Emotional Shifts and Recovery in the Post-COVID-19 Era: A Retrospective Survey Among Adolescents in Vietnam

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Summary

The article addresses a highly relevant topic: the emotional impact of the COVID-19 pandemic on adolescents and their subsequent recovery. Through a retrospective survey of high school students in Da Nang, Vietnam, the authors highlight the persistence of negative emotions such as sadness, fear, and anxiety, as well as the transition to positive emotions in the post-lockdown phase. This study contributes to understanding the long-term effects of public health crises on adolescent mental health and provides recommendations to improve social policies and services in future crises.

While the topic is pertinent, the article presents significant weaknesses in its structure and execution. Although it highlights important emotional changes in adolescence, the chosen methodology and some inconsistencies in the analysis hinder the extraction of solid conclusions. The article could benefit from structural adjustments and a more detailed discussion, particularly connecting the findings to concrete intervention strategies.

Below, I offer some comments that could enhance the manuscript's quality.

 

General Concept Comments

·         Introduction:

-          Strengths and Recommendations:

o    While the justification of the topic is strong, prior studies analyzing the relationship between mental health and COVID-19 in Vietnam, particularly among adolescents or adults, should be included. The current focus relies heavily on examples from China and the United States, offering limited insights into Vietnam-specific pandemic outcomes. Relevant literature is available but not reflected in the manuscript.

o    To improve clarity, the contextualization of the problem could be presented as a summary table, synthesizing the key factors affecting Da Nang during the pandemic.

o    Epidemiological data, such as the virus's impact on the population, youth infection rates, and mortality rates (for Da Nang and Vietnam), should be included to provide a comprehensive background. Was the epidemic more or less severe in this region compared to others in Vietnam?

-          Structure:

o    Consider restructuring the introduction to begin with theoretical elements and conclude with the contextualization of the pandemic's impact on Da Nang and its young population.

o    Section 1.5 (lines 108–122) should be restructured to present the study's main objectives, general research questions, and corresponding hypotheses. Details related to data collection (lines 111–112) should be moved to the methodology section.

o    The fourth research question (lines 120–122) is not clearly addressed in the manuscript.

 

·         Materials and Methods:

o    Was the selection of schools conducted through purposive or probabilistic sampling? (Lines 128–130). If non-probabilistic, this should be explicitly noted as a limitation.

o    Has the methodology used in questionnaire development and subsequent analysis been previously validated? Relevant references should be included in this section.

o    The origin of the encryption in Table 1 is unclear. Does it derive from qualitative questionnaire responses? If so, the methodology should provide a more detailed explanation of the coding process.

o    Are these codes based on pre-validated categories? If so, the source should be cited.

o    Indicate whether triangulation was employed between qualitative and quantitative data.

 

·         Results:

o    Figure 1 connects categories with continuous lines, implying a continuum in a set of variables that are inherently categorical. For this type of data, it would be more appropriate to use grouped bar charts or mosaic plots, where emotions are displayed as independent categories rather than a continuum.

o     Although resilience is mentioned among certain adolescents (evidenced by the presence of positive emotions such as enthusiasm during the pandemic), there is no in-depth analysis of whether a specific group consistently maintained positive emotions throughout the study period. The manuscript lacks disaggregated data or longitudinal analyses to identify and characterize such a group. Thus, the fourth research question (lines 120–122) lacks strong evidence and is challenging to answer in its current form.

·         Discussion:

o    The discussion needs to be expanded to include a more comprehensive analysis of the results and compare them with evidence from previous studies.

o    While the prevention strategies proposed for future crises are interesting, these recommendations should be more explicitly linked to the study’s findings.

 

·         Conclusions:

o    The conclusions reiterate the main results without delving into their practical or scientific implications. Reformulating the conclusions to emphasize the study's key contributions and the applications of its findings would be beneficial.

o    It would also be important to highlight methodological and analytical limitations, as well as propose future research directions based on the results obtained.

Specific Comments:

o   Include the total sample size in the first paragraph of the methodology section (lines 125–133).

o   Avoid short sections of only a few lines (e.g., page 4).

