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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


Saima Shams Hirani

A thesis submitted in partial fulfillment of the requirements for the degree of

Doctor of Philosophy

Faculty of Nursing

University of Alberta

© Saima Shams Hirani, 2017

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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

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

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-

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



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displaced persons affected by armed conflict. Pakistan Journal of Social and Clinical

Psychology, 10, 20-26.

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Appendix 8. Focus Group Guide

You have completed a 6 week social support intervention with us and we thank you for your


The purpose of getting together today is to learn about your experiences and opinions of the 6-

weeks group meetings you just completed.

Q1. What was your experience of attending the 6 week social support group meetings?

 Tell me about one specific thing that you like the most about it?

 Tell me about one specific thing that you did not like much?

Q2. How did you feel about being with other women and sharing your life experiences with


 How did you feel listening to other women‟s life challenges and their ways of managing


Q3. Have you noticed any changes in yourself after attending the social support group?

 Share any example?

Q4. What are your views about the group meetings themselves? If yes: why/ if no: why

 Did you get enough opportunity to talk?

 Did you feel listened to when you shared your experiences?

 Did you enjoy the activities that were carried out during the meetings?

Q5. Did you face any challenges getting to the weekly group meetings? If yes, what were some

of these challenges?

Q6. Would you participate in similar programs if they were offered in the future?

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If yes: Why

If no: why

Q7. Would you recommend this group to other women?

If yes: Why?

If no: Why

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