-->PONE-D-24-51857-->-->Social Support and Health Related Quality of Life among Older People in Covid-19 Pandemic: The Mediating Role of Resilience-->-->PLOS ONE

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Academic Editor

PLOS ONE

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Reviewers' comments:

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-->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: Partly

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

Reviewer #1: No

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 requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

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

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: 1. If the basis for dividing regions into weak, good, and strong categories is mentioned in the text of the article, specifying the criteria for these divisions (such as income, education, etc.) can enhance the reader's understanding.

2. Additionally, the data analysis should be presented in a more detailed manner, for example, stating how reliability and validity coefficients were calculated."

3. Enhance Statistical Analysis: Providing detailed descriptions of the statistical methods used and presenting comprehensive analysis results would increase transparency and scientific validity.

4. Improve Results Structure: Organizing and structuring the results section more coherently would enhance readability and comprehension.

Reviewer #2: Dear Editor

Thank you for the opportunity to review. The review of manuscript PONE-D-24-51857, entitled “Social Support and Health Related Quality of Life among Older People in Covid-19 Pandemic: The Mediating Role of Resilience” done and sent for you.

Comments to authors

Abstract

- Several grammatical errors are present, such as line 42 "341 older people over 60 years were participated," which should be corrected to "341 older adults over 60 years participated".

- In line 39, Phrasing such as "it will be possible to improve…" is vague and speculative. A more assertive tone is recommended.

- In line 48, there are misplaced commas (e.g., β = 0.44,).

- In lines 48 and 49, the statistical findings are not contextualized—what does a β = 0.097 mean in practical terms for HRQoL?

- I recommended briefly mention prior studies and highlight the novelty of this research.

Introduction

- I would suggest to summarize the introduction section.

- Definitions and relationships between HRQoL and social support are repeated unnecessarily.

- The concept of resilience is introduced multiple times with overlapping definitions and citations, which disrupts the flow and dilutes impact.

- The paragraph transitions are abrupt, and the logical progression of ideas is weak. For example, demographic data about Iran’s aging population is inserted without a clear link to the preceding or following content.

- The final paragraph claims novelty in examining the three variables concurrently but does not adequately support this claim with references or a synthesis of existing gaps in the literature.

In line 100, the writing is overly formal and verbose in places, which may hinder readability. Phrases such as "engendered by the emergence of this recent epidemic" could be simplified.

Materials and Methods

- Please explain the demographic factors.

- In line 137, Please replace the word "Instrument" in this sentence with "The questionnaires".

- Authors should be summarized the parts mentioned in lines 138-169.

- The study uses cluster random sampling across 16 neighborhoods, but the rationale for selecting two neighborhoods per district is not fully explained.

- It is recommended to clarify how the sample size was determined and whether power analysis was conducted to justify the inclusion of 341 participants.

- The method of replacing non-respondents with others from the same age group and neighborhood may introduce selection bias so, it is recommended to discuss the potential impact of this substitution on sample representativeness and data validity.

- While reliability coefficients are reported for all instruments, the validity of the resilience questionnaire in the elderly population is not discussed. It is recommended to provide more detail on the cultural and age-specific validation of the Conner-Davidson resilience scale in Iranian elderly populations.

- The authors mention controlling for gender, age, and employment status, but do not specify how these were included in the regression or SEM models.

- Include a statement confirming ethical clearance from an institutional review board and the process for obtaining participant consent.

- Clarify whether missing data were present and how they were handled.

Results

- In lines 185 and 188, tables and 2 change to Tables 1 and 2.

- In line 206, the relationship between resilience and HRQoL is reported with two different β values (0.34 and 0.24), which creates confusion.

- Differences in mean scores between demographic groups (e.g., gender, employment status, age) are described, but no statistical tests (e.g., t-tests, ANOVA) are reported to determine significance.

- The scales used for resilience (out of 125), social support (out of 115), and HRQoL (out of 100) are mentioned, but the instruments are not identified.