 

The article addresses an essential and timely topic, as understanding adolescent mental health in the aftermath of the COVID-19 pandemic is crucial for guiding future interventions and policies. The study provides valuable insights into emotional shifts among adolescents in Da Nang, Vietnam. However, the manuscript requires further refinement in several key areas before it is ready for publication. These include clarifying the origin and coding process of Table 1, ensuring methodological rigor in the questionnaire’s validation and sampling strategy, and addressing the limitations that prevent a clear response to the fourth research question. Additionally, the presentation of results, particularly Figure 1, should align with the categorical nature of the data. Expanding the discussion to better integrate the findings with existing literature and practical implications will also enhance the article's contribution to the field.

Author Response

We are very grateful to the reviewer who has given us a lot of suggestions to improve. The reviewer indeed spend a lot of time to give this paper detail comments. It is very convenient for us to respond one by one.

Comment 1: To improve clarity, the contextualization of the problem could be presented as a summary table, synthesizing the key factors affecting Da Nang during the pandemic.

Response: Figure 1 is added to illustrate the structure of this study. Since this is not an explanatory study for the COVID-19 medical impacts on Da Nang, but an exploratory study on the psychological states of young people before and after the pandemic, the factors studied are psychological reports on 5 positive and 6 negative emotions (Figure 1 and Table 6).

Comment 2: COVID-19 data of DaNang as compared to Vietnam.

Response: Added in line 64-69.

Comment 3: Provide theoretical elements as Introduction.

Response: revised accordingly, please refer to lines 46-53.

Comment 4: To restructure Section 1.5 for clear statement of research purposes, and data collection to be moved to methodology.

Response: corrected accordingly. Please refer to lines 130-143.

Comment 5: Fourth research question not addressed.

Response: The fourth question is deleted to include those only fully discussed in methodology and findings.

Comment 6: Selection of schools and its representativeness.

Response: Appropriatness and representativeness is clarified in lines 148-151.

Comment 7: Validation of questionairres.

Response: Citation and explanation of measurement tools were further elabotated in lines 172-211. 

Comment 8:  Origin of the encryption in Table 1.

Response: The Origin of the encryption in Table 1 is created by authors. An explanatory note is added in lines 251-252.

Comment 9: Origin of codes.

Response: Construction of codes is further clarified as from lines 231-249.

Comment 10: Triangulation between qualitative and quantitative data.

Response: An additional paragraph is added to explain the comparison of two sets of data. Please refer to lines 436-444.

Comment 11: Contributions of the study.

Response: A paragraph is added about contributions to replace the repetition of results. Please refer to lines 494-496.

Comment 12: Limitation of study.

Response: Recognition of limitations, contribution and and proposal for future research is added in lines 487-499.

Thanks many for the very detail guidance.

 

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

See enclosure

Comments for author File: Comments.pdf

Author Response

We are very grateful to the reviewer who has been very supportive and provide us a lot of suggestions to improve. Below are our responses:

Comment 1: The need to provide data on mental health of young people in Vietnam before COVID-19 for comparison.

Response: Since there is no direct data available for young people in Da Nang, a comparison is drawn with a study in 3 cities namely Hanoi, Hue and Hu Chi Ming conducted in 2019. Please refer to lines 421-435.

Comment 2: The study did not differentiate the performances of students with and without psychological weaknesses before the study.

Response: As psychological weaknesses of students are protected by personal privacy, we recognized that as a limitation and recommended for future research. Please refer to lines 499-501.

Comment 3: How well can young people expressed their emotional experiences and learn emotional regulation?

Response: This is the limitation of most self reported psychological studies. This research has identified only 5 positive emotions and 6 negative emotions which are not too difficult to evaluate and differentiate. This study unfortunattely, has not measured factors for successful emotional regulation. Again, this may be an area for future research. This need is added to line 502-504.

Thanks again for pointing out the inadequacies of this study.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

After reviewing the changes made, I believe the manuscript has improved substantially. The revisions have enhanced the clarity and rigor of the study, and I consider it suitable for publication.

Author Response

We are very grateful to the reviewer