Cancer Survivors Living in Rural Settings: A Qualitative Exploration of Concerns, Positive Experiences and Suggestions for Improvements in Survivorship Care
Round 1
Reviewer 1 Report
Dear authors
Thank you very much for sending your manuscript. Unfortunately, I cannot consider that the manuscript should be accepted in its current version.
The study they present is part of a larger project, from which they have separated a group of data relating to the people who answered live in rural areas. Although the theme and focus of the original project is adequate, ambitious and interesting, this quality is not transferred to the manuscript sent to this journal.
Below I specify the most important aspects that you have to review:
- The introduction is adequate, but it needs to be more specific to highlight the importance of this study and, in particular, describe and justify the initial project and why the authors can present parts of that study as a specific study. Was it planned from the beginning that this population was going to be analyzed separately? why this group? Did the study include any specific data or vision to later analyze this context?
- The methodology has shortcomings because it assumes that the reader must go to another publication to learn about the original project. The manuscript must include all the data that is necessary for the reader to understand and replicate the study. The methodology is essential to assess the quality and consistency. In this sense, reference [25] leads to an article on the global data of the study (objective, methodology, results).
o The study [25] shows a sample with age groups and not all are included here. Why? If some age group does not have people living in rural areas, it should appear as a result, why are certain types of cancer chosen? Each disease is different and can have a very different impact on care and lifestyle. Was this considered?
o The qualitative analysis methodology states that two people were in charge of designing the categories. Only two people? What expert profile did you have to carry out this research activity? What criteria did they follow that can be contrasted or replicated?
o The methodology also states that two researchers coded the responses, the same two researchers designing the categories or others? What criteria did you use to make the categories?
o There are technological tools that systematically carry out qualitative analysis and extract the main themes or categories. Why weren't these types of tools used that avoid the possible bias when using people?
- The results are summarized in a very generic way and are largely quantitative. A qualitative study delves into discourse and interpretation. This type of study is difficult with such a large and heterogeneous sample, but it can be improved if the authors delve into the discourse of the participants. In addition, the study indicates that there are 4,646 individuals, but this figure does not fit with the data in the article [25] in the demographic analysis table (people living in rural areas).
- The discussion should be improved because it has few articles with which to compare the results. In addition, the discussion neither integrates a qualitative vision nor does it reflect the analysis from the difference between the rural population and the population in the cities. The discussion could be used for other studies of the same project because it does not highlight the originality of applying the research to the population of rural areas.
- Ethics: the dates are from 2016, more than six years ago. The article [25] includes the study period that does not appear in this manuscript and is more than five years old. The study should show or take into account possible changes and incorporate an update.
In conclusion, I am sure that the research carried out is of quality and has many results to disseminate, but the authors must review the manuscript in depth.
Author Response
Please find the answers attached.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Dear Editor,
Thank you very much for inviting me to prepare a review of the manuscript “Cancer survivors living in rural settings: A qualitative exploration of concerns, positive experiences and suggestions for improvements in survivorship care”
The introduction in the article is a well-developed background for research. The aim of the research is multifaceted and well described. The authors listed the selection criteria for the study and the criteria for exclusion from the study. I have a request to the authors to describe in detail the method of random selection of subjects
The advantage of the study is the use of qualitative analysis, the method of conducting the study was very well described.
The applied qualitative analysis helped to understand the problems related to physical, mental and social functioning as well as the need for health care.
Additionally, we get to know suggestions for improvement focused on topics related to information and communication, support and self-care, and follow-up care. results presented in tables in a transparent manner. Discussion – interesting. The authors prepared the article on the basis of the current and rich literature. The authors listed the limitations of the study with which I agree. The conclusions are interesting - they give practical tips.
In my opinion, the manuscript is well prepared, the only remark is the description of the method of random selection
Author Response
Please find the answers attached.
Author Response File: Author Response.docx
Reviewer 3 Report
Dear authors:
Thank you for allowing me to read your work in advance.
I have some suggestions for improvement:
1. Please ensure that the philosophical background, research methodology and research purpose are described consistently. The reason for attempting content analysis should be stated.
2. Methodology:
Please describe the role of a specific research in the data collection. Please describe the characteristics of the researcher for 2 team members conductiong qualitative analysis. How is your team prepared for qualitative research? Have you been trained in content analysis?
Please check if there is anything about content analysis in the paper (#26).
3. How did you maintain trustwrothiness during data analysis?
Best regards
Author Response
Please find the answers attached.
Author Response File: Author Response.docx
Round 2
Reviewer 3 Report
I have reviewed the revisions.
I believe that this paper can be published as is.
Best regards.
