Social Determinants of Health Assessed Among Nurses: A KAP-Oriented Systematic Review Using the Dahlgren-Whitehead...

Background and Objectives: Social Determinants of Health (SDoH) are factors that can contribute to health inequities. Improving the conditions in which people are born, grow, and live requires collaboration between professionals from different health sectors. Given their health and well-being-focused care, nurses are crucial to promoting health equity in the care they provide. Thus, their knowledge, attitudes, and actions-i.e., practice-(KAP) regarding SDoH could serve as a helpful starting point for promoting care that also focuses on non-medical factors. This study aims to map the SDoH assessed in the literature in relation to nurses' and nursing students' KAPs, using the Dahlgren-Whitehead Rainbow Model as a logical framework. Methods: Following PRISMA guidelines, a systematic literature review was conducted using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO. Records published until June 2024 were selected from primary studies involving nurses and nursing students, with no time limits. The assessed determinants were adapted and categorised according to the Rainbow Model Levels. Results: 22 results were eligible. The SDoH (in general), poverty, social justice, social gradient, social inclusion and exclusion, discrimination, diversity, equity and inequality, food insecurity and access to nutritious food, employment status, geographical isolation, healthcare services, housing difficulties, transportation, social support, individual lifestyle factors, and health literacy were assessed on KAPs. Conversely, health equity has been assessed just for knowledge and attitudes. Considering the latter level of the Rainbow Model and the relative categorisation of the results, age, sex, and constitutional factors were not examined in the studies included in this review. Conclusions: This review maps the most and least frequently assessed SDoH in relation to KAP. As nurses are essential to providing care that considers SDoH, improving health outcomes, and addressing health inequities, and advocating for community health, it would be valuable to enhance nursing education from baccalaureate through postgraduate courses. Moreover, a strong relationship with different healthcare professionals is needed.