to include the software version you used in for analysis in the abstract section

2. Using consecutive sampling, you invited 390 participants. Then, 60 answered and chose to participate. In total, data from 60 families (60 former ICU patients and their family members, 85; 145 participants). The response rate will be 37.18%. How do you see it? Is it acceptable in research?

3. Table 1 and 2 describes the descriptive statistics only. They do not show the inferential statistics (t-test and ANOVA) but I haven’t seen any result of t-test and ANOVA? You should to do t-test and ANOVA analysis

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7. 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: Yes: Dr. Peter Nydahl

Reviewer #2: Yes: Wondim Ayenew Wudneh

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[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.

Exploring family functioning and - hardiness in families’ experiencing adult intensive care – A cross-sectional study.

PONE-D-22-33585R2

Dear Dr. Ahlberg,

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,

Wudneh Simegn Belay, MSc

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

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 #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. 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. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thank you for considering the comments to strengthen your manuscript.

All comments have been addressed.

**********

7. 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 #2: Yes: Wondim Ayenew

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