Title: "Family and society empowerment": A content analysis of the needs of Iranian women
who experience domestic violence during pregnancy: A qualitative study
Version: 2 Date: 10 Jan 2023
Reviewer:  Jennifer Ayton
Reviewer's report:
Thank you for the opportunity to review the manuscript; Family and society empowerment":
Abused women's exclusive needs during pregnancy- A qualitative study
This is an important topic. I applaud the authors for their efforts to document women’s stories.
To increase the strength of the reported study I suggest the following edits to the paper detailed
below. I suggest a careful grammatical edit and defining your key terms and using consistent
terminology throughout to improve the readability of the paper.
I wish the authors all the best with their revisions.
Title: may I suggest a change to the title; A content analysis of the needs of Iranian women who
experience domestic violence during pregnancy: A qualitative study
Abstract.
Line 38 – grammatical error ‘Abused pregnant women required several’ And delete the word
‘several’.
Line 40- It is unclear what is meant by ‘exclusive’ could you either delete this word or use a
more specific descriptive term such as social, family or personal needs?
Findings
Please briefly provide an overview/summarize the key findings first before narrowing to the
key finding.
Conclusion
The term abused pregnant women may be misinterpreted as it does not speak directly to intimate
partner & domestic violence. Please clarify and be consistent when using terminology. Please
address this within the manuscript as well.
Line 47- grammatical error – ‘was the main concept emerged from the data’ do you mean
emerging from the data?
Main manuscript
Line 63-65- include the date for the statistics reported, please.
I suggest you define ‘domestic violence in pregnancy here, in the first paragraph.
Again the term ‘abused’ is problematic- please revise.
Line 106- what is meant by ‘to authorize women against domestic violence’ please revise.
Line 111- Please clarify/quantify what is meant by ‘real needs’ this will help you then explain
the term ‘exclusive’ in your aim.
Line 116- Do you mean ‘the aim of this qualitative study was to explore the experiences of
abused Iranian pregnant women and identify their… (list the type of need) needs’.
Please consider including research questions or specific objectives.
Methods
Line 118-Under the heading Methods/Design please include a description and justify the
type of qualitative approach (descriptive, grounded theory, phenomenology, narrative etc) and
research paradigm (e.g., postpositivist, constructivist/ interpretivist) used in the first sentence
and paragraph. Please include a citation.
Line 120-Please include a citation for ‘conventional content analysis
Do you need another methodology citation to support the Content analysis as the one listed
(Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts,
procedures and measures to achieve trustworthiness. Nurse education today. 2004;24(2):105-12)
is more of an interpretation and overview.
Line 120-121. More information is needed here. Please include the rationale and the type of
content analysis used. Explain ‘conventional content analysis’.
Content analysis is the study of text – these are the unit of analysis. The aim, research design,
and paradigm should all align. Please include more information so that the reader can understand
the methodology of the study.
Line 123. Participants and setting
Line 123. I suggest you start with Setting and follow with Participants. Change the heading to
read Setting and participants
Before the participants are described include a description of the Sampling strategy then include
how and why research participants, documents, or events were selected; this will include much
of the information already provided under participants' criteria for deciding when no further
sampling was necessary (e.g., sampling saturation); rationale.
Consider including the number of births or fertility rate for the region in which the study was
undertaken to give context.
Line 127- did you include all pregnant women, irrespective of parity? If so please state this if
not please provide a rationale.
Mother age- include an age range, please. Was age part of the inclusion criteria?
Line 128- HITS- write out in full, please.
Line 130-do you mean ‘Clinically diagnosed physical and mental illnesses’?
Line 130- Please include details about how you identified and recruited the participants-women
and providers of care. How were they approached? Did the women self-report as domestic
violence victims?
Lines 133-136 this section could be moved to Data Collection. Delete the reference to tables
and include inclusion and exclusion criteria for the health professionals /disciplines.
Line 133- do you mean ‘with 14 women’
Data collection
Please describe the types of data collected; details of data collection procedures including (as
appropriate) start and stop dates of data collection and analysis, iterative process, triangulation
of sources/methods, and modification of procedures in response to evolving study findings;
rationale. This should be followed by Data collection instruments and technologies – the
description and rationale for the use of semi-structured -in-depth interviews. This section should
include a description of instruments (e.g., interview guides, questionnaires) and devices (e.g.,
audio recorders) used for data collection, if/how the instrument(s) changed over the course of
the study.
