Dear Dr. Otaka,

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Maheshkumar Baladaniya

Academic Editor

PLOS ONE

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Additional Editor Comments (if provided):

Reviewers has displayed some major flaws that should be reviewed and resolved to meet the acceptance criteria.

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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?

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: This is a topic of great scientific and social relevance, explored through a well-developed study that deserves recognition for its qualitative approach. In a field of research where quantitative studies predominate, it is particularly valuable to find studies that seek to deeply understand the complexity of human phenomena from the perspective of the individuals involved. While qualitative methods do not allow for the establishment of cause-and-effect relationships or statistical generalizations, their contribution lies in the richness of narratives, the contextualized understanding of experiences, and the ability to reveal nuances that would hardly emerge from purely quantitative approaches.

In this sense, the study already possesses intrinsic merit by proposing a well-structured qualitative methodology, with clear graphical presentation and cohesive writing. However, there is room for significant improvement that could further enhance the quality and impact of the research.

The introduction, for instance, could be enriched through a more comprehensive and updated literature review that not only contextualizes the investigated issue but also connects it to similar studies conducted in both local and international contexts. Such a review would anchor the study within a broader research panorama, reinforcing its relevance and originality. It would be especially beneficial to include tested intervention models, preventive strategies, and effective care actions in order to demonstrate how the literature has addressed the situations explored in this study and to what extent the current research contributes to this collective effort to improve health practices.

Additionally, the text would benefit from a more gradual and fluid introduction. The opening paragraph should primarily serve to situate the reader within the research problem, explaining its social and scientific significance before delving into theoretical definitions and conceptual frameworks. This would make the text more accessible and cohesive, facilitating comprehension of the topic from the outset.

From a methodological perspective, the study presents a solid structure but still lacks clarification on essential aspects. One such aspect is the sample definition. The number of participants — 17 physicians — needs to be justified. It is necessary to explain why this specific number was chosen and what inclusion and exclusion criteria were adopted. Comparing this choice with similar studies may help to support the decision methodologically and strengthen the study’s credibility.

Another crucial point concerns the data collection and analysis process. Qualitative methodology demands transparency and a rigorous level of detail to ensure the reliability of results. Therefore, it is recommended that the study present all guiding questions used in the interviews, as well as the interview protocol. It is also essential to describe, in as much detail as possible, the participant selection process, the conditions under which the interviews took place, and whether there were multiple rounds of interviews with the same participants. Such information enables a better understanding of the data production context and allows for the assessment of quality, while also helping to minimize bias and subjectivity.

Likewise, the inclusion of excerpts from participants’ responses is highly recommended. Beyond enriching the study’s narrative, these excerpts lend authenticity to the analysis and highlight the rigorous treatment of the data. Direct quotations, properly contextualized, reinforce the credibility of the findings and provide a deeper insight into the experiences reported.

Furthermore, the role of the researchers themselves should be made explicit. In qualitative research, it is crucial to acknowledge that the researcher is also part of the research context, particularly when conducting interviews or participating in data collection and analysis. Recognizing this dynamic strengthens the transparency of the research and adds legitimacy to the findings.

The discussion of results is one of the most central elements of the study and should be addressed with appropriate depth. It is vital that the findings are critically linked to the existing literature, highlighting similarities, divergences, and any novel contributions. This critical analysis not only demonstrates mastery of the subject area but also reinforces the relevance of the findings for scientific advancement. Moreover, the inclusion of practical and applicable suggestions aimed at healthcare professionals, public managers, and policymakers would be pertinent.

Another element that could further reinforce the study’s relevance is the proposal of future research directions. Identifying gaps in the current knowledge and suggesting promising paths for new studies reflects a strong commitment to the continuity of scientific inquiry and expands the reach of the research.

In summary, this is a study with great potential, supported by a solid methodological foundation and focused on a highly relevant topic. With some improvements — particularly in terms of theoretical grounding, methodological transparency, and analytical depth — the work could achieve even greater impact.

Reviewer #2: General Comments

The manuscript is methodologically sound, clearly structured, and provides useful insights into how rehabilitation staff perceive and address the emotional and psychological challenges of patients. However, a few areas require clarification, and some improvements could strengthen the manuscript’s rigor and practical relevance.

Major Comments

Abstract

Well-structured, but it would benefit from reporting specific examples of anxieties and interventions to provide more concrete insight.

Introduction

Consider adding a brief literature comparison with other qualitative studies addressing similar topics in different cultural or clinical settings.

Methods

Clarify if interview transcripts were returned to participants for review (member checking).

While the rationale for not interviewing patients (concerns about recall bias and individual variability) is mentioned, it still raises a limitation in terms of representativeness of patient voices. Include a more detailed justification for the exclusive use of medical staff input and discuss whether a triangulation approach involving both patient and staff perspectives might offer a richer analysis in future work.

Results

The current clustering provides breadth but lacks deep thematic interpretation. Complement the cluster results with qualitative excerpts or mini-case examples from interviews to give depth and voice to the findings.

Discussion

The implications for practice could be expanded. For example:

How can staff training be improved using these insights? Could an intervention toolkit or checklist be developed from these findings?

Author could write in implication section below phrase to strengthen the study findings.

“Recent evidence has demonstrated that psychological distress and suicide attempts follow distinct temporal patterns, with increased risk during afternoon and evening hours, particularly among vulnerable populations such as young and married individuals [Ref:sheikh et al. doi; https://doi.org/10.1016/j.bbii.2024.100072]. Our findings highlight the need for timely psychosocial interventions that are sensitive to daily fluctuations in mood and anxiety, especially in rehabilitation settings where patients face uncertainties about recovery and discharge.”

The study involved 17 staff members from a single hospital, potentially limiting generalizability.

Acknowledge this more clearly as a limitation and discuss if saturation was reached in the interviews. Consider explaining if there was any variation in responses between different professional roles (OT, PT, nurse, etc.).

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: comments.docx

Medical staff’s perspectives on patients’ anxieties and interventions in a rehabilitation ward: A qualitative study

PONE-D-25-07050R1

Dear Dr. Otaka,

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.

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Kind regards,

Maheshkumar Baladaniya

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Author has made the changes. Manuscript is acceptable for the publication.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #2: Yes

Reviewer #3: Yes

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

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #2: Authors have addressed all comments, and it is ready for acceptance. However, it depends upon editorial decision.

Reviewer #3: The writers have strengthened the introduction, methodology, and discussion by carefully addressing the prior reviewer's suggestions. Participant quotes and more obvious practical applications have increased the manuscript's impact and clarity. In its current form, the paper is appropriate for publishing, methodologically solid, and well-written.

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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 #2: No

Reviewer #3: No

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