Exploring parents’ experiences, attitudes and understanding of gastro-oesophageal reflux in infants

Kathryn McVicar; Lisa Szatkowski; Shalini Ojha; Simon Tunster; Manpreet Bains

doi:10.1371/journal.pone.0309081

Peer Review History

Original SubmissionJanuary 11, 2024
24 May 2024 Decision Letter - Jerry Zhou, Editor PONE-D-24-01188Exploring parents’ experiences, attitudes and understanding of gastro-oesophageal reflux in infantsPLOS ONE Dear Dr. Bains, 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 08 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. 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The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: No Reviewer #2: N/A ****** 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: Yes Reviewer #2: Yes ****** 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 ****** 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: The authors conducted a study to determine parental experiences, attitudes and understanding of the symptoms, diagnosis and management of infant GOR. There are several concerns that needs to be addressed. 1.The population may not be representative as convenience sampling was used 2.The sample size of the study is very small, hence the conclusion drawn is not significant. 3.Please justify the research question and how this study adds to the current literature Reviewer #2: Overall I feel the authors have delivered on their goal in providing a snippet into the experiences and attitudes of parents with children with GORD. The study is somewhat limited by the small numbers though this is acknowledged by the authors. ****** 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: Yes: Jeyasakthy Saniasiaya Reviewer #2: 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. Attachments Attachment Submitted filename: PONE-D-24-01188-WW.pdf https://doi.org/10.1371/journal.pone.0309081.r001
Revision 1
25 Jul 2024 Author Response We have attached a detailed response to reviewer comments with our revised document. Have pasted here: Reviewer WW comments sent via PDF Reviewer comment: pg 3, L44/45 can say lower oesophageal sphincter (LES)? Authors’ response: This has been amended as suggested. Reviewer comment: pg3 L48/49 whilst? Authors’ response: Amended, as suggested. Reviewer comment: Pg 4 L70 what does this statement mean? Authors’ response: This statement has been edited to read ‘A number of studies have shown the importance of parents in both diagnosis and management[5,6,13].’ Reviewer comment: pg 4 L70 dont think parenthesis are needed here (referring to L69). Authors’ response: Parenthesis removed. Reviewer comment: pg 5 L113-115 i think this point is a bit redundant. seems presumed. Authors’ response: Statement has been removed. Reviewer comment: p6 L126/127 i think maybe re-word this a bit? the sentence makes it seem like you didn't read the transcripts properly in the first instance. Authors’ response: The statement now reads as, ‘Firstly, transcripts were read and re-read to develop familiarity, and initial reflections were documented.’ Reviewer comment: p9 L198 is this specific to reflux though Authors’ response: Parents did link expectations not matching up to expectations due to symptoms of reflux. The sentence has been amended to read as, ‘Parents explained the impact that infant GOR/GORD had had on their parenting experiences, and how consequently this had not matched up to their expectations, as parents explained that the symptoms of reflux had affected their bonding with their child.’ Reviewer comment: p14 L315 what proportion/how many parents expressed sentiments with the themes mentioned above? Authors’ response: It is not normal practice to report frequencies for data analysed in a purely qualitative manner, and thus language is better suited to provide insights. Having said this, qualitative research is not necessarily concerned with proportions, instead we strive to reflect the breadth and depth of accounts. We analysed data using Braun and Clarke’s approach for thematic analysis, rather than a summative content analysis (which is an approach that combines both quantitative and qualitative components). Finally, given the small sample size, proportions can be misleading and/or allow for disclosure of who said what in the case where just one or two people gave a particular response. Reviewer comment: p14 L318 what number/proportion? would be better to have objectivity rather than 'many' Authors’ response: Above response applies here. We have however, amended text in places to use language to better reflect views of group as a whole e.g. here we have changed ‘many’ to ‘most’. Reviewer comment: p18 L421 i would be careful with this statement as it fairly inflammatory Authors’ response: The sentence has been amended to read, ‘Parents who have experienced GOR/GORD before could know the ‘right’ things to say to feel heard and understood, or alternatively, health professionals could be more trusting.’ Additional comments sent in body of e-mail: Reviewer comments: The population may not be representative as convenience sampling was used. The sample size of the study is very small, hence the conclusion drawn is not significant. Authors’ response: The two points above have been addressed to highlight that despite limitations with sampling approach and sample size (addressed as limitations), our findings do offer something novel in the area. The following has been added to the discussion section: ‘The sample size is smaller than planned as, despite pursuing several avenues of recruitment, responses were limited. ‘Convenience sampling was used which limited the breadth of demographics of those interviewed, however qualitative methods do not seek to achieve representative sampling or generalisable findings. Furthermore, such research is novel particularly within the UK setting and our findings highlight areas for improvement from both parent and healthcare professional perspectives (e.g. more consistent information needed for the former and training to address varying knowledge gaps for the latter).’ Reviewer comment: Please justify the research question and how this study adds to the current literature. Authors’ response: We have added to the Introduction section to highlight where current gaps are, to help justify the research question. ‘A number of studies have shown the importance of parents in both diagnosis and management[5,6,13], but research into parental knowledge and experiences of GOR/GORD is limited (e.g. in the United Kingdom).’ And again, ‘Given the recognised importance of parents in the diagnosis and management of GOR/GORD, and lack of exploration into their attitudes and experiences, further research is needed[5,6,13], to understand whether findings from other settings are transferable to the UK, and to identify where gaps in knowledge are and ways to better support parents in the diagnosis and management of GOR/GORD (including who could input into this and how). The purpose of this study is to explore parental experiences, attitudes and understanding of the symptoms, diagnosis and management of infant GOR and GORD. This study is needed to begin to identify ways forward for future approaches to parental education and support, which would faciliate GOR/GORD management[17].’ Changes to the Discussion e.g. including the above adds commentary, or that we have rephrased prior sections to make more explicit what this work adds to the literature: ‘A novel finding from our study is that GOR/GORD can impact a mother’s decision to breast feed future children, an additional factor that could affect parental mental wellbeing[33].’ ‘Crucially, our work suggests a lack of consistency in the knowledge and attitudes among healthcare professionals regarding infant GOR/GORD.’ ‘Another novel finding from our work was the marked difference in attitudes from professionals between first-born and subsequent children which has not been previously identified in this context. This could reflect the increased parental knowledge and experience of having a previous child with GOR/GORD, and links with the parent-driven nature of management.’ Attachments Attachment Submitted filename: Response to reviewer comments.docx https://doi.org/10.1371/journal.pone.0309081.r002
6 Aug 2024 Decision Letter - Jerry Zhou, Editor Exploring parents’ experiences, attitudes and understanding of gastro-oesophageal reflux in infants PONE-D-24-01188R1 Dear Dr. Bains, 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 will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, 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, Jerry Zhou, Ph.D. 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 #1: 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 #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A ****** 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 ****** 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 ****** 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: the authors present an interesting an important study. The authors have addressed all the comments adequately. ****** 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: Jeyasakthy Saniasiaya ******** https://doi.org/10.1371/journal.pone.0309081.r003
Formally Accepted
12 Sep 2024 Acceptance Letter - Jerry Zhou, Editor PONE-D-24-01188R1 PLOS ONE Dear Dr. Bains, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, 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 customercare@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. Jerry Zhou Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0309081.r004

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