PONE-D-24-30276Health Inequity; Possibilities of Initiating Pulmonary Telerehabilitation Programs for Adults with Chronic Obstructive Pulmonary Disorders in Conflict and Low-Resourced Areas; A mixed-methods Phenomenological StudyPLOS ONE

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Diphale Joyce Mothabeng, PhD

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: 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: No

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Reviewer #1: No

Reviewer #2: Yes

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Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1:  Abstract:

The abstract should be revised for grammar and language editing. The aim in the abstract is not clear. Methods not clear with regards to what has been investigated / determined. What was the exact conclusion of the study?

Introduction:

Line 52 – To which conflict are you referring or is this in general? Add the latest data for COPD cases and not only 2019. List examples of environmental factors limiting the access to Pulmonary rehabilitation programs. To whom is the “others” in line 72 referring to? In general, the introduction should be revised to keep thoughts together and in a logical flow. In the current format the facts are not following each other. What will the Pulmonary Telerehabilitation program consists of? How will communication be confirmed in a conflict area in order for telecommunication?

Methodology:

The methodology is not repeatable. Study process and data collection tools used are not clear. The aim mentioned in line 105 and 110 are not aligned. To whom was the questionnaire given? Who was part of the interviews? How will this research inform the Smart-OPEP development? Who were included for the sampling? How were participants recruited? Survey and questionnaire are used interchangeably – be specific in which tool was used for which objective.

Results:

Suggest present the result according to the objectives. Data tables not visible in the document.

Discussion & Conclusion:

The author needs to justify and interpret their findings and compare with other literature. The novelty of the study is not clear in the discussion.

General:

Suggestion that the manuscript be submitted for language and grammar editing. The manuscript should be written in scientific language and be more concise.

Reviewer #2:  Thankyou for the opportunity to review this informative work. I would like to commend the authors for embarking in this topic and aligning with transformation in healthcare in the fourth industrial revolution where telehealth is important.

Below I will cite my suggestions on areas when emphasis needs to be made:

1. Abstract: Please add the following: The journal starts with objective not background. Please include how qualitative data was analysed. Add key word= low resourced environment.

2. The Background is written well, I have a few comments which are editorial.

3. Methods: Please clarify if you conducted a retrospective records review or document analysis, if document analysis-provide the framework that guided the document analysis. Clarify what did the questionnaire measure, how many sections did it have? And describe its development before it was administered to participants. Please mention the language/s used when conducting interviews. How many days post hospital discharge were considered for patients to be included in the study.

4. Data Analysis: Quantitative data analysis is described well; however qualitative data analysis is not detailed. Qualitative phase analysis needs to be clarified. COREQ is a checklist for reporting qualitative research and not for analysing data. Please clarify which methods was used to get themes.

5. Results: Triangulation of results is well described and the three themes explain the quantitative results.

6. Discussion and conclusion: is written well.

General:

This paper is written well, just minor editing, consistency in the use of symbols and terms. It will add value to the body of knowledge of healthcare for patients with COPD and has a potential to improve the quality of care.

Authors need to make minor corrections which involve clarifying the methodology in terms of how the questionnaire was developed? Language used and data analysis for qualitative phase. Clarify more the number of days after hospital discharge, after which participants were recruited and included in the study.

Thankyou

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Reviewer #1: No

Reviewer #2: Yes:  Prof. Nombeko Mshunqane

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Submitted filename: Reviewed PONE-D-24-30276_N. Mshunqane.pdf

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Submitted filename: Plos One_Comments from Prof Mshunqane.docx

Health Inequity: Possibilities of Initiating Pulmonary Telerehabilitation Programs for Adults with Chronic Obstructive Pulmonary Disorders in Conflict and Low-Resourced Areas; A Mixed-method Phenomenological Study

PONE-D-24-30276R1

Dear Dr. Ghaben,

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,

Diphale Joyce Mothabeng, PhD

Academic Editor

PLOS ONE

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