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This review is the result of a virtual, collaborative Live Review discussion organized by one of PREreview's 2025 Champions on October 18, 2025. The discussion was joined by 6 people: 2 facilitators and 4 live review participants. The authors of this review have dedicated additional asynchronous time over the course of 3 weeks to help compose this final report using the notes from the Live Review. Special thanks to all participants who contributed to the discussion and made it possible to provide feedback on this preprint.

Summary:

In this study, the coping strategies and quality of life among adolescent cancer patients were investigated. Two validated instruments were completed by the participants: the pedsQL (oncology version) to assess quality of life and kidCOPE questionnaire to identify coping strategies.

A total of 20 adolescents (12 boys and 8 girls) with age range between 12 and 18, participated in the study. The scores were converted to a scale from 0 to 100, with higher values indicating a better perceived quality of life. The overall mean score on the Pediatric Quality of Life Inventory (pedsQL) was 70, which suggests a generally good quality of life among patients.

The responses were visualized using a bar chart showing the perceived quality of life (pedsQL) dimensions and the frequencies of reported coping strategies. The figures showed that acceptance, distraction and social withdrawal were the most frequently reported strategies, which reflects a predominance of coping strategies among patients that focused on emotion and avoidance.

The study also emphasized that environmental factors and interpersonal relationships can influence the treatment and well-being of oncology patients, suggesting that effective care extends beyond medical treatment alone. However, a key limitation lies in the small sample size and the fact that the study included only in-patients, which limits the generalizability of the findings. Nevertheless, this limitation is understandable, as a small sample size may be appropriate for a pilot study designed to explore feasibility and generate preliminary insights.

List of major concerns and feedback:

• The study does not include control groups during the experiment (e.g., healthy adolescents or patients with other chronic illnesses). The absence of the control group makes it difficult to determine whether the coping patterns or quality of life level are specific to cancer or reflect general adolescent responses to stress. Future studies should consider including one or more control groups to provide a clearer benchmark for comparison. This would allow researchers to distinguish coping mechanisms that are specific to a particular disease from general developmental or situational responses.

• There are potential confounding factors that were not controlled for statistically. For example stage of disease, type of treatment, the time when the cancer was diagnosed, or patient’s family support. These could have an influence on coping scores and quality of life scores. Subsequent studies should collect and control for these key variables whether through stratified sampling, covariate analysis, or multivariate regression models. Adding these factors would improve the precision and interpretability of the results, to ensure that observed effects can be more confidently attributed to coping strategies rather than external influences.

List of minor concerns and feedback:

• Some statements in the discussion section appeared to be overgeneralized. For example, suggesting that coping “predicts” quality of life despite the correlational nature of the study design. This phrasing should be revised to reflect association rather than causation, using terms like “is related to” or “is associated with”, to ensure accuracy with the concept and methodology.

• There are some other factors like disease severity, treatment phase, pain levels, socioeconomic status, time since diagnosis, age and or gender differences, that are not included in the analysis of this study. These factors may significantly affect coping styles and perceived quality of life. Incorporating these variables either as covariates or subgroup analyses will help readers to gain a more comprehensive understanding of the psychosocial determinants of quality of life.

• Table 3 could benefit more from using letters or asterisks to show the level of significance among the predictors. This would enhance the clarity and readability of the table, allowing readers to more easily identify significant and non-significant results.

• The contents of the anonymous questionnaire was not revealed, so it cannot be replicated. The authors should include sample items or a detailed description of questionnaire structure and scoring (either in the main text or as an appendix) to facilitate replication by future researchers.

• The study does not specify the software used for data analysis, how missing data were handled, or whether any data-cleaning procedures were performed. In addition, the sampling timeframe beyond February 2025 was not reported. The authors should specify the statistical software (e.g., SPSS, R, etc), describe the handling of missing or incomplete responses, and clarify the duration of the data collection period to enhance transparency in methods and reproducibility.

Figures and Tables 

• Table 3 could benefit more from using letters or asterisks to show the level of significance among the predictors. This would enhance the clarity and readability of the table, allowing readers to more easily identify significant and non-significant results.

• The figures are clearly labeled and well presented, making the data easy to interpret and visually accessible. The graphical representations effectively complement the text and help readers understand the distribution of quality of life dimensions and coping strategies among participants.

Additional comments

• There are several minor typographical errors and issues with style in the manuscript. For example, the phrase “predominantly would predominantly” appears redundant, and the discussion section repeats the point about interventions promoting autonomy more than once. The authors should carefully proofread and edit the manuscript to remove typographical errors and redundant expressions. This will improve overall readability and maintain the academic quality of the manuscript.

• The manuscript does not report the reliability coefficients (e.g., Cronbach’s alpha) for the instruments (PedsQL and KidCOPE) as obtained in this study, even though such values are essential for confirming internal consistency within the sample. In addition, the study would benefit from a short paragraph clarifying the participants’ treatment stage, diagnosis type, and time since diagnosis, as these clinical characteristics may influence both coping and quality of life.

• Although the study briefly mentions its small sample size, this limitation could be expanded upon to better reflect its methodological implications.

Concluding remarks

We thank the authors of the preprint for posting their work openly for feedback. Many thanks also to all participants of the Live Review call for their time and for engaging in the lively discussion that generated this review.

Toba Isaac Olatoye was a facilitator of this call and one of PREreview's 2025 champions. No other competing interests were declared by the reviewers.

Competing interests

The authors declare that they have no competing interests.

Use of Artificial Intelligence (AI)

The authors declare that they did not use generative AI to come up with new ideas for their review.