Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study

Round 1

Reviewer 1 Report

Thank you for this manuscript. A few issues have been identified that are pointed out below. 

a) Abstract:

The focus is clearly provided on persons with solid organ transplants. However, the rationale for the proposed review remains vague. A rationale stating that self-management in one particular group of patient has not been sufficiently explored, seems insufficient. 

b) Introduction: Although some numbers and general problems of persons with transplants are provided, the rationale for focusing on solid organ transplantation remains unclear. It is recommended to focus in more detail on the necessity of such a systematic work in relation to persons with solid organ transplants. 

This section may also profit of a tightening of the contents. It is suggested to start with general numbers, maybe followed by statistics in Germany. It could be helpful to be more specific on the associated problems of persons having to undergo solid organ transplantation such as inadequate lifestyle, etc. In addition, it seems relevant to provide an overview of potential challenges patients face when leaving the hospital after transplantation and trying to living life despite this invasive treatment and the underlying disease(s). It may then be logical to follow up with a short history of self-management. As this study is focusing on nursing, it is recommended to refer to nursing theories treating self-management or associated theories such as health promotion theories. This may help guide the subsequent manuscript. 

Based on these elaborations, it may be possible to describe the rationale for this study in more detail. After all, it is necessary to explain why self-management should be conceptualised differently for the patient group at the centre of this study. 

c) Methods:

It appears that three steps were undertaken including a systematic review of the existing writings on self-management, content analysis and some sort of mapping. It seems odd to not refer to existing ways of conducting a concept analysis in nursing such as provided in: 

Hupcey, J. E., Morse, J. M., Lenz, E. R., & Tason, M. C. (1996, Fall). Wilsonian methods of concept analysis: a critique. Scholarly Inquiry for Nursing Practice, 10(3), 185-210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9009818 

Hupcey, J. E., & Penrod, J. (2005, Summer). Concept analysis: examining the state of the science. Research & Theory for Nursing Practice, 19(2), 197-208. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16025698 

Risjord, M. (2009, Mar). Rethinking concept analysis. Journal of Advanced Nursing, 65(3), 684-691. https://doi.org/10.1111/j.1365-2648.2008.04903.x 

Rodgers, B. L., & Knafl, K. A. (2000). Concept development in nursing: foundations, techniques, and applications (2nd ed.). Saunders.

Please provide some sample search strings.

Reporting guidelines for scoping reviews can be found here: PRISMA (prisma-statement.org). It is recommended to check the manuscript accordingly.

d) Results:

Figure3 is not legible. Maybe something can be done about this?

Table 3 is very crowded.

The criteria put forward (section 3.6) to analyse the definitions, are difficult to understand. Please detail in the methods section the development of these criteria.

e) Discussion:

It is recommended to review the discussion in more detail. Currently, it seems more like a repetition of the results.

Please explain the term “forensic” in the limitations.

f) Conclusions:

Please aim to provide more concrete and practice relevant information in this conclusion.

g) General comments: 

Some language problems can be detected such as "complete life". It seems more adequate to write "full life". Another careful review is warranted. 

Reference to a thesis as part of the rationale needs further underpinning with published work. 

Would it be possible to develop another abbreviation than "SM" for self-management? 

Thank you.

Your reviewer

Some language problems can be detected such as "complete life". It seems more adequate to write "full life". Another careful review is warranted. 

Reference to a thesis as part of the rationale needs further underpinning with published work. 

Would it be possible to develop another abbreviation than "SM" for self-management? 

Author Response

Thank you for your comments- we attach a Word file in response.

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear authors, thank you for the opportunity to review the manuscript. The article summarises the concept of self-management among solid organ transplant recipients.

Below are my comments concerning the article:

1. In the abstract, please specify the purpose of the study. Please remove line 27-28.

2. In the introduction section, please consider the nursing intervention to increase self-management and self-care among transplant recipients.

3. In line 113, you state that you used the scoping review methodology in your study - however, in the method, there is no description of this.

4. Please systematize the description of the methodology section

Author Response

Thank you for your comments- we attach a Word file in response.

Author Response File: Author Response.pdf