Reviewer's report
Title:Comparison of health-related quality of life between housewives and
employed women in Zahedan City, Southeast Iran during 2009-2010 : A
cross-sectional study
Version: 6Date:8 May 2012
Reviewer: Pawel Zagozdzon
Reviewer's report:
The authors report data on Quality of Life in housewives and employed women in
southeast Iran. This is in principle an interesting investigation since it deals with
the important issues related to social determinants of women health in the
context of culture dominated by Muslim religion.
Major Compulsory Revisions:
The major methodological concern is related to lack of controlling for several
important confounders in the analysis. There are significant differences in major
characteristics between housewives and employed women (Table 1). Employed
women were older and better educated. These differences were not addressed in
the analysis of health-related Quality of life in this paper. It is well known that
education positively affect quality of life. The authors fail to adequately
characterized groups under the study. It would be interesting to see the
differences regarding the income and number of children between the two groups
as aforementioned characteristics may also influence quality of life in women. In
order to correctly address the question posed in the paper some kind of
approach to the multivariate analysis should be proposed to assess the role of
employment independently of other variables.
Minor Essential Revisions:
There are also a few minor issues that would need attention before it could be
published and I have listed some comments below:
1. 1. Page 2 line 6 and Page 4 line 7: authors use term “case-control study” for
design and methods used in their work. From technical point of view this is not
case-control study as there are no cases of any disease at the start of
investigation but simple two groups comparison coming from survey and groups
were distinguished according to employment status. Obviously, the data from
survey can be analysed like in case-control study if definition of “cases” is
applied. The cases would be those with worse health-related QoL.
2. Page 3 line 16: data on Iranian women labor force participation need to have
adequate reference.
3. Page 5 line 1 to 7: it seems that the standard version of SF-36 was used in the
standard way. Therefore it is not necessary to described it in details.
4. Page 5 line 9: non-parametric version of ANOVA should be considered as the
QoL data usually does not have normal distribution.
5. Page 7 line 5: Authors refer to study limitation. They should emphasize
cross-sectional character of this study and the lack of information about important
confounders e.g. the income level of the participants.
This is a informative article and will be an important contribution to the literature
in documenting the impact of social participation and employment on women
quality of life.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
I declare that I have no competing interests