Line 139- please remove the word ‘adequate’
Line 140-were semi-structured and in-depth interviews conducted? please clarify the type of data
collected and the rationale. Was an interview guide used for the questions if so please include
it as part of the supplementary material.
Line 143- Please delete ‘due to participant approval.’
Line 144- t appears you used theoretical sampling to achieve saturation. Please clarify.
Documentation of approval by an appropriate ethics review board and participant consent, or
explanation for lack thereof; other confidentiality and data security issues
Was any other data collected? Field notes, policy, guidelines
Data analysis
please provide a description of data handling, verification of data integrity, data coding, and
anonymization/deidentification of excerpts.
How was the trustworthiness and credibility of the data analysis checked /managed – member
checking? Audit trail, triangulation etc?
Ethical consideration
Please include ethical considerations and data security issues. This is particularly important
given the sensitive nature of the topic and setting.
Trustworthiness
Line 175- it may be better to delete the first sentence (Guba and Lincoln's …) and explain how
this was done – and use the citation to support the process.
Line 178- Move the ‘Similarly purposive sampling with maximum variation and appropriate
participants and key informants were used to a section under Sampling strategy as part of Setting
and Participants and a citation is needed to support.
Line 180 How many researchers were involved?  And include their qualifications, please
If the main researcher was a student please state this and the type i.e., PhD candidate or other.
Line 186- SRQR. Please consider deleting this sentence or include how this was used as part
of the methodology
Findings
Line 189-193- The first paragraph is an opportunity to provide an overview of the sample. This
would include the participant's demographics and describe and interpret the HITS core and what
this means in relation to the aim of the study and the sample.
Please include the total number of participants here. If any withdrew – please include this
information in methods under Data collection. Did the mothers self-report their age and
education level or was demographic data collected? If so when and how and by whom. Please
include a statement about this under Data Collection – how was this data analysed?
Please refer to Tables 1 and 2 here.  Table 1. Remove the Participant 1 column and combine
tables 1 and 2. See the comment below.
This table requires editing- I suggest you summarise the data and include the mean and standard
deviation if possible for the variables, age, education gestational age, and HIT score. If you have
Confidence Intervals that would be even better.
Table 2. Please remove the Participant column and include the total sample size in the title.
Instead, combine Tables 1 and 2 and the first column should include the sample size of mothers
and the sample size of key informants
Table 3. please refer to this table and describe/use it to describe the findings. If a codebook was
used please include this as supplementary material or incorporate this into the manuscript.
Please include the gender, and the specifics of the sample of key informants  –i.e.,  midwifery
n=, reproductive health =n etc
Line 194 – Please consider a flow diagram or table to help the reader to show the derivation of
the codes, subcategories and final three categories.
Content analysis is about the context of the text (interview) and focuses on language and the
use of language – how was this assessed and coded? In a qualitative context sometimes this
is achieved by counting the number of times a particular work is used to describe a need. It is
also important when using content analysis and interpreting the data that the political and social
context (domestic violence and Iran) is taken into consideration when interpreting and coding
the data. Please make sure this is highlighted in the Findings as well.
Themes
This section requires editing. It is not always necessary to include all subthemes it is far better
to tell the story – the needs of the women using the themes as headings. This way you do not
overwhelm the reader.
It is better to use a combination of direct and indirect quotes/paraphrase quotes to support your
interpretation of the theme. Please do not end the theme with a direct quote otherwise the reader
is left to interpret the meaning. Using two participant quotes is unnecessary – perhaps rationalise
the use of direct quotes. Please include the gender of the participant to support context or another
descriptor such as the occupation of a key informant.
Strength and Limitations
There is no need to repeat the aim of the study at the start of this section- please delete the first
paragraph.
The authors state that some interviews were undertaken via phone- I do not recall reading this
in the methods section. Please make sure this is included as part of the data collection.
Apologies if I missed this.
This section needs to include limitations such as trustworthiness, transferability, triangulation,
and any known bias- such as one researcher undertaking the coding, rigour, what is missing
from the study, and what would strengthen the study.
Ethical consideration
Much of this information has already been included in the Methods section. Please review and
delete or move any relevant information to the Methods section as it is not needed here.