Review: Wounded Healers as Agents of Change: A Comparative Study on Stress and Work Satisfaction of Nepali Accompaniers {under peer review}

 

Reviewer: Selin Tanyeri Kayahan

 

Completed: 16-09-2025 20:37

 

Recommendation: Revision Required

 

 

	Yes	No	N/A
Is the research question clearly defined?	+
Are the methods appropriate and sufficiently detailed?		+
Is the data analysis robust and replicable?	+
Are the conclusions supported by the results?	+
Is the manuscript well organised and clearly written?	+
Are tables, figures, and supplementary material informative and necessary?	+
Is the abstract an accurate summary of the study?	+
Does the manuscript contribute meaningfully to the field?	+
Is it relevant to the field of mental health or related disciplines that are connected to the scope of the Journal?	+
Are ethical approvals and participant consents adequately described?	+
Have competing interests, funding, and data availability been transparently declared?	+

 

Comments for the authors:

 

Dear Editor and Authors,

I had the privilege to review the research article titled “Wounded Healers as Agents of Change: A Comparative Study on Stress and Work Satisfaction of Nepali Accompaniers”. I would like to congratulate the authors for their work regarding this important topic in humanitarian context.

The research article aims to explore retrospective data of accompaniers’ psychological status and to compare their personal growth, meaningfulness of work, and work satisfaction as lay counselors. Two groups of accompaniers, those who were not related to the missing persons (n=39) and those who were (n=26) were compared using mixed methods. The study found that two-thirds of respondents from both groups disagreed that their work was very stressful. One-third expressed that their stress was initially increased due to the narratives of personal loss, uncertain life circumstances of families of missing persons and economic hardships. It was concluded that accompaniers involved in this study found hope, dignity, identity, opportunities and pride due to their service and victims can be trained and supervised to function as agents of change for service recipients and themselves.

The strengths of the paper include the comparative overview between two groups of lay counselors, as well as the qualitative methodology that delves into their experiences as both humanitarian support workers and individuals with lived experience.

In my opinion, although the topic is timely and relevant, and the article is clear and precise, there are a few points that could be improved:

General Remarks:

-      Kindly provide more information on the context of the conflict in Nepal and why people go missing.

Abstract:

-      The abstract methods and results should elaborate on the 3 step process of the lay counselors’ work, in terms of recruiting, training and service provision.

Introduction:

-      Kindly write the full forms of abbreviations in their first use in the main text: ICRC, FoMP, LMIC, UNHCR etc.

Methods:

-      As part of qualitative work reporting principles, briefly indicate the authors’s perspectives and personal standings on the subject (of the qualitative evaluation).

-      The methodology should be explained in detail, both quantitative and qualitative parts.

-      *Please indicate how the validation of the locally-developed 13 question self-administered perceived-impact scale was made, along with the development process in detail. Also kindly explain why there was not a validated questionnaire used.

-      Please indicate how and by whom the semi-structured interview guidelines were developed, with which prompts and how those were selected.

-      Kindly justify the sample size used in this study.

-      The scale was developped 5-Likert type but then only 3 levels of answers were analyzed. Kindly explain why this was made in data analysis. Indicate this usage when first explaining the assessment tool in methodology as well.

-      Kindly explain how the focus group participants were selected and who conducted the focus groups.

Results:

-      The reporting of the findings should be systematized.

-      Kindly explain how the statement “The program was perceived as a source of company, social recognition, and social support, with access to opportunities.”

Discussion:

-      Kindly discuss gender-related outcomes in particular.

-      Kindly add the part “A five-day-long training on topics such as rapport-building, communication skills, responding skills, problem-solving, counselling skills, conducting household surveys and resource-mapping for referrals were provided to accompaniers immediately after their recruitment through adult learning methodologies, including role-plays for each set of skills.” to the methodology section briefly.