Reviewer’s report
Title: 
Middle-aged Lebanese women interpretation of sexual difficulties: A
qualitative inquiry
Version: 
0 
Date: 
22 Feb 2020
Reviewer: 
Ibrahim A.
Reviewer's report:
Dear Editor 
I am grateful to give me the opportunity to review the article entitled (Middle-
aged Lebanese women interpretation of sexual difficulties: A qualitative
inquiry).
Although the article discussing an interesting subject, I have concerns regarding
the article presentation and ethical consideration.
1. Authors in the abstract stated that the article (The study is part of a work
programme that is guided by a qualitative research design to provide a
comprehensive understanding of women`s sexuality.) I cannot find specific aim
for the article in the abstract or the article is an announcement about the authors
future program. Then the authors mentioned at the end of the introduction that
the article aim (to present a narrative analysis of the meaning and experiences of
sexual concerns and difficulties from the perspective of middle-aged Lebanese
women). I found that the authors contradict themselves.
2. Key words is too long and not indicative (Female sexual difficulties/problems,
sexual health, middle-aged women, qualitative study, semistructured interviews,
focus groups).
3. Sample size (52 Lebanese women aged 40-55 years women used in the
authors article). On what scientific sample size program this sample size was
used to produce a statistically accepted figure. In addition, I cannot find any
scientific statistical analysis in this article.
4. Participants section (Authors mentioned that the women were recruited from
clinical and non-clinical settings (mammography units of two university
hospitals, one private and one public, outpatient clinics, and working
organizations). I cannot understand how many hospitals from which women were
recruited for this study and what is the meaning of no-clinical setting.
5. Participants section (who had acute or chronic physical problems) what is the
meaning of acute or chronic physical problems.
6. Participants section; authors mentioned that (The interviews were audio
recorded and transcribed verbatim along with all the fieldnotes and both verbal
and non-verbal cues. Reflections, impressions and preliminary interpretations
were added). Did the authors take an consent from the women for publication of
their data for scientific work?. 
7. In the ethical approval authors mentioned that (Authors mentioned that ethical
approval was obtained from the Research Committee/Institutional Review Board
at the University of Balamand and Saint Georges Hospital University Medical
Centre. Another one was obtained from Rafik Hariri University Medical Centre).
Two universities for ethical approval while authors stated that the recruited their
women from non-clinical setting what is the meaning of this non-clinical setting
and what is the organization that give approval to collect data for research from
this non-clinical setting?. 
8. Authors mentioned that the consent for publication is not applicable. Did the
authors take approval from the women to publish their data in scientific journal?
Definitely no as the authors mentioned. 
Based on the above-mentioned reasons and the highlighted parts in the attached
article PDF, I am sorry I cannot accept this work for publication. 
Regards 
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
No
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
Not relevant to this manuscript
Quality of written English
Please indicate the quality of language in the manuscript:
Acceptable
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 conflict of interest in relation to this article
I agree to the open peer review policy of the journal. I understand that my name
will be included on my report to the authors and, if the manuscript is accepted
for publication, my named report including any attachments I upload will be
posted on the website along with the authors' responses. I agree for my report to
be made available under an Open Access Creative Commons CC-BY license
(
http://creativecommons.org/licenses/by/4.0/
). I understand that any comments
which I do not wish to be included in my named report can be included as
confidential comments to the editors, which will not be published.
I agree to the open peer review policy of the journal