PONE-D-23-06552Self-care practices and associated factors among heart failure patients in Ethiopia: A systematic review and Meta-AnalysisPLOS ONE

Dear Dr. Bekele,

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.

==============================

Reviewer #1: Independent Review Report

Evaluation

The evaluation is for the review article titled “Self-care Practices and associated factors among heart failure patients in Ethiopia: A systematic review and Meta-Analysis”

With the present study, the following areas are observed, commented and recommended.

1. Throughout the main text, it was sequential and well organized.

2. It requires grammatical corrections throughout the document.

3. This manuscript has a sum up of novelty.

Comments to the author/s

Abstract:

1. Try to avoid abbreviation of words in the abstract part

2. “We have used three databases such as Pub Med, Science Direct and Google Scholar.

Why do you exclude other important databases that you might get potential primary studies from?

3. Heterogeneity was evaluated using the I2 tests and the Cochrane Q test statistic.

What is the advantage of performing the Q test in addition to the I2 test to assess heterogeneity?

4. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test were utilized. What is the importance of using different tests?

5. “The extent of self-care behaviour adherence is shown to be low among heart failure patients”. What is the standard reference to say “low or high”?

Method

6. Please use the uniform reference citation system

7. Please try to strictly adhere to all the PRISMA 2020 guidelines to write up your paper, especially the method section.

8. Does this review registered on PROSPERO?

9. What is your last search date included in the method part?

10. What you have done if a study has low quality or higher risk?

11. “Finfinnee" is not a legal name, not yet known

12. What you have done if there is heterogeneity and publication bias between the primary studies?

13. How to perform the pooled effect of odds ratio to identify the factors associated with good selfie care? Please show on your paper as it is critical.

Result

14. Table 1 column 6 gender (male). What is this???

15. Why you have performed sub-group analysis and sensitivity test?

Reviewer #2: Dear authors, thank you for your contribution. In general the issue you raised is very good. However, I have some comments and questions which described below.

1. Language edition service is required throughout the document

2. Please rephrase this sentence found in your abstract’ ‘The patient's understanding must therefore be improved by effective health education if self-care behaviour is to be improved.’’

3. The databases scrutinized to search studies are too small. Why only three databases? I think some papers are missed. Therefore please search on at least familiar databases like HINARI, Scopus, and AJOL

4. The MESH terms are little, why?

5. Why you preferred CoCoPop?

6. With this visible heterogeneity among studies, it is difficult to accept. Therefore, I need further evidence /explanation for this because the authors even mentioned the presence the presence of heterogeneity between studies conducted in Oromia. Why?

7. In your discussion part you mentioned this’ ’The prevalence of adherence is comparable with the study conducted in Brazil (35.17%)(9) and lower than the study of Netherland(41%)(6) and Taiwan(53.37%)(26) and higher than the study of Korea(31.98%)(14). This discrepancy could be due to the difference in the study method.’’ What type of difference in study method?

8. On your limitation please rephrase this sentence’ ‘The small sample due to a limited number of included studies with a small sample size for all included studies was a limitation of this study. ‘’

9. The number of studies included in your study is 11 but in the funnel plot it is more than 20 (each dot on the figure represent one study), Why this variation

Thank you

==============================

Please submit your revised manuscript by Jun 11 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.

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We look forward to receiving your revised manuscript.

Kind regards,

Mohammed Feyisso Shaka, MPH

Academic Editor

PLOS ONE

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2. We noticed you have some minor occurrence of overlapping text with the following previous publication(s), which needs to be addressed:

- https://doi.org/10.1186/s12889-019-8133-y

- https://doi.org/10.1016/j.hrtlng.2008.11.002

- https://www.slideshare.net/negesesewagegn/adherence-toselfcarebehavioursandknowledgeontreatmentamongheartfailurepatientsinethiopiathecaseofatertiaryteachinghospital23760419s4001

In your revision ensure you cite all your sources (including your own works), and quote or rephrase any duplicated text outside the methods section. Further consideration is dependent on these concerns being addressed.

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6. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

"Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

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We will update your Data Availability statement to reflect the information you provide in your cover letter.

