Professional and Family Carers’ Perspectives on the COVID-19 Pandemic and Its Impact on Supported Decision-Making with Adults with Intellectual Disabilities: A Qualitative Online Survey

Round 1

Reviewer 1 Report

Personal choices of people with ID is a topic of growing interest. Until now, little is known about how Pandemic affected this aspect. So the aim of this study is relevant.

I hope that the following recommendations will be useful in improving this good paper:

-I think that brief explanation about the adecuation of the qualitative approach chosen could add value to this paper. Also, being aware that qualitative research is influenced by the researcher’s position, it could be included a paragraph about author's position. More details about authors contributions during the process or way to ensure rigor could be proporcionated to ensure transparence and credibility.

-People with disability voice should be taken into consideration. The sample didn't include them. It could be considered in limitations section in order to future research take it into account. 

-There's a little mistake in themes numeration (3.1 appears two times and there isn't 3.2).

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear colleagues,

It was a real pleasure to read and learn from your article.

I advise the editor to ask for some minor adjustments from you  before the article can be accepted, I hope you can find my questions sufficiently valuable

1. the characteristics of the group of people with intellectual disabilities are so varied that some additional information about the participants in your study is appropriate (it is clear that someone with severe disabilities often leads a very different life than a young adult with mild intellectual disabilities, for example)

2. can you elaborate on the difference between a 'reflexive' thematic analysis and a thematic analysis tout court?

3. the illustrations accompanying the analysis are useful, but in my opinion deserve additional explanation

4. 37 responses were received, sixteen of which turned out to be useful--> can we have more information why some of the respondents dropped out?

5. can we get - in the introduction e.g., - a little more info on the use/deployability of remote support in Ireland?

6. throughout the article, the distinction 'lives with family'/lives in a facility is maintained --> are there typical characteristics that characterise both groups and can help us understand differences in the analysis?

Author Response

Please see the attachment

Author Response File: Author Response.docx

Reviewer 3 Report

Thanks for the opportunity to review Disabilities 2283408 The Impact of COVID-19 on Supported Decision-Making in Adults with Intellectual Disabilities: An Online Survey of Professional and Family Carers. This topic is important because it explored the impact of COVID-19 on carers for individuals with intellectual disabilities. However, there are several areas that need to improve. Please see the following comments to see more details.

Introduction

·      This manuscript summarized the topic well. Definitely, exploring the experience of caregivers and service during the COVID-19 is important.

·      According to the intro, what we already know is about COVID-19 restrictions on negatively affected shared decision-making (SDM) of individuals with disabilities. The authors indicated that they were interested about the effects of COVID-19 on SDM practices among adults with intellectual disabilities. However, this qualitative manuscript explores carers’ experience during the pandemic, but it does not directly discuss the impacts of the pandemic on SDM practices as the title indicate. To improve this manuscript for the publication, it will be critical to align title, intro, and result section.

Methodology 

• 2.2 Procedures
• How did you come up with the survey questions? Any framework did you use? Or was it based on the literature review?
• Did you take the validity test for the survey questions? What was the result for validity check of your survey questions?
• 2.3. Data analysis
• Need more description on data analysis, relating with Figure 1 and 2. It looks like different subthemes were made between family carers and professional carers.  How did they have main themes despite it? Need more explanation is needed.

Results

·      I believe participant demographic information needs to be a part of 2.1 demographic information.

·      Numbering needs to be corrected for 3.1. Adapted Covid. It needs to be converted to 3.2. Adapted Covid instead.

·      As I commented above in 2.3. data analysis, it is difficult to see how overall themes are related to sub themes. Because of the lack of the related details, it is difficult to connect the quotes to the themes. For example, some quotes on family cares from 3.2 Adapted Covid sound better fit to the section to 3.3. Restricted Lives.

o   This does not limit to only those sections. Please review the whole findings section and revise or justifying as needed.  

Discussion

·      Overall, this manuscript made great points on providing supports on the needs for family and professional carers based on the results. In addition, the authors did great job in coming up with strategies of how to better support these stakeholders by using technologies.

·      However, it was hard to connect the COVID-19 restrictions on SDM. Rather, this study describes the effects of COVID-19 on carers’ experiences. This raise a question that the focus of this study is about SDM.

·      The strengths and limitation section seems not to be complete. As the authors addressed, the small sample size is limited, which means the findings could not be generalized.

Author Response

Please see the attachment. 

Author Response File: Author Response.docx