Mental health has gained significant recognition and importance as a crucial aspect of overall well-being. An individual's mental health is influenced by the intersection of individual, social, cultural, and systematic sources of stress and resilience. It is important to include subjective conceptualizations of mental health and well-being to develop culturally sensitive approaches to mental health promotion. This qualitative study aimed to understand how urban-dwelling women living in Pakistan who are micro-finance loan recipients conceptualize the meaning of mental health. Using interpretive description methodology, data were collected and analyzed through in-depth, semi-structured interviews conducted in Urdu with a purposeful sample of 32 women. An inductive approach to content analysis was employed to code and categorize the data. Participants conceptualized mental health as the presence of peace and the absence of tension. Chronic sources of tension included a lack of essential resources, safety, and security in their day-to-day living in Karachi, Pakistan. Implementing policies to address women’s basic needs, including access to education, would be a helpful first step towards mental health promotion for Pakistani women. Integrating concepts that reflect women’s understanding of mental health will also be a useful first step in developing culturally sensitive mental health assessment tools.


women, mental health, perception, interpretive description, qualitative research, Pakistan

Author Bio(s)

Dr. Farhana I. Madhani is currently an assistant professor at Brock University. She holds a PhD in nursing from McMaster University, Canada. Dr. Madhani is a qualitative researcher, and this study represents a component of her PhD thesis. With guidance from her thesis committee, she successfully carried out participant recruitment, interviews, and data analysis. Dr. Madhani has extensive experience teaching various theory and clinical practice courses to both basic and accelerated nursing students at different universities. Her research program primarily centers around women's mental health, domestic violence, and nursing education, with a specific focus on clinical facilitation and evaluation. Dr. Madhani is passionate about community service and engagement, driven by her desire to share her knowledge and skills with others. Correspondence regarding this article can be addressed directly to: fmadhani@brocku.ca

Catherine Tompkins is a retired faculty member. She joined McMaster University in 1977 as a lecturer in the School of Nursing. Between 1977 and 1988 she was promoted to assistant professor and then to associate professor within the school. In 1998, she became the Assistant Dean of the Undergraduate Nursing Education Programs. Subsequently, she served as the Associate Dean of the Faculty of Health Sciences (Nursing) from 2004 to 2014. Her primary research interests include women’s health; women’s and family issues in chronic illness and disability; educational research and qualitative research methods.

Dr. Susan Jack is professor at the School of Nursing, an associate member of the Department of Health Research Methods, Evidence, and Impact, and a core member of the Offord Centre for Child Studies. She is the program lead for the Public Health Nursing Practice, Research and Education Program (PHN-PREP). Dr. Jack’s clinical background is in community health and public health nursing, and her program of research focuses on the development and evaluation of public health interventions. She completed her post-doctoral training in the Department of Psychiatry & Behavioural Neurosciences (McMaster) and the Centre for Knowledge Translation (University of Alberta). Dr. Jack has been a full-time faculty member since 2003 and has taught in all levels of the BScN undergraduate and graduate program. Dr. Jack is a Fellow of the Canadian Academy of Nursing and served as the president of the Board of Directors of the Nursing Network on Violence Against Women International (2016-2020).

Carolyn Byrne is a retired faculty member and professor emeritus. She began her academic career in the School of Nursing at McMaster in 1981. During her time at McMaster, she taught in the undergraduate and graduate-nursing programs, chaired the Undergraduate Nursing Program, received the President’s Award for Educational Leadership, and was a nurse consultant in Mental Health Nursing Hamilton Wentworth Public Health Unit. In 2014 Dr. Byrne became the Associate Dean and Director of the School of Nursing. Her clinical background is in community mental health both with adults and children.


Thank you to all the participants for their contributions to this study. We greatly appreciate their resilience, positive attitude, and willingness to share their stories. Without their involvement, this study would not have been possible.

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