Title: Mothers' efforts to overcome difficult twists and turns in living with children with cancer:
a phenomenological study
Version: 1 Date: 28 Jun 2024
Reviewer's report:
I read with interest your qualitative findings regarding mothers' lived experiences with their
child's cancer. While much has been published on this topic, few papers represent the
experiences of mothers in Iran, I appreciate this opportunity to focus on their experiences. And
to this end, my first recommendation for the discussion is to call out unique experiences of the
mothers in your studies as compared to other studies previously published OR as importantly the
lack of differences in these mothers' experiences. Both aspects of mothers' experiences would
be of interest to readers. Since few papers have focused specifically in this cultural context, your
study provides important contributions to the literature.
Overall, the article is very well written. I will list my comments and suggestions below that will
align with the manuscript copy.
In abstract - you use the term gestational mothers - does this mean biologic or biological
mothers? If so, I think this term will be more understandable to readers.
Methods: 1. Please report methods in past tense. 2. First sentence, please delete current and
change employ to employed. 3 . You write that the analysis methods were used to "make
sense" of the data. This phrase is not commonly used from my perspective, the analysis helps
to summarize and interpret findings - is that what you meant? 4. Suggest using simple terms to
help make writing clear consider replacing utilization with use.
Results:  I appreciated how you listed code/category, then summary of findings and an
illustration (quotation). This really makes the information very understandable and easy to read.
Conclusions: I am not sure what reductions in cultural taboos means - please provide 1-2
examples to help the reader understand. If it is specifically related to cultural context these
examples are critical.
Discussion: In first paragraph, line 8 please include a page number for the quotations associated
with Heidegger. Important to not include new findings in the discussion, so please clarify what
is in the quotations? If attributed to the author need to include a page number for each. If these
are parent quotations, please limit discussion to interpretation of findings and not introduce new
findings in the discussion. Second page of discussion, need to include a citation for the sentence
that includes 'life-deadlock.' I think it relates to citation 22 but not clear. The phrase 'cancer-
diagnosed' is awkward, rather other mothers of children with cancer.  Finally, I would like for
you to explain any unique experiences Iranian mothers that might be related to religious views
of illness that were reported or perhaps how there were not any of these types of influences
noted and thus underscores a more universal experience of a mother when her child has cancer.
Finally, please elaborated on your final sentence under conclusions .... will require extensive
cultural interventions within the health care system such as... What surprised and pleased me
is that there didn't seem to be cultural differences for this largely (I think given the country)
Muslim sample of mothers as compared to other research of mothers from other cultures, i.e.
North America, Europe, Asia
Thank you again for this very interesting work.