Reviewer’s report
Title: 
Internal growth of women with recurrent miscarriage: a qualitative
descriptive study based on the post-traumatic growth theory
Version: 
2 
Date: 
22 Dec 2022
Reviewer's report:
Thank you for the opportunity to review manuscript entitled "Experience of
internal growth of women with recurrent miscarriage: based on the posttraumatic
growth theory." It is an interesting and relevant research, especially as it focuses
on experiences of women from Korea. My main feedback is that these paper
lacks proper command of English which makes it challenging to understand.
Collaborating with an English-speaking author may greatly benefit the paper.
Moreover, reason for this study and its significance is unclear.
Below please find my specific feedback.
Abstract:
Be more tentative in your language - not all women experience "despair" -
change to "may experience despair" instead. Frustration is too mild of a
descriptor when defining trauma, consider using a different adjective.
Background:
The general definition of loss is not necessary here since this is not the focus of
the article. 
Discussing prevalence of recurrent miscarriage would be helpful to illustrate that
in general this is not a common occurrence. Also including reasons associated
specifically with recurrent miscarriage rather just miscarriage in general would
be helpful. 
Provide more information regarding PTSD and miscarriage. There are few
studies that looked at this relationship as well as relationship between PTG and
miscarriage. 
You mentioned "fatal impairment" for untreated PTSD - can you cite specifically
what does that include? Is there a relationship with suicidal behavior?
Provide more information regarding PTG theory - there is a huge leap in
logic/assumption of how deliberate rumination fits with this theory. 
Introduction of study focused on cancer does not seem to fit the general
narrative. Please restructure and include the reason for discussing this study and
it's relevance. 
The reason for conducting this study is unclear- please strengthen the argument. 
Methods
Research design 
Thematic analysis is a method of analyzing the data not a study design. Please
include the study design. 
Participants - provide more information.
Results
Was the theme 4 centered around God, religion or spirituality? This could be
better defined as those terms are not interchangeable. Spirituality may be more
inclusive term here. 
Discussion
This was not a causal study so causality should not be inferred. 
A lot of what is discussed in this section should have been explored in the
introduction.
PTG theory is overly simplified in this paper and it is unclear how the result fit
with the theory. 
Declaration of competing interests
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
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