Title: Validation of the Premenstrual Symptoms Questionnaire Among Mongolian Nursing
School Students
Version: 1 Date: 15 Oct 2024
Reviewer's report:
The paper is interesting. However, I raised some concerns that may improve the paper.
Introduction
1. Contextual Background: The introduction should provide a more comprehensive overview
of the prevalence and impact of premenstrual symptoms (PMS) and premenstrual dysphoric
disorder (PMDD) in Mongolia specifically. This would help justify the need for a validated tool
in this context.
2. Literature Review: There may be a lack of references to existing studies on PMS and PMDD
in similar populations or regions. Including this information could strengthen the rationale for
the study.
3. Objectives Clarity: The objectives of the study should be clearly stated. While the aim to
translate and validate the PSQ is mentioned, specific research questions or hypotheses could
enhance clarity.
Method
1. Sample Size Justification: The study mentions analyzing data from 431 students, but it does
not provide a rationale for this sample size. A power analysis or justification for the chosen
number of participants would be beneficial.
2. Inclusion/Exclusion Criteria: While the criteria are outlined, it may be useful to elaborate on
how these criteria were determined and whether they align with similar studies. This could help
in understanding the generalizability of the findings.
3. Pilot Testing Details: The method of pilot testing the questionnaire is briefly mentioned. More
details on how feedback was incorporated into the final version of the PSQ would provide insight
into the rigor of the translation process.
4. Statistical Analysis: The statistical methods used for validation (e.g., Kappa values, ICC) are
mentioned, but a more detailed explanation of why these specific methods were chosen and how
they relate to the study's objectives would enhance the methodological rigor.
Results
1. Clarity and Organization: The results should be presented in a clear and organized manner.
It would be beneficial to use subheadings to separate different types of results (e.g., reliability
analysis, validity analysis, demographic characteristics) for easier navigation.
2. Statistical Reporting: While the internal consistency (Cronbach's alpha) is reported as 0.945,
additional statistical details such as confidence intervals or standard deviations for the scores
would provide a more comprehensive understanding of the data.
3. Factor Analysis Details: The results mention that factor analysis supported a one-factor
structure. However, more details on the factor analysis process (e.g., type of factor analysis
used, criteria for factor retention, loadings of items) would enhance the transparency and
reproducibility of the findings.
4. Correlations with External Measures: The correlations with the PMDD Scale, SSS-8, PHQ-9,
and BAI are mentioned, but it would be helpful to include the exact correlation coefficients and
significance levels for all measures to provide a clearer picture of convergent validity.
5. Demographic Characteristics: While demographic data is likely included, a more detailed
breakdown of the participants' characteristics (e.g., age range, educational background,
menstrual history) would help contextualize the findings and assess the representativeness of
the sample.
6. Visual Representation: Consider including tables or figures to visually represent key findings,
such as the correlation matrix or factor loadings. This can make the results more accessible and
easier to interpret.
7. Limitations of Results: The results section should briefly acknowledge any limitations related
to the data collection process or sample characteristics that may affect the interpretation of the
findings.
8. Comparison with Previous Studies: If applicable, the results could briefly mention how the
findings compare with those from previous studies on the PSQ or similar instruments in other
populations, which would provide context for the significance of the results.
Discussion
1. Interpretation of Results: The discussion should provide a deeper interpretation of the
findings, particularly how the reliability and validity of the Mongolian PSQ compare to other
validated instruments in different languages or cultures.
2. Limitations: While some limitations may be acknowledged, a more thorough discussion of
potential biases, such as selection bias or cultural factors influencing responses, would provide
a more balanced view of the study's findings.
3. Implications for Practice: The discussion could benefit from a clearer articulation of the
practical implications of the findings for healthcare providers and policymakers in Mongolia.
How can the validated PSQ be utilized in clinical settings?
4. Future Research Directions: Suggestions for future research could be expanded. For instance,
exploring the PSQ's applicability in different demographics or settings within Mongolia could
be valuable.