Dear Dr. Raijmakers,

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.

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ACADEMIC EDITOR:  Dear Authors, could you please address the feedback suggested by the two reviewers. Additionally, in the abstract it states ‘in order to realise an appropriate fit at IPSO for this group’ is unclear. Could this please be amended? Perhaps ‘to optimise the services provided by IPSO centers’ as per the introduction. Additionally, the COREQ guidelines are missing for this submission as well as the interview guide as supplementary material

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PLOS ONE

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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: N/A

Reviewer #2: N/A

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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: No

Reviewer #2: No

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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: Thank you for the opportunity to review the paper titled “Experiences and needs of patients with incurable cancer and their relatives with informal care in psychosocial supporting centres in the Netherlands: a qualitative study”. This paper describes the experiences and needs of people impacted by incurable cancer who visited an IPSO centre in The Netherlands for supportive care. The paper provides some insightful findings regarding the value and suitability of these services for this population group. Please see my detailed comments below.

Criteria:

1. The study presents the results of original research. Yes.

2. Results reported have not been published elsewhere. Yes.

3. Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail. Yes.

4. Conclusions are presented in an appropriate fashion and are supported by the data. Please see my suggested edits below.

5. The article is presented in an intelligible fashion and is written in standard English. Predominantly. Please see minor suggestions below.

6. The research meets all applicable standards for the ethics of experimentation and research integrity. Yes.

7. The article adheres to appropriate reporting guidelines and community standards for data availability. Unsure - I am unable to see the completed COREQ checklist.

Abstract:

• Line 12, page 2 – this sentence would be better suited to your Results section.

• If word count permits, please briefly elaborate on the perceived benefits of having separate peer groups for those with incurable cancer, and what aspects of the group set-ups made them inaccessible for some participants.

Introduction:

• Overall, the introduction is well-written and provides a clear and concise overview of what is currently known on this topic and justification for the aims of this study.

• I would recommend reviewing the paragraph structure in the introduction to improve readability. Ensure each paragraph includes a clear topic and concluding or linking sentence.

• Please provide a short explanation of what is meant by ‘informal caregiver’ in this study and expand on the justification as to why it is important to consider the perspectives of this population group, particularly in the context of incurable cancer.

• Line 22, page 3 – if possible, please define the acronym ‘IPSO’. I would also suggest tweaking the wording slightly to ensure it’s clear that this organisation offers ‘volunteer-led’ support, rather than support for volunteers per se. In addition, could you elaborate further on the reach of this organisation? For example, how widely distributed are the centres? Do they offer online/telephone support in addition to in-person support? Are services accessible free of charge? What are their opening days/hours? Are services general or targeted to specific groups including those impacted by incurable cancer?)

• Lines 1-2, page 4 – ensure consistency in the punctuation of ‘wellbeing’.

• Line 3, page 4 – ‘impact’ on what? Please elaborate.

• Lines 4, page 4 – are decimal places on these numbers necessary?

Methods:

• The authors stated that they used the COREQ checklist for their reporting; however, I cannot see this. Could the authors please confirm if this was submitted with their manuscript?

• Could the authors please elaborate on how purposive sampling was used? For example, did they purposively recruit to ensure variation in age, gender, and other demographic characteristics, or focus on people with specific experiences with the IPSO service? Otherwise, I wonder if this is more convenience sampling.

• How many IPSO centres were contacted and then subsequently agreed to distribute recruitment flyers to their visitors?

• How was study eligibility for each visitor assessed?

• I commend the authors for collaboratively developing an interview guide based on a review of the literature and expert opinion, and for piloting this interview guide before use. I encourage the authors to include this guide in their Supplementary Materials, and to provide more detail on the following: i) what concepts were identified in the literature review and subsequently applied to the interview guide? ii) who was the interview piloted with?

• The authors have indicated that ‘data saturation’ was defined based on the description by Morse (1995). To support reader understanding, could the authors please elaborate on how this definition was applied in the context of their study?

• Please provide a citation for the data analysis method used. It seems to reflect more of a thematic analysis approach rather than a content analysis approach.

• Demographic characteristics of participants are reported. Please clarify in Methods how these data were collected.

Results:

• Table 1 - I am not sure I understand the footnote about level of education. Please provide further explanation. I have also not seen education categorised as ‘low’, ‘middle’, and ‘high’ before – for an international audience, please define what these represent.

