PONE-D-23-25156Evaluating Dyadic Factors Associated with Self-Care in Patients with Heart Failure and Their Family Caregivers: Using an Actor-Partner Interdependence ModelPLOS ONE

Dear Dr. An,

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Academic Editor

PLOS ONE

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Reviewers' comments:

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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: 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?

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Reviewer #1: Yes

Reviewer #2: Yes

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

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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: In this article entitled “Evaluating dyadic factors associated with self-care in patients with heart failure and their family caregivers: using an Actor-Partner Interdependence Model” the authors analyze how relationships of patient-caregiver physical function and depressive symptoms to the self-care behavior of the disease. A study highlighting the need to assess the physical and psychological conditions of both patients and caregivers, and the importance of caregiver assistance in self-care. The manuscript addresses an important and interesting topic, especially that chronic HF is increasing in prevalence with an ageing population. However, I have a few comments on some issues that require more attention.

Introduction:

• In addition to the recent review mentioned in the authors' review, I found a more recent review: Uchmanowicz I, et al. Heart Failure Care: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model (APIM)-A Scoping Review. Int J Environ Res Public Health. 2022 Feb 9;19(4):1919. doi: 10.3390/ijerph19041919. PMID: 35206131; PMCID: PMC8871794, and it seems reasonable to include it as well, particularly as it talks about the emotional components of HF management within the framework of APIM.

Discussion

• the discussion part could be a little bit shorter and easier to follow

• In the discussion section, I would recommend avoiding figures from other authors' studies such as," In China, the mean scores of CCPS maintenance and management were 52.4 and 55.6 [63], which are similar or somewhat lower than those in Italy."

Reviewer #2: This study used a cross-sectional, correlational design to investigate the physical function and depressive symptom status of patients with heart failure (HF) and their caregivers as dyads, examining their associations with patient self-care and caregiver contribution to patient self-care (CCPS). The study collected data from four university-affiliated hospitals in South Korea between June 12, 2019, and October 29, 2021.

The study focused on patient-caregiver dyads, which provides a more comprehensive understanding of the interactions between patients and their caregivers, as opposed to solely studying patients or caregivers in isolation.

Heart failure is a significant health concern, and understanding the factors affecting self-care and caregiver contributions is essential for improving the quality of care for patients with HF.

The study employed well-established tools, such as the Revised Self-Care of Heart Failure Index and the Patient Health Questionnaire-9, to assess self-care and depressive symptoms. This enhances the validity of the findings.

The study was conducted following ethical guidelines, including obtaining informed consent from participants and approval from Institutional Review Boards, ensuring the ethical conduct of research.

The study used a convenience sampling method, which may limit the generalizability of the findings to a broader population. Convenience samples might not represent the entire population of patients with HF and their caregivers.

The study's cross-sectional design limits its ability to establish causal relationships. Longitudinal studies would be more suitable for examining changes over time and identifying causality.You should adress it in the paper as the study limitations.

While the sample size was deemed adequate for the power analysis, larger samples could enhance the robustness of the findings, especially given the complexity of the dyadic relationships being examined.

The study was conducted in South Korea, which may have cultural and regional nuances affecting self-care and caregiver contributions. The findings may not be directly transferable to other cultural or geographical contexts.

The study primarily focused on physical function and depressive symptoms as factors influencing self-care. Other variables, such as socioeconomic status, education, and social support, may also play significant roles but were not explored.

In summary, this study offers valuable insights into the relationships between physical function, depressive symptoms, self-care, and caregiver contributions in patient-caregiver dyads dealing with heart failure. However, it has limitations, and future research should aim for larger, more diverse samples and consider additional factors that may impact self-care and caregiving.

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Reviewer #1: No

Reviewer #2: Yes: Izabella Uchmanowicz

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PONE-D-23-25156R1Evaluating Dyadic Factors Associated with Self-Care in Patients with Heart Failure and Their Family Caregivers: Using an Actor-Partner Interdependence ModelPLOS ONE

Dear Dr. An,

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 Jul 22 2024 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,

Shigao Huang

Academic Editor

PLOS ONE

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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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 #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 #2: (No Response)

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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

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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: Since the title is built on this manuscript it is worth to add the citation Uchmanowicz I, Faulkner KM, Vellone E, Siennicka A, Szczepanowski R, Olchowska-Kotala A. Heart Failure Care: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model (APIM)-A Scoping Review. Int J Environ Res Public Health. 2022 Feb 9;19(4):1919. doi: 10.3390/ijerph19041919. PMID: 35206131; PMCID: PMC8871794.

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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: Izabella Uchmanowicz

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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.

Evaluating Dyadic Factors Associated with Self-Care in Patients with Heart Failure and Their Family Caregivers: Using an Actor-Partner Interdependence Model

PONE-D-23-25156R2

Dear Dr. An,

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.

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Kind regards,

Shigao Huang

Academic Editor

PLOS ONE

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