Reply to the Letter Entitled “The Relationship Between Learning Needs and Care Dependency in Individuals With Chronic Obstructive Pulmonary Disease”

We, the authors, are delighted that Mehta and Sah reviewed our article examining the interaction between learning needs and care dependency in individuals with chronic obstructive pulmonary disease (COPD) with great interest and considered it evidence contributing to future research. We also consider the suggestions for improving our article as a significant indicator of international collaboration. Mehta and Sah pointed out the inconsistency between the research design and causal inference. However, the primary purposes of a cross-sectional research design are to identify healthcare needs, provide information about the health status of the population, and gather data on a treatment method [1]. Because the design's purposes are directly aligned with the purpose of our research, this study is primarily descriptive, cross-sectional, and correlational. Examining the relationship between the Patient Learning Needs Scale (PLNS) and care dependency (CDS) is a research topic determined by direct clinical observation. Although Mehta and Sah found the correlation between the scales to be improved, considering the demographic characteristics of the study participants, it can be said that the clinical observations and statistical results are consistent. However, Mehta and Sah's suggestion led us, the authors, to consider the need to eliminate confounding factors related to the participants in further research. Our study is one of the rare examples of research examining inhaler medication errors in our country. The reason for not classifying inhaler errors by device is that most of the steps involved are similar, and the goal is to identify the actual step where mistakes occur, rather than to identify device-specific training requirements. However, Mehta and Sah's valuable suggestion provides us with a new perspective, allowing us to identify another learning need that needs to be explored in this area. Although no validated cognitive assessment was conducted in our study, the inclusion criteria included participants who were open to communication and did not have any mental disabilities that would prevent them from responding to the data collection tools. However, considering the average age of the sample, the recommendation to use a Turkish-adapted measurement tool, such as the Mini-Mental Test [2], is a sound suggestion. Similar to Mehta and Sah, we authors support the inclusion of cognitive assessment in prospective studies. The primary reason Mehta and Sah commented on the uncertainty surrounding the clinically meaningful implications of some findings may be that the study aimed to identify numerous demographic, clinical, and other population-specific characteristics that could influence the need for training. Therefore, we, the authors, believe that the research conducted as a master's thesis study was limited in its timeframe. Furthermore, stating that the results of our research are generalizable only to the research sample directly qualifies each of Mehta and Sah's suggestions as a relevant research topic. In conclusion, we, the authors, were pleased that our research, published in a respected nursing journal, received comments and suggestions promptly. Furthermore, we consider the remarkable and reviewable nature of our study an indication that we are addressing a significant issue for nursing care. As the authors, we sincerely thank Mehta and Sah for their valuable reviews, comments, and suggestions. Neslihan Duman Kırmacı: writing – original draft, writing – review and editing. Seval Ağaçdiken Alkan: conceptualization, methodology, validation, supervision, project administration, writing – original draft, writing – review and editing. The authors have nothing to report. Generative Artificial Intelligence Use Statement: No generative artificial intelligence tools were used in this study. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. No data was obtained or analyzed in this study.