Title: WOMEN'S EXPERIENCES WITH BREAST CANCER DURING DIAGNOSIS AND
THERAPY, WOLAITA, ETHIOPIA: A QUALITATIVE STUDY
Version: 2 Date: 03 Oct 2023
Reviewer's report:
Feedback for Author’s.
1. Title.
Your area of research topic is so interesting however you could modify little bit. And What
if your focus Women over all lived experiences or women lived experiences on diagnosis and
treatment.
Women’s lived experiences with breast cancer among women diagnosed by breast cancer. I
think this more appropriate if you did not focused specifically on women’s experience with
diagnosis and therapy.
1. Abstract: your abstract has structure however, its content is not attractive because abstract
should be self-explanatory and easy understandable for the readers.
Therefore please modify the following points
# Please re write it clearly sampling method, and the methodology part is not comprehensive.
So re write it by considering the main content of methods and materials.
# What are the main lived experiences that women reported in addition to these major themes?
Therefore include these main findings in the result part.
# Does not seems conclusion and constructed poorly. So, try to re write the conclusion based
on your main findings.
2. Introduction: It is good.
3. Methods; your main gap of your study is a method part, even content wise it is constructed
poorly. So I have commented on the manuscript doc so please correct accordingly and also we
have to include some important methods part not included yet.
4. Results: - Your interviews are seems shallow, because I have not seen which can’t be
addressed through quantitative methods.
# What are your main findings/ variables that does not addressed yet.
5. Discussion: It is not discussion, please rewrite it by considering the discussion contents.
# What are the content of discussion
6. Conclusion and limitation: please rewrite it in attractive way.
MATERIALS AND METHODS
Study Design and setting
This was a qualitative study involving breast cancer patients at Wolaita Sodo University
Comprehensive Specialized Hospital (WSUCSH). The hospital is located in Wolaita Sodo town
in South Ethiopia. The WSUCSH has nine departments, one of which is the Oncology clinic. The
WSUCSH serves approximately 3-5 million people in the Wolaita zone and surrounding zones.
Currently, it provides service for more than 500 patients of all cases per day. The oncology
department has three wards and consists of one oncologist, four medical doctors, and nine
nurses currently working in the clinic. The 2021 report of WSUCSH showed that approximately
800 cancer patients were treated at the oncology ward. Oncology OPD, inpatient service, and
pharmacy services are among the services provided by the oncology departments. There are 12
beds in the oncology inpatient unit. The research was conducted from August 1-September 30,
2022.
Participants
Participants were women diagnosed with breast cancer at least six months earlier and followed
up at Wolaita Sodo University Comprehensive Specialized Hospital (WSUCSH) in 2022. The
participants were recruited through purposeful sampling. We included women diagnosed with
breast cancer, undergoing any form of therapy and aged 18 and above. Those with mental health
illness, severe comorbidity, and unwillingness to or declined participation were excluded. Before
recruiting study participants, we reviewed all of the women’s clinical situations on their profiles
with the assistance of oncology clinic staff to recruit appropriate women for the interview.
Sampling continued until data saturation (n=10) was reached.
Data Collection
To learn more about women's breast cancer experiences, in-depth interviews (IDIs) were
conducted. A topic guide was developed based on a review of the pertinent literature. Participants
were questioned and probed about their feelings regarding the results of the diagnosis, how they
dealt with the situation, and their experiences during therapy and follow-up at the cancer clinic.
Data collection and analysis were carried out concurrently. The IDIs took place in Amharic.
Repeated visits and interviews with participants were conducted to achieve data saturation; new
concepts were incorporated, and the main themes were compared across interviews. To preserve
the "contexts," the IDI audio recordings were transcribed verbatim. The audio-taped interviews
were completely transcribed to Amharic before being translated into English for analysis.
Data Analysis
The audiotape recordings of the interviews were transcribed and merged with field notes
taken during the session. The interview transcripts and raw data were closely read and then
categorized. All interviews were transcribed verbatim. The transcripts were analysed using
a thematic analysis[16]. The transcripts were written in Amharic and translated into English
verbatim. Data analysis was carried out concurrently with data collection. While listening
to the audio recordings, the researchers extensively reviewed the transcripts. The data were
initially open-coded line by line using Open code software version 4.02. The study team also
met for discussions. As a result, the validity and intersubjectivity of the analytic process are
ensured. The research team argued about the broad initial codes used to create and name
categories, as well as compress subthemes and themes until they reached an agreement. Member
checking, which entails validating the results and interpretations with study participants, was
used to operationalize credibility[17]. The codes were evaluated and analysed for differences
and similarities, and 8 subthemes were identified before identifying four themes. Subthemes are
meaning threads that run through a certain section of an interview. The researchers maintained
their reflexivity throughout the analysis process, returning to the data and discussing the personal
categories where there were disputes or misunderstandings. Then, all of the researchers returned
to the original data to review the text and reach an agreement on the data categories.