The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I read with interest the paper from Al-Azri et Al. deals with social interation patterns following a cancer diagnosis in Omani women. I believe the paper has some merit, since it showcases reactions to a condition in a social setting whose exposure in literature is scarce, when compared to the overabundance of related works focused on the Western world. On the other side, it may be hard to completely generalise the results in different scenarios, a limitation the Authors well recognize.

The paper appears to be well structured according to the qualitative research standards. My suggestions are minor, as the paper is already well written in my opinion. I just believe that, in the methods, details on data saturation and coding methods could be expanded to provide more transparency regarding thematic analysis and the coding framework.

 

Good job

Author Response

Manuscript ID: curroncol-3303809 - Major Revisions

We would like to thank the reviewer for providing their valuable comments. We have now addressed the reviewer’s comments below and in the revised manuscript using Track Changes. 

 

Reviewer 1

 

Comments and Suggestions for Authors

I read with interest the paper from Al-Azri et Al. deals with social interation patterns following a cancer diagnosis in Omani women. I believe the paper has some merit, since it showcases reactions to a condition in a social setting whose exposure in literature is scarce, when compared to the overabundance of related works focused on the Western world. On the other side, it may be hard to completely generalise the results in different scenarios, a limitation the Authors well recognize.

Author's Reply: We would like to thank the reviewer for this comment. We have mentioned in the study’s limitations that qualitative research does not aim for the generalizability of findings but rather focuses on providing in-depth insights and understanding of the experiences, perspectives, and contexts specific to the participants under study. We have now added this sentence to the revised manuscript.

The paper appears to be well structured according to the qualitative research standards. My suggestions are minor, as the paper is already well written in my opinion. I just believe that, in the methods, details on data saturation and coding methods could be expanded to provide more transparency regarding thematic analysis and the coding framework.

Authors’ Reply: We would like to thank the reviewer for this comment. Additional details about the coding methods and data saturation have now been included in the revised manuscript. 

Good job

 

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

The study is a potentially useful contribution to the field, and the results have the potential to be of significant value. Nevertheless, I would like to make a few suggestions for your consideration and further improvement.

 

Title

 

The title does not capture the essence of the study. "A qualitative study" is a very general characterization; please consider modifying the title to reflect the merit of your findings.

 

Abstract

Line 18 says "types of interaction" which is not accurate. This is because it is not about types of interaction in the sense of different patterns of action (how), but rather about different actors in those interactions (with whom).

 

The messages in lines 24-30 are your own suggestions, but in the context of the study conducted, this is only a speculative statement because it is not the real experience of the participants involved. It seems that the study was not designed to test the feasibility of the suggestions made. Therefore, please consider replacing this information with real conclusions that are supported by empirical evidence.

 

Introduction

It would be helpful if the introduction summarized the findings to date on the topic of the research. Specifically, it would be useful to focus on the issues of stigma perception and public acceptance, the importance of the social environment and social networks, social interaction patterns, and possibly even coping strategies or ways of dealing with stress or disruptive life changes.

 

It would be helpful if, at the end of this introductory section, the aim and purpose of the study were stated or the research question formulated (I understand that in the case of exploratory qualitative research it is not easy to formulate specific hypotheses).

 

Section 2.3

At this point it would be desirable to add the main arguments for choosing semi-structured interviews. It is not clear from the text why the more common method of in-depth interviews was not chosen in this case. How did semi-structured interviews help to better achieve the research objectives?

 

Section 2.4.

Please specify the specific method used to conduct the qualitative analysis. How was open and axial coding carried out? What software was used for qualitative analysis? Etc. The existing description is not sufficient.

 

Table 1

Would it be possible to add also the time since diagnosis? It seems that experiences and ways of coping with the diagnosis are not static but evolve over time (many sources can be found for this). In this context, it would be useful to add information about the stage of the disease at which the interviews were conducted.

