PONE-D-24-44533Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in EnglandPLOS ONE

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Funding for NHS CHECK was received from the following sources: Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees Trust (M952 and PGL22/100103); Economic and Social Research Council (ES/V009931/1); NIHR ARC North Thames; NHS England and NHS Improvement; Manolo Blahnik International; Koa Health; Colt Foundation; as well as seed funding from National Institute for Health Research Maudsley Biomedical Research Centre, King's College London, National Institute for Health and Care Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London. 

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Additional Editor Comments :

Dear Authors ,

Please address reviewers's comments to improve the manuscript.

Kind regards,

Dr Patricia Dina Pariona Cabrera

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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: 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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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

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Reviewer #1: Dear Authors,

Well done on a manuscript that addresses an interesting topic on Resilience during the COVID-19 pandemic:

I have made some comments and suggestions which you may wish to consider in revising and refining your paper. I hope these are helpful.

Abstract: In your abstract it would be helpful to conclude with the key implications of your results and significance of your findings to practice and theory. Outline your main contributions.

Introduction: You have made some good points in your introduction regarding the importance of the concepts you are studying. I also suggest that it would be helpful to the reader if you could clearly articulate your research question at the end of your introduction section.

Your final paragraph before you launch into your methods seems to me to belong in the methods section – perhaps under a subheading ‘Sample’.

Just a minor point – I noticed you are missing a punctuation mark after reference [8].

Methodology: In your methodology section, you launch straight into the methodological approach you undertook to collect the data. I suggest you start this section with a justification of your chosen methodological approach – including why this was an appropriate methodological choice to answer your research question. In this section, readers may expect to see citations to researchers who have adopted this approach previously or researchers who have written about the methodological benefits/drawbacks of your selected approach. In particular, I would like to see some more justification of the use of the NHS CHECK study. Justification of methodological approach can help strengthen your manuscript by ensuring you provide adequate reasoning and explanation of your selected methodological approaches. This includes information on methodological approach at a high level (i.e. epistemological approach, choice of qualitative/quantitative, research paradigm i.e. constructivist/positivist etc) as well as the specific method adopted for collecting and analysing data – in your case the NHS Check study. Remember readers may not be familiar with the NHS Check study so it is important to provide some more details and discussion of why it is appropriate in your study context.

Discussion: Good job in the first paragraph summarising your key findings at a high level, but I believe there is room to elaborate on these further. For example, in the section “Despite staff with higher resilience levels showing lower burnout overall, these findings do not support some previous research suggesting that healthcare workers may have ‘bounced back’ from the initial peak of the pandemic [24, 27], although this may be because of the ongoing challenging work environment effectively meaning that staff cannot bounce back to a more usual, less stressful, workplace” - I suggest you further elaborate and explain what this may mean. This will link nicely into a section on theoretical and practical implications of your paper.

My further suggestions:

I believe a section on implications of your study and future research would add value to the paper: You allude to the opportunity for future research stemming from this study, but I encourage you to tease this out a little more beyond what you have provided. Be a little more specific – what studies would you like to stem from this research to add to the contributions of your study? I also suggest you have a section where you discuss the implications of your study and another to discuss your future research recommendations - have separate headings for these. I also suggest you separate the implication section into implications for practice and implications for theory. You may need to add to these sections. This will help highlight your research contribution and value of the study.

Also, I suggest you think resilience post-COVID-19 and justifying why it is still relevant now. I believe it is relevant but stronger justification would help your case and contribution.

Conclusion: It would be great to see a conclusion that summarises the key points of your manuscript.

Theory section: The main drawback of your paper is that you do not appear to use a theoretical lens or theoretical framework through which you discuss your findings. A theoretical lens is helpful when it comes to making sense of how the variables in your study fit together and in this case, impact the wellbeing and mental health of staff in England. For example – you may want to consider some resources such as the Conservation of Resources Theory (as an example) -t here are many other theories you can draw upon which may suit your study objectives better. We would then expect your discussion to interpret the results through your chosen theoretical lens. This will also help you with the theoretical implications section that I am suggesting you add.

Thanks for the opportunity to review your paper!

Reviewer #2: My review did not focus on the methodology and statistical analysis. All my feedback are aimed at simplification to improve clarity because several sentences are long and complex, usually combining multiple ideas. Suggested text were provided to illustrate an example, rather than for adoption. However, feel free to use if you find the suggested edits conveys the message better. All the best on your publication. Cheers!

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Reviewer #1: No

Reviewer #2: No

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Submitted filename: PONE-D-24-44533_reviewer_(due_25_Jan).pdf

Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England

PONE-D-24-44533R1

Dear Dr. Natalia Kika,

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,

Patricia Pariona-Cabrera

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Dear Authors,

Please addresses some minor points:- Please proof read for grammar and ensure you do not start sentences with because where possible.

- I suggest actually wording your research questions as questions, complete with question marks.