The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania

Emmanuel Z. Chona; Emanueli Amosi Msengi; Rashid A. Gosse; Joel S. Ambikile

doi:10.1371/journal.pone.0289925

Peer Review History

Original SubmissionApril 13, 2023
6 Jun 2023 Decision Letter - Eric L Krakauer, Editor PONE-D-23-10682The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, TanzaniaPLOS ONE Dear Dr. Chona, 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 see the reviewers' comments below and respond to each comment. In addition:- It should be noted in the methods that all study participants had early stage disease.- The background should be made more concise.- There is redundancy in the quotations, please remove redundant passages.- The English needs polishing. Please submit your revised manuscript by Jul 21 2023 11:59PM. 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ****** 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: This is a lovely qualitative study that enriches the field. The authors quite rightly note that a limitation was not interviewing women with cervical cancer who have progressed and maybe dying. But I note that was part of their exclusion criteria. So the authors should add in their discussion that future studies should include this group Reviewer #2: the paper reports the qualitative analysis done on 12 interviews of women with stages I-II cervical cancer treated at national referral public center for cancer in Tanzania .The objectives of the study were to explore the lived experiences and caring needs of the patients .The interviews followed a semistructured approach with 8 prespecified questions followed by probes during the interview.the methodology needs some clarifications .In the data analysis(line175) it is specified that some statements in the transcribed interviews were highlighted according to the preconceived categories stated in the study objectiveas s,which is nto the case,please clarify or report them.Question 7 exploring the experience with the health care services are not mentioned and it is not part of the themes and categories,explain why ..Line 184 To ensure the credibility..credibility is not a term used in qualitatve analysis,do the authors mean reliability? plese clarify The quotes taken from the interviews represent a significant part of the paper,there are overlappings and they make difficult the reading I suggest to reduce their number , to keep the signficant statements and report them in extent with references to the paper in the appendix English to be fully and carefully revised ****** 6. 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Revision 1
19 Jul 2023 Author Response Editor's Comments 01. It should be noted in the methods that all study participants had early-stage disease -We have added in the methods that 12 earlystage cervical cancer patients were recruited for the study. Please see the revised manuscript (Line 125). 02. The background should be made more concise -The background has been revised to make it more concise. Please see the revised manuscript. 03. There is redundancy in the quotations, please remove redundant passages -We have revised the analysis critically and we removed redundant quotations reporting the same category in a specific theme. Please see the revised manuscript. 04. The English needs polishing The revised manuscript has been thoroughly copyedited by an expert university faculty competent in English with a strong scientific background in the field of medical research to make it clear and unambiguous. Please see the revised manuscript. Reviewer’s comments 01. 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. -After we reviewed all parts of our manuscripts followed the reviewer’s comments, we found some technical errors of our manuscript and we corrected them accordingly. We ensured that the conclusions made in the manuscript are drawn appropriately based on our study findings presented. Please see the revised manuscript. 02. Have the authors made all data underlying the findings in their manuscript fully available? -After we reviewed the PLOS Data policy, we have agreed to share our minimal anonymized data set (Excerpts of transcripts) as supporting information. 03. Is the manuscript presented in an intelligible fashion and written in standard English? -The revised manuscript has been thoroughly copyedited by an expert university faculty competent in English with a strong scientific background in the field of medical research to make it clear and unambiguous. Please see the revised manuscript. 04. The authors quite rightly note that a limitation was not interviewing women with cervical cancer who have progressed and maybe dying. So, the authors should add in their discussion that future studies should include this group. -We have revised the manuscript to incorporate the recommendation that further qualitative studies should be done to explore the lived experiences and caring needs of terminal cervical cancer patients. Please see the revised manuscript (Line 503- 506). 05. In the data analysis (line 175) it is specified that some statements in the transcribed interviews were highlighted according to the preconceived categories stated in the study objectives, which is not the case, please clarify or report them -During the analysis process, authors performed iterative reading of the transcribed data to obtain a general impression and an overall understanding of each transcript. With the objective of this study being exploration of the lived experiences and caring needs of cervical cancer patients, hence meaning units reflecting the study’s objectives were highlighted with different colors during iterations for easy generation of patterns and codes from the text. Hence, categories were developed from actual phrases in the text segments and similar ones were linked to generate themes. Please see the revised manuscript (Line 151- 160). 06. Question 7 exploring the experience with health care services are not mentioned and it is not part of the themes and categories, explain why -The experience with health care services were explored as per question 7. During the analysis process, several codes emerged concerning the health care services which were used to generate different categories reported in the manuscript. For instance, high costs associated with radiation therapy, high consultation fees, limited capability to purchase chemotherapy drugs were among the codes revealed by some participants under the aspect of health care services which were then linked with other codes arising from response to different questions like reduced capability to perform productive activities to generate a category of financial hardship. Also, codes like chemotherapy associated side-effects (example nausea and vomiting) were revealed upon probes on health care services which were then combined with other codes like radiotherapy associated side-effects to generate a category of treatment side-effects. Please see the revised manuscript. 07. Line 184, to ensure credibility. Credibility is not a term used in qualitative analysis, do the authors mean reliability? Please clarify -By stating credibility, we meant the degree to which the results of a qualitative research are credible or believable from the participant’s perspectives since the purpose of qualitative is to describe or understand phenomena of interest from participants, hence they are the only ones who can legitimately judge the trustworthiness of the results. With this technique of establishing trustworthiness, data interpretations and conclusions were discussed by investigators and shared with the participants to allow them to clarify what their intentions were, correct misunderstandings and provide additional information if necessary. 08. The quotes taken from the interviews represent a significant part of the paper, there are overlapping and they make difficult the reading. I suggest to reduce their number, to keep the significant statements and report them in extent with references to the paper in the appendix -We have revised the analysis critically and we removed redundant quotations reporting the same category in a specific theme. Please see the revised manuscript. 09. English to be fully and carefully revised -The revised manuscript has been thoroughly copyedited by an expert university faculty competent in English with a strong scientific background in the field of medical research to make it clear and unambiguous. Please see the revised manuscript. Attachments Attachment Submitted filename: Response to Reviewers.pdf https://doi.org/10.1371/journal.pone.0289925.r002
31 Jul 2023 Decision Letter - Eric L Krakauer, Editor The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania PONE-D-23-10682R1 Dear Dr. Chona, 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, Eric L Krakauer, MD, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Your paper is publishable with some minor edits as follows: LINE 25: Please change "increasing costs of treatment" to "resulting in financial burdens" (or clarify what is meant). LINES 46 and 497: Delete the word "vital" LINE 47: Delete "urgent" LINE 50: Change "terminal" to "advanced" LINES 83-84: Shorten to "Women with cervical cancer experience ... " LINE 87: Delete "positive" LINE 122: Delete "patients" Reviewers' comments: https://doi.org/10.1371/journal.pone.0289925.r003
Formally Accepted
2 Aug 2023 Acceptance Letter - Eric L Krakauer, Editor PONE-D-23-10682R1 The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania Dear Dr. Chona: 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. Eric L Krakauer Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0289925.r004

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