PONE-D-25-00806Relationships between perceived stress, coping strategies and quality of life in patients with hematological malignancies: A cross-sectional studyPLOS ONE

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Reviewer #1: Partly

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Reviewer #1: N/A

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Reviewer #1: Yes

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Reviewer #1: No

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5. Review Comments to the Author

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Reviewer #1: General Comments:

The study examines the relationship between perceived stress, coping strategies, and quality of life in patients with hematological malignancies. The topic is relevant and important for clinical and psychological research. However, there are several areas for improvement in clarity, methodological justification, coherence, and language precision.

Specific Comments:

Title: The title could be more precise: “Relationships Between Perceived Stress, Coping Strategies, and Quality of Life in Patients with Hematological Malignancies: A Cross-Sectional Study” is slightly lengthy. Consider revising it to be more concise, e.g., "Impact of Stress and Coping Strategies on Quality of Life in Hematological Malignancies".

Abstract:

Line 4: “It is not clear how stress perceptions, and medical coping strategies affect the quality of life (QoL) with hematological malignancies.” The phrase "stress perceptions" is awkward; consider "perceived stress."

Can you rewrite like this? “The impact of perceived stress and medical coping strategies on the quality of life (QoL) in patients with hematological malignancies is not well understood.”

Line 9: "Additionally, we explored the associations between stress perceptions, medical coping strategies and QoL." Missing comma before "and."

Line 16: "The avoidance exhibited a significant positive correlation with unction scores (p<0.05)." Typo in “unction” (should be "function").

Introduction:

Paragraph 1:

Line 2: "These diseases account for approximately 9% of all cancers, ranking as the fourth most common type of malignancy." Needs a citation.

Line 7: “These factors will increase the patients' economic burden and cause severe psychological disorders.” The phrase "severe psychological disorders" may be too strong without evidence. Consider "psychological distress."

Paragraph 2:

Line 3: "Studies have shown a correlation between perceived stress and QoL, indicating that the more negative perceptions of the disease, the poorer the QoL." Needs references. Also, rephrase for clarity: “Studies indicate that higher perceived stress is associated with lower QoL.”

Methods:

Study Design & Population

Line 3: "The study, involving 185 hematologic cancer patients in China, was conducted between 8, 2024 to 12, 2024." Incorrect date format. Should be “from August 2024 to December 2024.”

Line 10: “Patients who were fully cognizant of their own medical condition.” "Fully cognizant" is vague. Does this mean cognitively intact? Consider “Patients who were aware of their diagnosis and treatment.”

Questionnaire survey and ethical considerations

Line 7: "We did not involve minors and all them received written informed consent." Grammar error, should be “We did not include minors, and all participants provided written informed consent.”

Statistical Analysis:

Line 5: "p<0.05 was considered statistically significant." The manuscript does not mention multiple testing correction (e.g., Bonferroni adjustment). Were adjustments made?

Results:

Table 1 & Demographics

The manuscript states that 40.4% of the participants were female but does not compare this distribution to the general population of hematological malignancies. Was gender distribution representative?

Correlation Analysis (Table 4):

Line 6: “The avoidance exhibited a significant positive correlation with function scores (p<0.05).” The interpretation is unclear—avoidance typically has a negative impact on QoL. More discussion is needed.

Regression Analysis (Tables 6–8):

Line 9: "Crisis perception and yielding were the main factors influencing overall QoL." The manuscript should explore why these factors are significant—what mechanisms are at play?

Discussion:

Interpretation of Results:

Paragraph 2: The section discussing gender differences in QoL is interesting but lacks references to studies supporting these findings.

Paragraph 4: “Therefore, it is crucial for healthcare providers to recognize and address the psychological needs of these patients.” This conclusion is important but should be more specific—what types of psychological interventions are recommended?

Limitations:

Line 4: “Future studies should aim to include a larger and more diverse sample.” Good point, but clarify what aspects of diversity (e.g., socioeconomic status, ethnicity, or geographic region) are lacking in this study.

Conclusion:

Line 3: "Strengthening the attention in this factors will help to improve the QoL." Incorrect grammar. Should be “Strengthening attention to these factors may help improve QoL.”

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Reviewer #1: Yes:  Sunil Shrestha

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Impact of Stress and Coping Strategies on Quality of Life in Hematological Malignancies : A cross-sectional study

PONE-D-25-00806R1

Dear Dr.

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