 

Please consider whether it would be more appropriate to present socio-demographic characteristics on a case-by-case basis in this case. Thus, such a table would have 11 rows (one row per participant), and it would show that participant 1 was 33 years old, married, high school educated, with income OMR 1,000-2,000 at stage III. Such a format would better describe the context of the individual quotes that are provided in the following sections.

 

Section 3.2

On line 154 you state that six types of interactions "were identified". The question is by whom were they identified - by the authors of the study, were they based on previous research, were they mentioned directly, spontaneously, by individual participants, were participants specifically asked about them, did they emerge from the summary analysis or synthesis of the interviews? Please be more specific.

 

Sections 3.2.1 - 3.2.6

This simplistic way of presenting the results is not appropriate as it lacks a real analysis of the responses (transcripts). The quotes given appear to be random - it is not apparent to what extent they represent the attitudinal or behavioral patterns identified. It is not possible to determine what part of the topic they cover (thematic saturation). Nor is it clear for what purpose they are presented (is it because of their content, because of their form, or because of a particular way of verbalization?). I also missed the appropriate context in that the particular statements or responses were given.

 

Discussion

It would be beneficial to include a brief overview of the results at the beginning of this section.

 

Conclusions

I think it is appropriate to supplement the conclusions with a list of ways in which the study can be used in practice. Highlighting the potential applications of the results, both in terms of further research and practical implications, would emphasize the significance and impact of the study.

 

I am grateful for your commitment to advancing the understanding of this issue. I look forward to seeing the improved version of your study.

Sincerely,

Author Response

Manuscript ID: curroncol-3303809 - Major Revisions

We would like to thank the reviewer for providing their valuable comments. We have now addressed the reviewer’s comments below and in the revised manuscript using Track Changes. 

Reviewer 2

Comments and Suggestions for Authors

Dear Authors,

The study is a potentially useful contribution to the field, and the results have the potential to be of significant value. Nevertheless, I would like to make a few suggestions for your consideration and further improvement.

Authors’ Reply: We would like to thank the reviewer for this comment.

 Title

 The title does not capture the essence of the study. "A qualitative study" is a very general characterization; please consider modifying the title to reflect the merit of your findings.

Authors’ Reply: We would like to thank the reviewer for this  comment. The title has been modified to be as “The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study”

 Abstract

Line 18 says "types of interaction" which is not accurate. This is because it is not about types of interaction in the sense of different patterns of action (how), but rather about different actors in those interactions (with whom).

Authors’ Reply: We would like to thank the reviewers for this comment. The sentence has been modified in the abstract and in the finings as “Six key types of interactions with various groups were identified”.  

 The messages in lines 24-30 are your own suggestions, but in the context of the study conducted, this is only a speculative statement because it is not the real experience of the participants involved. It seems that the study was not designed to test the feasibility of the suggestions made. Therefore, please consider replacing this information with real conclusions that are supported by empirical evidence.

Authors' Reply: We would like to thank the reviewers for this comment. The conclusion section has been modified according to the findings. 

Introduction

It would be helpful if the introduction summarized the findings to date on the topic of the research. Specifically, it would be useful to focus on the issues of stigma perception and public acceptance, the importance of the social environment and social networks, social interaction patterns, and possibly even coping strategies or ways of dealing with stress or disruptive life changes.

Authors’ Reply: Authors’ Reply: We would like to thank the reviewer for this comment. A section has been added to the introduction to address the different issues raised in this comment. 

It would be helpful if, at the end of this introductory section, the aim and purpose of the study were stated or the research question formulated (I understand that in the case of exploratory qualitative research it is not easy to formulate specific hypotheses).

Authors’ Reply: Authors’ Reply: We would like to thank the reviewer for this comment. The sentence already exists in the manuscript at the end of the introduction: “Therefore, this research aimed to explore the interaction patterns of young Omani BC survivors following diagnosis” 

 Section 2.3

At this point it would be desirable to add the main arguments for choosing semi-structured interviews. It is not clear from the text why the more common method of in-depth interviews was not chosen in this case. How did semi-structured interviews help to better achieve the research objectives?

