1. I appreciate that English is not your first language. However, the English language and expression used in this paper is poor or incorrect in many places throughout. As the reviewer states this makes it hard for the reader to read and understand what your study is about. Publishers will not publish papers that do not have acceptable English. Can I suggest that you check throughout the paper that the English syntax, grammar, spelling, expression and meaning are clear and correct. On the JAN website guide to authors there is a help sheet on tips for writing. I suggest that you take a look at that. Also, you will need to have a person who is fluent in written and spoken English check and correct the paper, if necessary. We are unable to do this.Our answer: The paper has now been scrutinised by a native English speaker and we hope you will find her work well. Our answer: "In the world" has been changed to "Globally" in accordance to recommendation.
Introduction. Instead of -3. Avoid using he/she use they instead.Our answer: We are now using "they" throughout the paper. Our answer: Rheumatoid arthritis (RA) is first mentioned at page 6 and then we use RA in the Discussion.
Comments to reviewer 1Dear reviewer 1, Thank you for valuable comments and for finding our paper interesting. We hope that the following comments and our changes will fulfil the questions you raised.This revised manuscript is improved in description of intent and methods, and its relevance for the care of people with rheumatic diseases is more clear. Overall, the paper remains difficult for the native English speaker, and it still needs significant editing for word usage, English grammar and sentence structure. The reader is frustrated by the fact that you know there is something very worthwhile within the paper, but it is very difficult to get at it because of the intensity of attention required.Our answer: The paper has now been scrutinised by a native English speaker and we hope you will find her work well.There are only two remaining substantive comments. In general, methodology is well described, but in the section on "Rigour", little is said about how credibility was established. Later, in "Study Limitations", conformity and dependability are alluded to. Please move the comments on conformity and dependability to the earlier section and describe how these were established.Our answer: We have now tried to describe more in the section on "Rigour" about how credibility, conformity and dependability were established.Second, conclusions are overdrawn. It is not reasonable at this point to extend the study findings to other people with rheumatic diseases. Although the authors have clarified the rationale for the purposive sampling approach, the sample is far too small (and the methods are qualitative) for generalizing the results to others.Our answer: We have changed the conclusions.Two other areas of discussion in which conclusions are not based on the study findings are: 1. page 17. No data are presented that lead to the conclusion that the s...