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Social Support Intervention to Improve Resilience and Quality of Life of Women Living in Urban Karachi, Pakistan: A Randomized Controlled Trial Open Access


Other title
social support
women's resilience
mental health
Type of item
Degree grantor
University of Alberta
Author or creator
Supervisor and department
Lasiuk, Gerri (Faculty of Nursing, University of Saskatchewan)
Norris, Colleen (Faculty of Nursing)
Examining committee member and department
Richter, Solina (Faculty of Nursing)
Liebenberg, Linda (Dalhousie University)
Cujec, Bibiana (Faculty of Medicine, Cardiology)
Karmaliani, Rozina (School of Nursing & Midwifery, Aga Khan University, Pakistan)
van Vliet, Jessica (Educational Psychology)
van Zanten, Sander (Faculty of Medicine)
Faculty of Nursing

Date accepted
Graduation date
2017-06:Spring 2017
Doctor of Philosophy
Degree level
Although the World Health Organization has declared that there is “no health without mental health”, mental health still does not receive its due recognition by stakeholders and health care systems around the world. The rising global burden of mental health disorders among women is a serious concern because of its impact on their children and families. This situation is more critical in developing countries. Various socioeconomic factors such as poverty, illiteracy, unemployment, male dominance, domestic violence and low social support are associated with poor mental health of women. Pakistan’s scarce and inaccessible resources to most of its population, calls our attention for a paradigm shift from symptom reduction to improving mental well-being by implementing low cost, feasible, and gender sensitive interventions that can be applied at the primary health care level. Social support is a robust intervention that improves health outcomes but has not been tested to improve resilience (a positive determinant of mental health) in the Pakistani context. The aim of this dissertation was to develop and test a 6-week social support intervention to improve women’s resilience and quality of life. This dissertation is based on three papers. Paper one is a conceptual paper that explains the phenomenon of resilience using a gender lens. The next paper is the main research paper that presents a randomized controlled trial that was conducted with 120 community dwelling women living in a low socioeconomic area of Karachi, Pakistan and tested the effects of a 6-week social support intervention on women’s resilience and quality of life. Paper three compares the Urdu version of two different resilience scales (The Resilience Scale-14 [RS-14], and the Resilience Scale for Adults [RSA]) that were used in this study. i The study demonstrated that there is an intersection between gender and resilience that must be considered when addressing interventions in primary care. Furthermore, women in a social support intervention group reported statistically significant improvements in resilience as measured by RS-14 and the structured style domain of RSA (measures ability to see life goals and plan to achieve them) compared to women in the control group. Results of this study identified that it is possible to integrate an economical and feasible social support intervention into primary health care setting in order to promote the mental health of women living in socioeconomically disadvantaged urban settings of Karachi, Pakistan.
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Hirani, S., Lasiuk, G., & Hegadoren, K. (2016). Intersection of gender and resilience. Journal of Psychiatric and Mental Health Nursing, 23(6-7), 455-467. doi:10.1111/jpm.12313.

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