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

• Author / Creator

  Hirani,Saima

• 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.

• Subjects / Keywords

  • Social support
  • Mental health
  • Women's resilience

• Graduation date

  Spring 2017

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3VD6PH4Z

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. 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.