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: 
13 Mar 2023
Reviewer: 
Sadika Akhter
Reviewer's report:
Review Comments: 
The study was completed in 2017; why are the authors publishing the manuscript
now? Please explain why the authors are so late in publishing the findings. 
Please clarify the timeline of the data collection. The authors mentioned that the
interviews were conducted from May-July, 2017. Still, in line number 86, it is
written that in-depth interviews were conducted with research participants from
July to December 2017. The authors stated that they had applied a semi-
structured interview questionnaire, but they presented all open-ended questions
in table 1. Why the authors used a semi-structured interview questionnaire? Why
haven't they presented them in table 1? Please provide the rationale for using the
semi-structured questionnaire. 
What was the sampling procedure of the study? How the authors recruited the
study participants? How do the authors reach themes? What were the sub-
themes? The authors didn't provide any details of the process. Please explain
where the study was conducted. 
Which author conducted the interviews? What was the language of the
interviews? Who translated the interviews if interviews are conducted in the
Korean Language? How did the authors ensure the data's meaning when
translating the findings into English? What is the educational background of the
authors? The details lacking in the manuscript in the method section and why?
The authors mentioned the author's contribution at the end, but details are needed
to present in the data collection section. 
The authors mentioned in line 88 that a transcription process was followed. What
type of transcription was done? Was it verbatim? Which author did the
transcription? How did the authors check the transcripts' consistency and
language when translated into English? 
The authors mentioned in line number 90-91 that researchers made the
questionnaire, and the validity of the content was verified by experts in theme
analysis and qualitative research. Who are these experts? Did you pilot the
interview questions in the natural field before data collection began? If not, why?
The data analysis part is written in brief. Who did the coding? How many
authors performed the coding? How was the rigour of the data ensured? How
many codes emerged from the data initially? How were the themes developed?
Why haven't the authors mentioned the data analysis process in detail? What
about the point of data saturation? How did the authors ensure the inter-coder
reliability? Only referencing the articles is not enough. What and how the
authors' analysed data by following the process of the referred articles are not
there. 
There is a variation in the number of miscarriages among the participants from 3-
10 times. How did the authors interpret the data about post-traumatic stress
disorder (PTSD), who had experienced more miscarriages than other
participants? 
The authors didn't follow the process of presenting quotes. They presented
quotes, but it is unclear whether the quotes were from one or two or three
participants. Please see the quotes under theme 1. Please review the quotes from
line number 123-127. It is not clear. Secondly, in quotes, an inverted coma was
given end of the sentence after the full stop; in some quotes, an inverted coma
was given after the full stop. Please follow a consistent process. Thirdly, in lines
162-63, the authors levelled the interview quotes of P9 and 30s but haven't
levelled any other quotes as per the number of the interview. Is it "P9" means
that a pregnant woman is nine, and what about the 30s? 
Please see the quote below from line number 173-80. Is it the quote from one
participant? If yes, why did the authors write these quotes under several inverted
commas? If these quotes are from different participants, why haven't the authors
levelled them under Pg1, 2….. 
"I am now over 40 years old. But I think I've just become an adult. Before, it was
thought that pregnancy and
childbirth were easy and natural for women. My mother looks great, and how
grateful for her... My point, for now, is that I am growing up".
"The experience of miscarriage is like mud in water... I don't think it can be
cured. Nevertheless, I think that the
experience is meaningful. I became more grateful for my life and started to think
about what I would do as a good woman."
"Previously, I could not live a woman's life differently. But I also live an
unpredictable life... so
it could be... There is not only one way in a woman's life..."
Overall, grammar and spelling checking is needed. Please see the spelling
mistake in theme 5. Please elaborate on the discussion part more with some
references. 
I suggest the authors provide more detailed information about the study
participants' demographic information. What do they mean by High School?
What type of job do they do? Do they have a child? Are the participants married?
If yes, how their husbands helped them to cope? Did they receive any support
from their families? The authors can present these data in the result section. 
Declaration of competing interests
Please complete a declaration of competing
interests, considering the following questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests' below
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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?
No
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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