Additional Editor Comments:

• Needs extensive language revision
• Use consistent font style
• How do proper understanding of HF measured? Or you are speaking about the knowledge?
• Under your conclusion you have said, “…. patients with co-morbidities and depressive symptoms require extra care. What findings imply for such conclusion? Please rephrase it based on your findings.
• Write Pub Med as PubMed
• Use consistent bracket for references. E.g. you used square bracket for reference #24
• Please share us the data extraction checklist on Microsoft excel which you have used to extract data with the extracted data for both objectives
• Please correct the I²  under the data analysis section on page 5
• Did you measured adherence to selfcare or the practice of good selfcare. Your result and what you have described in the methodology is confusing. Please clearly describe what was measured and how it was measured

[Note: HTML markup is below. Please do not edit.]

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: Yes

Reviewer #2: Partly

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

Reviewer #1: Yes

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: No

Reviewer #2: No

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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: Independent Review Report

Evaluation

The evaluation is for the review article titled “Self-care Practices and associated factors among heart failure patients in Ethiopia: A systematic review and Meta-Analysis”

With the present study, the following areas are observed, commented and recommended.

1. Throughout the main text, it was sequential and well organized.

2. It requires grammatical corrections throughout the document.

3. This manuscript has a sum up of novelty.

Comments to the author/s

Abstract:

1. Try to avoid abbreviation of words in the abstract part

2. “We have used three databases such as Pub Med, Science Direct and Google Scholar.

Why do you exclude other important databases that you might get potential primary studies from?

3. Heterogeneity was evaluated using the I2 tests and the Cochrane Q test statistic.

What is the advantage of performing the Q test in addition to the I2 test to assess heterogeneity?

4. To examine publication bias, a funnel plot, Egger's weighted regression, and Begg's test were utilized. What is the importance of using different tests?

5. “The extent of self-care behaviour adherence is shown to be low among heart failure patients”. What is the standard reference to say “low or high”?

Method

6. Please use the uniform reference citation system

7. Please try to strictly adhere to all the PRISMA 2020 guidelines to write up your paper, especially the method section.

8. Does this review registered on PROSPERO?

9. What is your last search date included in the method part?

10. What you have done if a study has low quality or higher risk?

11. “Finfinnee" is not a legal name, not yet known

12. What you have done if there is heterogeneity and publication bias between the primary studies?

13. How to perform the pooled effect of odds ratio to identify the factors associated with good selfie care? Please show on your paper as it is critical.

Result

14. Table 1 column 6 gender (male). What is this???

15. Why you have performed sub-group analysis and sensitivity test?

Reviewer #2: Dear authors, thank you for your contribution. In general the issue you raised is very good. However, I have some comments and questions which described below.

1. Language edition service is required throughout the document

2. Please rephrase this sentence found in your abstract’ ‘The patient's understanding must therefore be improved by effective health education if self-care behaviour is to be improved.’’

3. The databases scrutinized to search studies are too small. Why only three databases? I think some papers are missed. Therefore please search on at least familiar databases like HINARI, Scopus, and AJOL

4. The MESH terms are little, why?

5. Why you preferred CoCoPop?

6. With this visible heterogeneity among studies, it is difficult to accept. Therefore, I need further evidence /explanation for this because the authors even mentioned the presence the presence of heterogeneity between studies conducted in Oromia. Why?

7. In your discussion part you mentioned this’ ’The prevalence of adherence is comparable with the study conducted in Brazil (35.17%)(9) and lower than the study of Netherland(41%)(6) and Taiwan(53.37%)(26) and higher than the study of Korea(31.98%)(14). This discrepancy could be due to the difference in the study method.’’ What type of difference in study method?

8. On your limitation please rephrase this sentence’ ‘The small sample due to a limited number of included studies with a small sample size for all included studies was a limitation of this study. ‘’

9. The number of studies included in your study is 11 but in the funnel plot it is more than 20 (each dot on the figure represent one study), Why this variation

Thank you

**********

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Reviewer #1: Yes: Mulugeta W/Selassie (Assistant Professor)

Reviewer #2: Yes: Bekahegn Girma Negie

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Attachments

Attachment

Submitted filename: Reviewer comment.docx

Adherence to self-care practices and associated factors among heart failure patients in Ethiopia: A systematic review and Meta-Analysis

PONE-D-23-06552R1

Dear Dr. Bekele,

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.

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Kind regards,

Mohammed Feyisso Shaka, MPH

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: