Health seeking behaviors of nurses diagnosed with hypertension and providing health care in resource-constrained setting in a rural part of Northern Ghana: A qualitative study

Thomas Ankomanin; Kennedy Dodam Konlan; Kwadwo Ameyaw Korsah

doi:10.1371/journal.pone.0342406

Peer Review History

Original SubmissionOctober 29, 2025
26 Dec 2025 Decision Letter - Javier Fagundo-Rivera, Editor Dear Dr. Konlan, 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. Please submit your revised manuscript by Feb 09 2026 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. A letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols . We look forward to receiving your revised manuscript. Kind regards, Javier Fagundo-Rivera, PhD Academic Editor PLOS One Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1.Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. 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If your submission does not contain these data, please either upload them as Supporting Information files or deposit them to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. 3. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 5. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments: Dear Authors, Thank you for your work and for your interest in PLOS ONE as a venue to disseminate your research. Three reviewers have evaluated your manuscript. A major revision is required, addressing the comments from all three reviewers. Please revise your manuscript accordingly and submit a detailed response-to-reviewers letter indicating how you have addressed each of the reviewers’ comments. Kind regards, [Note: HTML markup is below. Please do not edit.] 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: Partly Reviewer #3: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes Reviewer #2: N/A Reviewer #3: N/A ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: No Reviewer #2: Yes Reviewer #3: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: No Reviewer #2: Yes Reviewer #3: Yes ****** Reviewer #1: SEE DOCUMENT ATTACHED This study, titled "Health seeking behaviors of nurses diagnosed with hypertension and providing health care in resource-constrained setting in a rural part of Northern Ghana: A qualitative study," explores the personal health management strategies and associated challenges faced by nurses living with hypertension in a high-stress, resource-constrained environment in Ghana. The manuscript provides valuable insights into the persistent gap between high professional knowledge and poor health-seeking behavior, attributing this divergence primarily to organizational and systemic barriers. I reviewed the study following PLOS ONE criteria which I now submit. Reviewer #2: I recommend major revision: (1) sample/ID inconsistency (n=12 but quotes labeled “Nurse 13”); (2) clarify recruitment, voluntariness, and privacy (management involvement; interview location); (3) align the Data Availability statement with PLOS requirements; (4) correct the Limitations section. Reviewer #3: SEE DOCUMENT ATTACHED The manuscript is scientifically sound and backed by data. The authors need to correct grammar mistakes and try not to mix discussion with results, otherwise the manuscript reflects good scientific rigor and the conclusions and recommendations tie up well with the findings of the study. With minor corrections, it is a good manuscript for publication. ****** 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 #1: No Reviewer #2: Yes: Federico Cucci Reviewer #3: Yes: Chipo Chimamise ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. Attachments Attachment Submitted filename: PONE-D-25-57892_Reviewed_20251224CC.pdf Attachment Submitted filename: MGB Revision of PONE-D-25-57892.docx https://doi.org/10.1371/journal.pone.0342406.r001
Revision 1
31 Dec 2025 Author Response University of Ghana College of Health Sciences School of Nursing and Midwifery Department of Adult Health 26th DECEMBER, 2025 The Editor PLOS ONE Dear Sir/Madam, Response to review General comments of authors We have addressed all the comments of the editor and reviewers as suggested and we hope the revised manuscript meets the standards for publications. Comments of the Editor PONE-D-25-57892 Health seeking behaviors of nurses diagnosed with hypertension and providing health care in resource-constrained setting in a rural part of Northern Ghana: A qualitative study PLOS One Dear Dr. Konlan, Dear Dr. Konlan, 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. Please submit your revised manuscript by Feb 09 2026 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: • A letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Javier Fagundo-Rivera, PhD Academic Editor PLOS One Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1.Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. We note that your Data Availability Statement is currently as follows: All relevant data are within the manuscript and in Supporting Information files. Please confirm at this time whether or not your submission contains all raw data required to replicate the results of your study. Authors must share the “minimal data set” for their submission. PLOS defines the minimal data set to consist of the data required to replicate all study findings reported in the article, as well as related metadata and methods (https://journals.plos.org/plosone/s/data-availability#loc-minimal-data-set-definition). For example, authors should submit the following data: - The values behind the means, standard deviations and other measures reported; - The values used to build graphs; - The points extracted from images for analysis. Authors do not need to submit their entire data set if only a portion of the data was used in the reported study. If your submission does not contain these data, please either upload them as Supporting Information files or deposit them to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of recommended repositories, please see https://journals.plos.org/plosone/s/recommended-repositories. If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. If data are owned by a third party, please indicate how others may request data access. 3. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please move it to the Methods section and delete it from any other section. Please ensure that your ethics statement is included in your manuscript, as the ethics statement entered into the online submission form will not be published alongside your manuscript. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 5. