Engaging in Action Research with Nurses: Overcoming Challenges and Gaining Positive Insights into End-of-Life Care
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
Thank you for the opportunity to review this manuscript. I consider there is some merit in the content, but it will need additional work before it is ready for publication.
Line 17 remove the word needy to significant care for example...
Line 34 The article does not analyse the author does
Lines 40-41 re write to connect in the same sentence
Line 43and 52 needs reference to support evidence
Lune 54 its stated a new research method please discuss
Line 55-59 re write theses sentences so they are clearer
Line 60 mention belief is this the aim of the research?
Line 75 was ethical approval from the family/patient to include such personal information in a publication?
Line 134 I am uncertain as to what is being referred to is this the Case study or the patient?
Line 155 is author referring to the action part of the research?
Line 226 is author referring to Psychological support?
Line 307 Author states participants were patients I am uncertain this was the case
Comments on the Quality of English Language
Some rewriting required, sentence structure and content in the manuscript I have noted this above.
Author Response
Dear Reviewer
We would like to thank you for their prompt review and accurate comments.
Based on your comments as well as those from the other reviewers, we have revised the introduction and methods sections as outlined.
We have expanded the introduction to focus more deeply on current research and interventions in end-of-life care. We have included information on what kinds of research and interventions are being conducted in the fields of end-of-life and geriatric nursing, and how action research and case study methods are useful in this context, including what they entail. We believe these revisions address your following comments. Could you please review the background and methods sections again?
- Line 17 remove the word needy to significant care for example...
- Line 34 The article does not analyse the author does
- Lines 40-41 re write to connect in the same sentence
- Line 43and 52 needs reference to support evidence
- Lune 54 its stated a new research method please discuss
- Line 55-59 re write theses sentences so they are clearer
- Line 60 mention belief is this the aim of the research?
- Line 75 was ethical approval from the family/patient to include such personal information in a publicat
Yes, we have obtained consent from the individuals involved. This point has been included in the section on ethical considerations.ion? (p6 L233~234)
- Line 155 is author referring to the action part of the research?
As you pointed out. We believe that by adding Figure 1 related to the research process, we have clarified this part.
- Line 226 is author referring to Psychological support?
This section demonstrates how detailed support during training improved knowledge and skills while being attentive to individual circumstances. (P8 L344)
- Line 307 Author states participants were patients I am uncertain this was the case
Sorry for the confusion. The subjects of this study are four nurses who provided care to patient A and participated throughout the research period. However, for patient A, ethical considerations were necessary, so we obtained consent after explaining the purpose of the study, the assurance of voluntariness, and other relevant details. This is detailed in sections 2.3 Participants (P4 L164) and 2.6 Ethical Considerations (P5 L227).
Thank you once again.
Reviewer 2 Report
Comments and Suggestions for Authors
Dear authors
Reviewing your paper was exciting. Congratulations!
Your paper is well-written and follows the scientific guidelines for reporting these studies.
In my revision, I just suggest the following:
1) "Study limitations and challenges"
a) to include the method limitations and the bias
2)"Conclusions"
a) Instead of describing what you did, you must write what the study achieved.
Congratulations
Kind regards
Author Response
Dear Reviewer
We would like to thank you for their prompt review and accurate comments. We have made revisions and additions based on your comments as outlined below. The corrections are indicated in red in the manuscript. Please review the updated content.
- "Study limitations and challenges"
a) to include the method limitations and the bias
In this study, we have demonstrated that the two methods used yield useful results. However, there are also challenges, such as the need for long-term practical research and the development of facilitators. We have added these points to the manuscript (p13 L560~565)
- 2)"Conclusions"
a) Instead of describing what you did, you must write what the study achieved.
Thank you for your advice. We have revised and added to the latter part of the conclusion to focus on the insights gained from this study (p13 L570~577)
Thank you once again.
Reviewer 3 Report
Comments and Suggestions for Authors
Excellent work, it provides evidence of the importance of nursing beyond the walls of a hospital and the benefit that terminally ill patients can obtain from an approach like the one they propose.
It would be beneficial for the transparency and reproducibility of the research to include a statement about the availability of the data used in the study, indicating whether they are open to other researchers.
Author Response
Dear Reviewer
We appreciate your prompt review despite your busy schedule. Your encouraging comments are a great motivation for us to continue our research. Thank you very much.
Reviewer 4 Report
Comments and Suggestions for Authors
Dear Editor,
Thank you for the opportunity to review the article titled "Engaging in Action Research with Nurses: Overcoming Challenges and Gaining Positive Insights in End-of-Life Care." This study aims to explore the processes by which nurses support end-of-life cancer patients through frequent nurse calls and to gain positive insights through action research.
I am forwarding my suggestions for an article that requires significant improvements. The introduction needs to be expanded to more deeply and currently focus on the study's topic, which considers end-of-life care. It should discuss what studies and interventions have been developed in this area, how action research might be useful in this context, what it entails, and its stages.
The authors discuss action research, but based on the methodological aspects presented, I consider this to be a case study. The methodology is very confusing. Was it applied to just one patient? Were the participants only four ward nurses? How were the practices categorized?
I suggest revising the presentation of results and discussion accordingly, as the changed.
Best Regards
Author Response
Dear Reviewer
Thank you for your valuable comments despite your busy schedule. As you pointed out, the literature review in the previous submission was insufficient. Therefore, we have expanded the introduction to focus more deeply on current research and interventions in end-of-life care (Introduction).
We have included information on what kinds of research and interventions are being conducted in the fields of end-of-life and geriatric nursing, and how action research and case study methods are useful in this context, including what they entail. We believe these revisions address your comments. Could you please review the background and methods sections again?
Additionally, we apologize for any confusion caused by the use of the case study method in conjunction with action research, as it is a new approach and the literature review was insufficient.
We have added Figure 1 (p6) to illustrate the research process, clearly demonstrating that this study employs both methodologies.
Furthermore, we have explicitly stated that the participants include four nurses who were involved in the care of Patient A and participated in all practical research activities (2.3 Participants p4 L164).
With these revisions, we believe that the consistency of the previously presented results and discussion has been maintained, making our argument more convincing. We are grateful for your appropriate advice. Additionally, since other reviewers have approved the results and discussion, we have determined that it is best not to make major changes to these sections. We apologize for any inconvenience. We have further refined this study.
Round 2
Reviewer 1 Report
Comments and Suggestions for Authors
THank you for you rework of your manuscript, you have taken into consideration the reviewers' comments and your manuscript includes these.
Reviewer 4 Report
Comments and Suggestions for Authors
Dear Authors,
I would like to congratulate you on the effort dedicated to revising the article. It is clear that your efforts to enhance the literature review and deepen the introduction on current research and interventions in end-of-life care have added significant value to the study.
The addition of figures to illustrate the research process was particularly enlightening, clearly demonstrating that all phases are integrated, and clarifying methodological aspects for the reader.
Thank you again for your commitment to refining the study based on the feedback provided.
I look forward to the continued success of your work and the final version of the manuscript, which I believe will be a valuable contribution to our academic community.
Best Regards
