Development of the INpaTiEnt Rehabilitation App Compliance QuesTionnaire [INTERACT]

Round 1

Reviewer 1 Report (New Reviewer)

Comments and Suggestions for Authors

The authors of the manuscript titled "Development of the Inpatient Rehabilitation App Compliance Questionnaire" have made significant changes in the revised manuscript. In my opinion, the manuscript has been thoroughly revised, and I have no further suggestions for improvement.

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

The purpose of this study was to conceive items for a questionnaire that tackles noncompliance with physical therapy in an inpatient setting using the expert review technique and to put these elements in the light of early postoperative rehabilitative appguided physical therapy program.

The aim of the study was to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period. A literature search was conducted to identify elements that prevent patients from performing their prescribed physical therapy exercises.

A statistical analysis was done to evaluate the responses. The results of the expert review technique identified some  conceptual problems. The quality of the resulting questionnaire was deemed to be good as patients were able to fully under stand the concepts and answer accordingly.

Survey of non-compliance  was crossculturally adapted and validated. However, the elements were deemed insufficient  as they tackled concerns of patients in private physiotherapeutic practice. A comparative study that contrasts inpatient and outpatient physical therapy could facilitate the identification of some non-adherent parameters.

A systematic review attempted to compare the effectiveness of inpatient and outpatient physical therapy care and found that there was no scientific evidence relevant to the research question in question. Telerehabilitation is believed to have the same effect as outpatient physiotherapy treatment under professional supervision. The primary result of this study was non-compliance with the physiotherapy questionnaire adapted for hospitalization. The literature review resulted in a synthesis of suitable survey items, subject-wise evaluation and questionnaire experts, which led to the refinement of individual elements and methods of pre-testing. The study can serve as a pilot for finding new measures to increase patient adherence to physiotherapy using telerehabilitation.

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This study was conducted to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with telerehabilitative physiotherapy in the early postoperative period

Strengths of this manuscript:

1.      This study addresses an important research question and the questionnaire for use in telerehabilitative service is highly needed.

2.      The writing order was logic and clear.

3.      The writer cited sources adequately and appropriately.

However, I am afraid that this study has major limitations

1.      The methods used in the study can’t achieve the purpose of the study, questionnaire validation process should involve different methods such as face validity, content validity, predictive validity, and concurrent validity. This wasn’t achieved in this study.

2.        The questionnaire itself contains questions (those start with how 2,4,6,8) that shouldn’t elicit the responses from 1 (completely disagree or false) 113 to 5 (completely agree or completely right).

3.      Many factors that could affect compliance were not included e.g. patient’s  general condition, mood, expectations, the complexity of regimen, etc.

Reviewer 2 Report

Comments and Suggestions for Authors

 

Thank you for giving me an opportunity to review this manuscript entitled Developement of the INpaTiEnt Rehabilitation App Compliance quesTionnaire [INTERACT].

 

I suppose it is great work, but the authors did not mention actual relationship between the result of questionnaire and patient’s compliance. So, I cannot evaluate the meaning of this manuscript so far.

 

Reviewer 3 Report

Comments and Suggestions for Authors

DEVELOPEMENT OF THE INPATIENT REHABILITATION APP COMPLIANCE QUESTIONNAIRE [INTERACT]

General Commentary

This article presents a very interesting and pertinent question of research of the investigated purpose of this study is to validate elements of a non-compliance survey in an in-hospital setting and discuss aspects of compliance with tele rehabilitative physiotherapy in the early postoperative period.

Please review all text citations, formatting, and writing in the manuscript.

 

MAJOR CONSIDERATION

METHODS

The method description is very succinct. I suggest authors add a lot of information about the steps of creating the questionnaire, such as:

Sample

Sample, sample calculation, exclusion and inclusion criteria!

Sequential description of the creation of the questionnaire (flowchart, or table illustrating such condition)

Based on which criteria did the sample judge the questionnaire? add in manuscript

Expert Sample

Expert sample, inclusion and exclusion criteria

Expert evaluation (final version of questionnaire)

in relation to the specialists, what were the criteria adopted for the judgment of each question? has this been standardized? add in manuscript

Brief description of what each item (question) represents in the questionnaire.

Analysis and Statistics

How were these responses extracted and classified to adapt the questionnaire, what statistical model was used for this.

DISCUSSION

I suggest inserting two subchapters at the end of the discussion:

Limitations

I suggest that the authors comment in more depth on the limitations, and if necessary, justify it from the literature.

Implications

 

What will such a questionnaire be used for? in which populations can it be applied?

Comments on the Quality of English Language

Please review all text citations, formatting, and writing in the manuscript.