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. Additional Editor Comments: Dear Authors, Thank you for your work and for your interest in PLOS ONE as a venue to disseminate your research. Three reviewers have evaluated your manuscript. A major revision is required, addressing the comments from all three reviewers. Please revise your manuscript accordingly and submit a detailed response-to-reviewers letter indicating how you have addressed each of the reviewers’ comments. Kind regards, [Note: HTML markup is below. Please do not edit.] Authors’ Response to Comments of editor General Response to editor’s comments We are grateful for the comments of the editor and have addressed all the concerns and comments of the editor. Authors’ response to Journal Requirements: 1. We have ensured that our manuscript meets PLOS ONE's style requirements, including those for file naming. 2. We have ensured that our ethics statement appeared only in the Methods section of our manuscript. This is found on page 11 of the revised manuscript. 3. We have stated on page 11 that all the participants gave consent for interview transcript to be published. 4. We have removed all personal identification information in the revised manuscript 5. This was not applicable to our manuscript. Additional Editor Comments: We have addressed the comments of the editor in the revised manuscript. REVIEWER 1 COMMENTS Reviewer #1: SEE DOCUMENT ATTACHED This study, titled "Health seeking behaviors of nurses diagnosed with hypertension and providing health care in resource-constrained setting in a rural part of Northern Ghana: A qualitative study," explores the personal health management strategies and associated challenges faced by nurses living with hypertension in a high-stress, resource-constrained environment in Ghana. The manuscript provides valuable insights into the persistent gap between high professional knowledge and poor health-seeking behavior, attributing this divergence primarily to organizational and systemic barriers. I reviewed the study following PLOS ONE criteria which I now submit. Authors’ response to reviewer 1 We are grateful for the comments of the reviewer. We have addressed the grammatical errors and we are grateful for the favourable comments of the reviewer in the attached filed. Reviewer 2 comments Reviewer #2: I recommend major revision: (1) sample/ID inconsistency (n=12 but quotes labeled “Nurse 13”); (2) clarify recruitment, voluntariness, and privacy (management involvement; interview location); (3) align the Data Availability statement with PLOS requirements; (4) correct the Limitations section. Authors’ responses to comments of reviewer 2 1. We have ensured the sample/ID are consistent and removed the error of nurse 13 found in the manuscript. This is found on page 6 on the sample size and also in the results on pages 12 to 28 of the revised manuscript. 2. We have clarified the recruitment, voluntariness, and privacy (management involvement; interview location). This is found on page 8 of the revised manuscript on selection of participants and data collection. 3. We have aligned data availability with PLOS requirements as suggested by the reviewer. 4. We have worked on the limitations section of the revised manuscript. This is found on pages 31 and 32 of the revised manuscript. Reviewer 3 comments Reviewer #3: SEE DOCUMENT ATTACHED The manuscript is scientifically sound and backed by data. The authors need to correct grammar mistakes and try not to mix discussion with results, otherwise the manuscript reflects good scientific rigor and the conclusions and recommendations tie up well with the findings of the study. With minor corrections, it is a good manuscript for publication. Authors’ responses to comments of reviewer 3 We are grateful for the comments of the reviewer. We have worked on the grammatical mistakes and ensured that the discussion is separated from the results in the revised manuscript. We have addressed all the concerns of the reviewer. We hope the revised manuscript will meet the standards for publication. Thank you Yours sincerely, Dr. Kennedy Dodam Konlan (Corresponding author) Attachments Attachment Submitted filename: Response to reviewers .pdf https://doi.org/10.1371/journal.pone.0342406.r002
22 Jan 2026 Decision Letter - Javier Fagundo-Rivera, Editor Health seeking behaviors of nurses diagnosed with hypertension and providing health care in resource-constrained setting in a rural part of Northern Ghana: A qualitative study PONE-D-25-57892R1 Dear Dr. Konlan, 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. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact billing support . If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Javier Fagundo-Rivera, PhD Academic Editor PLOS One Additional Editor Comments (optional): Dear Authors Congratulations for your work. This manuscript can be accepted. Kind regards. Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed Reviewer #3: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: (No Response) ****** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: (No Response) ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes Reviewer #2: Yes Reviewer #3: (No Response) ****** Reviewer #1: This revised manuscript demonstrates substantial improvement in clarity, structure, and methodological transparency. The authors have engaged seriously with previous reviewer comments and have strengthened the manuscript in ways that make it both analytically rigorous and highly relevant for publication. The study now presents a coherent, well-documented, and ethically sound contribution that is appropriate for the scope of PLOS ONE. Considering the revisions made and the overall quality of the manuscript, I recommend acceptance. Reviewer #2: The manuscript “Health seeking behaviors of nurses diagnosed with hypertension and providing health care in a resource-constrained setting in a rural part of Northern Ghana: A qualitative study” is ready for publication. Reviewer #3: (No Response) ****** 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 #1: No Reviewer #2: Yes: Federico Cucci Reviewer #3: Yes: Dr Chipo Chimamise ******** Attachments Attachment Submitted filename: renamed_18dc9.docx https://doi.org/10.1371/journal.pone.0342406.r003
Formally Accepted
Acceptance Letter - Javier Fagundo-Rivera, Editor PONE-D-25-57892R1 PLOS One Dear Dr. Konlan, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS One. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. You will receive an invoice from PLOS for your publication fee after your manuscript has reached the completed accept phase. If you receive an email requesting payment before acceptance or for any other service, this may be a phishing scheme. Learn how to identify phishing emails and protect your accounts at https://explore.plos.org/phishing. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Javier Fagundo-Rivera Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0342406.r004

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