• Line 2, page 8 – I do not think it is necessary to repeat the sample size – either report it in the Methods or Results. If possible, I encourage the authors to include a participant flow diagram showing the number of i) visitors to the IPSO centres and/or visitors approached during recruitment, ii) visitors screened as eligible, iii) visitors who consented to participate, and iv) visitors who completed an interview, to improve transparency around recruitment and sampling. As per the COREQ checklist, this should also include reasons for not participating.

• Line 3, page 9 – ‘IPSO hosts’ is a new term here that has not yet been introduced. Please clarify what is meant by this.

• Lines 30-31, page 11 – could the authors please elaborate on this finding by explaining why some people did not perceive it necessary (or ideal) to have specific peer groups for people impacted by incurable cancer?

• Line 21-23, page 12 – “Participants indicated that their environment sometimes draws the wrong conclusions when they talk about how they are doing, which they find frustrating” – I am a little unsure what is meant by this. Could the authors please clarify (or perhaps include an example)?

• Line 8-9, page 13 – the second use of the word ‘practical[ly]’ is somewhat redundant in this sentence.

• I think it would be worthwhile including a quote to illustrate the theme of ‘a need for information’ specifically one that highlights the need for disease-specific and/or practical information.

• Lines 10-11, page 14 – avoid using contraction words – e.g., ‘didn’t’.

Discussion and conclusion:

• Overall, the authors have raised some important points regarding the suitability and value of supportive care services, such as those offered at IPSO centres, for people impacted by incurable cancer, that emerged from their findings. I recommend that the authors elaborate further on their findings regarding peer groups that are exclusive to people diagnosed with incurable cancer or to bereaved relatives. Given that not all participants supported this approach, further discussion of the perceived advantages and disadvantages would strengthen the interpretation of these findings. I also recommend that the authors compare their findings to previous research conducted with IPSO visitors, to demonstrate the novelty and uniqueness of their findings for people impacted by incurable cancer.

• Line 25, page 15 – please check the punctuation here. There is an inverted comma at the beginning of a sentence.

• Line 30, page 15 – remove ‘that’.

• For improved flow, I would suggest including the ‘Implications and further research’ section above ‘Strengths and limitations’

Strengths and limitations:

• To clarify, were all participants returning visitors as opposed to once-off visitors? If so, this should be clarified in Methods.

• Another limitation could be a lack of contextual information for individual participants that could have an impact on their experience with the service (e.g., race/ethnicity, geographic remoteness, cancer type, duration and nature of engagement with services in the IPOC centres).

Implications:

• Lines 13-19, page 16 – perhaps provide some specific examples of how these recommendations could be achieved.

Conclusion:

• Line 6, page 17 – Please soften the language of “[needs]…will be addressed through peer contact”. The findings of this study allude to the fact that special peer groups may be of benefit to some people impacted by incurable cancer, but we cannot say for sure that these groups will address all the aforementioned needs.

Reviewer #2: Data availability:

I completely understand that raw qualitative data is not appropriate to be made available publicly due to ethical/confidentiality concerns; I simply feel this needs to be stated more clearly in the submission.

Please see attached file for all other feedback.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-25-30108_Review comments_20250814.docx

Experiences and needs of patients facing incurable cancer and their relatives with informal care in psychosocial supporting centres in the Netherlands: a qualitative study

PONE-D-25-30108R1

Dear Dr. Natasja Raijmakers

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,

Alexandre Morais Nunes, Ph.D.

Academic Editor

PLOS One

Additional Editor Comments (optional):

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

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

Reviewer #2: N/A

Reviewer #3: No

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

The PLOS Data policy

Reviewer #2: No

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: Thank you for addressing my previous comments and congratulations on this paper which I feel addresses an important gap in the literature.

Reviewer #3: The paper presents an interesting and relevant topic. The paper examines the experiences and needs of visitors of IPSO centers (psychosocial support centers for living with and after cancer) for people facing incurable cancer, with the aim of optimizing the services provided by IPSO centers for this group. However, it suffers from several drawbacks that need to be addressed before possible acceptance.

The abstract needs to be rewritten, especially to clarify the methods (one sentence instead of two).

I reviewed the authors’ responses to the editors and compared them with the previous version, and I conclude that the authors carefully implemented all suggested revisions. The previous reviewer was quite demanding, so I believe the article is now in a good position to be accepted.

My only negative point is that the conclusion is very short.

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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: Yes:  Emma Kemp

Reviewer #3: Yes:  Andreia Matos

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