Dania Javaid  ( Quaid-i-Azam University, Islamabad )
Rubina Hanif  ( Quaid-i-Azam University, Islamabad. )
Tasnim Rehna  ( Riphah International University, Islamabad. )

Madam, quality of life is acknowledged by specific indicators including the individual\\\'s physical and psychological wellbeing, level of self-sufficiency, interpersonal relationships, beliefs and their relationship to the outside world.¹ The significant threat to any of these physical and functional abilities by accident, health related problems i.e. cancer, tumour or heart attack, surgery, severe injury, burn or other severe medical conditions may hamper quality of life of patients.² Such problems referred as stressors may inculcate certain psychological symptoms such as anxiety, depression, post-traumatic stress, suicidal attempts, and substance abuse which may negatively predict a patient\\\'s satisfaction with his health.³ Considering such situations, adequate social support is  associated with better functioning, improved quality of life and reduced psychiatric symptoms i.e., having  positive relationships and supportive persons in patient\\\'s life significantly  increase  the  levels of psychological resources which in turn facilitate the individual\\\'s coping mechanism and  ultimately improve his satisfaction with quality of  life.⁴
In Pakistan, when a patient is diagnosed with any severe medical health problem like cancer, tumour, the major focus regarding health related severe conditions is on the medical treatment given to the patients.  Nowadays, the patients tend to rely on their physician more in terms of medicine and the psycho-social aspects tend to be ignored when managing the treatment. For medical health professionals, it is, therefore, significant to provide counseling to their patients and the family members in order to make them well prepared and strong. In such situations, patients are in dire need of some support from their loved ones to be cared for, comforted and being helped.⁵ Far little research has been conducted on such socio-psychological aspects of patients in Pakistan i.e. the protective factors for patients, that may play important role in hampering or enhancing his/her quality of life. In literature, a positive correlation between quality of life and social support have been found and the results suggested that a supportive and compassionate social environment, mainly support coming from family as well as friends were related to improved quality of life.⁶
In Pakistan, there is a special need to develop distinctive psychosocial programmes or trainings that may be helpful in the treatment of patients with severe illnesses by educating family and friends in order to improve their perceptive about the impact of social support on poor health and quality of life and highlighting the importance of the social ties with respect to a healthy life as well. Keeping in mind the health outcomes, the clinical goal of medical problems should also be on improving the quality of life of patients by providing them a supportive network of informal relationships rather than simply minimizing symptoms. Although, pharmacological treatment may be helpful in reducing stress when an individual faces severe medical conditions,⁷ but the equal importance should be given to social support system that is needed to reduce or control one\\\'s anxiety in stressful circumstances. This can only be viable in the presence of a supportive figure i.e., friend, family member or any other significant individual. Therefore, in Pakistan (as it is based on a collectivistic culture) boosting social support system along with the treatment will be beneficial in prevention programmes for reducing stress and the improved health condition of the patient in the wake of severe medical problems.

References
1. World Health Organization. Division of Emerging, Other Communicable Diseases Surveillance. WHO recommendations on rabies post-exposure treatment and the correct technique of intradermal immunization against rabies. World Health Organization, Division of Emerging and other Communicable Diseases Surveillance and Control; 1997.
2. Kampman H, Hefferon K, Wilson M, Beale J. "I can do things now that people thought were impossible, actually, things that I thought were impossible": A meta-synthesis of the qualitative findings on posttraumatic growth and severe physical injury. Can Psychol/Psychologie canadienne. 2015; 56: 283-94
3. Migliorini C, Tonge B, Taleporos G. Spinal cord injury and mental health. Aust N Z J Psychiatry 2008; 42: 309-14.
4. Lakey B, Orehek E. Relational regulation theory: a new approach to explain the link between perceived social support and mental health. Psychol Rev 2011; 118: 482-95
5. MacGeorge EL, Feng B, Burleson BR. Supportive communication. Handbook of Interpersonal Communication 2011; 26: 317-54. [different authors found online]
6. Chikawa M, Natpratan C. Perceived social environment and quality of life among people living with HIV/AIDS in northern Thailand. AIDS Care 2006; 18: 128-32.  
7. Bonanno GA. Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events?. Am Psychol 2004; 59: 20-8.