- The phrase "considering demographic variables" is used repeatedly, but it is unclear which variables were controlled for and how they were incorporated into the models.

- Some reported β values (e.g., 0.097 for direct effect) are statistically significant but small. The practical relevance of these findings is not discussed.

- The finding that unemployed individuals had higher social support than employed ones contradicts common assumptions and prior literature.

Discussion

- The reported direct effect of social support on HRQoL (β = 0.04) is statistically significant but extremely small. The discussion does not address whether this effect is practically meaningful.

- While the authors cite numerous studies, the discussion lacks critical analysis of conflicting findings, methodological differences, or contextual limitations.

- The mediating role of resilience is reiterated multiple times without adding new insights or elaborating on mechanisms. It is recommended to consolidate repetitive statements and expand on how resilience functions as a mediator in practical terms.

- The manuscript suggests that findings can inform policy but does not specify how interventions might be designed or implemented. Offer concrete examples of resilience-building or social support strategies that could be applied in community or clinical settings.

References

- Please correct the errors in throughout the References. However, Authors must use the abbreviation for journal name. Articles rewrite according to "PLOS ONE" format.

- In line 355, "WH" change "WHO".

- Please delete "" in line 377.

- In lines 406 and 409, articles with more than 6 authors must also rewrite according to "PLOS ONE" format.

- In line 423, please delete ".", ":" and ";".

- In line 424, Karimi Y KM HY should be corrected.

- 2006;5(1):0-. in line 431, rewrite.

- Please delete "," in line 434.

- In line 444, authors should be corrected.

- In line 450, please delete space and ",".

- In lines 466 and 472, authors should be corrected.

Tables

- Authors should explain "*" in Table 5.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-24-51857.docx

Social Support and Health Related Quality of Life among Older People in Covid-19 Pandemic: The Mediating Role of Resilience

PONE-D-24-51857R1

Dear Dr. Hadi Darvishi,

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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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,

Bibi Razieh Hosseini Farash

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.-->

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?

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 #2: Yes

Reviewer #3: Yes

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-->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 requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #2: Yes

Reviewer #3: No

**********

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

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #2: Yes

Reviewer #3: Yes

**********

-->6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #2: Dear Authors

Some minor corrections need to be made in manuscript as follows:

Page 2, line 67: "the advent of epidemics" can be replaced to "the onset of epidemics"

Page 2, line 68: "While the disease can impact" can be replaced to "While the disease can affect"

Page 2, line 70: "This matter holds significant importance for nations experiencing population aging. Iran is one of the countries with a high rate of population aging [4]. Iran is poised to witness a substantial rise in the proportion of its elderly population over the next three decades [5]." Should be replaced by "This issue is particularly important for nations experiencing population aging. Iran is one of the countries with a high rate of population aging [4] and is expected to see substantial increase in the proportion of its elderly population over the next three decades [5].

Page 4, Line 111: carried out

Pages 8, 9, lines 228-233: In this specific cross-sectional study, the focus was on examining the mediating role of resilience in the relationship between social support and HRQoL among the elderly during the Covid-19 pandemic. The results indicated that the availability of appropriate social support is a key factor in improving both resilience and HRQoL. Notably, these effects remained significant even after accounting for potential confounding variables such as demographic characteristics.

Page 9, lines 236: Existing literature provides insight into...

Reviewer #3: Thank you for your cooperation and kindness . All the points I had suggested have been corrected.

Recommendations:

1. If the basis for dividing regions into weak, good, and strong categories is mentioned in the text of the article, specifying the criteria for these divisions (such as income, education, etc.) can enhance the reader's understanding.

2. Additionally, the data analysis should be presented in a more detailed manner, for example, stating how reliability and validity coefficients were calculated."

3. Enhance Statistical Analysis: Providing detailed descriptions of the statistical methods used and presenting comprehensive analysis results would increase transparency and scientific validity.

4. Improve Results Structure: Organizing and structuring the results section more coherently would enhance readability and comprehension.

**********

-->7. PLOS authors have the option to publish the peer review history of their article (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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