Authors’ Reply: We would like to thank the reviewer for this comment. A sentence has been added to address this comment.

 Section 2.4.

Please specify the specific method used to conduct the qualitative analysis. How was open and axial coding carried out? What software was used for qualitative analysis? Etc. The existing description is not sufficient.

 Authors’ Reply: We would like to thank the reviewer for this comment. We employed a framework analysis method, as detailed in this section. Additionally, further details have now been provided in response to the previous comments.

Table 1

Would it be possible to add also the time since diagnosis? It seems that experiences and ways of coping with the diagnosis are not static but evolve over time (many sources can be found for this). In this context, it would be useful to add information about the stage of the disease at which the interviews were conducted.

Authors’ Reply: We would like to thank the reviewer for this comment. We agree that the time since diagnosis and the stage of the disease can significantly influence patients' experiences. While the stage of the disease was documented and is mentioned in the manuscript, the time since diagnosis was not systematically collected in this study. We acknowledge that including this information would have added valuable context to the findings, and consider as another limitation of the study.

Please consider whether it would be more appropriate to present socio-demographic characteristics on a case-by-case basis in this case. Thus, such a table would have 11 rows (one row per participant), and it would show that participant 1 was 33 years old, married, high school educated, with income OMR 1,000-2,000 at stage III. Such a format would better describe the context of the individual quotes that are provided in the following sections.

Authors’ Reply: We would like to thank the reviewer for this comment. Presenting socio-demographic characteristics on a case-by-case basis could indeed provide a more individualized context for the quotes and narratives shared in the study. However, implementing this recommendation poses certain challenges, as the current study design was not structured to directly link specific quotes to detailed participant profiles. We acknowledge this as a limitation as another limitation of the study.

 Section 3.2

On line 154 you state that six types of interactions "were identified". The question is by whom were they identified - by the authors of the study, were they based on previous research, were they mentioned directly, spontaneously, by individual participants, were participants specifically asked about them, did they emerge from the summary analysis or synthesis of the interviews? Please be more specific.

Authors’ Reply: We would like to thank the reviewer for this comment. The sentence has been corrected to be more specific. 

Sections 3.2.1 - 3.2.6

This simplistic way of presenting the results is not appropriate as it lacks a real analysis of the responses (transcripts). The quotes given appear to be random - it is not apparent to what extent they represent the attitudinal or behavioral patterns identified. It is not possible to determine what part of the topic they cover (thematic saturation). Nor is it clear for what purpose they are presented (is it because of their content, because of their form, or because of a particular way of verbalization?). I also missed the appropriate context in that the particular statements or responses were given.

Authors’ Reply: We would like to thank the reviewer for this comment. We have made every effort to analyze and present the data as comprehensively as possible within the scope of our study. We will address these issues in future analyses to ensure greater clarity and depth in presenting qualitative findings.

 Discussion

It would be beneficial to include a brief overview of the results at the beginning of this section.

Authors’ Reply: We would like to thank the reviewer for this comment. A brief overview of the results at the beginning of the discussion section has been added. 

 Conclusions

I think it is appropriate to supplement the conclusions with a list of ways in which the study can be used in practice. Highlighting the potential applications of the results, both in terms of further research and practical implications, would emphasize the significance and impact of the study.

Authors’ Reply: We would like to thank the reviewer for this comment. A paragraph addressing this comment has been added at the end of the conclusion. 

I am grateful for your commitment to advancing the understanding of this issue. I look forward to seeing the improved version of your study.

Authors’ Reply: We would like to thank the reviewer for this comment.

Sincerely,

 

 

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

The improved manuscript seems to be adequately revised. It has an appropriate title, an informative abstract summarizing the main features of the study. Even the main body of the manuscript, i.e., the Introduction, Methods and Results sections are now easier to follow. In addition, the Discussion and Conclusion sections are now more in line with the current state of the art. In summary, the previous comments have been satisfactorily addressed and the manuscript now has the potential to be useful. I believe that it does not require any further adjustments and can be accepted in its present form.

Sincerely,