Philosophical Perspectives on the Integration of Social Services into Nursing Practice: An Integrative Review

Abstract

Background: Contemporary healthcare increasingly recognizes that health outcomes are influenced not only by clinical care but also by social determinants such as housing, education, income, social support, and access to community resources. As healthcare systems transition toward integrated, person-centered models of care, nurses are expected to play a greater role in identifying and addressing patients' social needs. Although the integration of social services into nursing practice is gaining global attention, its philosophical foundations have not been comprehensively synthesized.

Objective: This integrative review aimed to examine and synthesize the philosophical perspectives underpinning the integration of social services into nursing practice and to develop a conceptual framework illustrating how these perspectives inform contemporary nursing care.

Methods: An integrative review methodology, guided by Whittemore and Knafl's framework and reported in accordance with the PRISMA 2020 guidelines, was employed. A comprehensive search of PubMed, Scopus, CINAHL, Web of Science, and Embase identified relevant literature published between 2015 and 2026. Eligible publications included theoretical, qualitative, quantitative, mixed-methods, and review studies addressing the philosophical, ethical, or conceptual dimensions of integrating social services into nursing practice. Data were extracted, critically appraised, and synthesized using thematic analysis.

Results: The review identified six interrelated philosophical perspectives supporting the integration of social services into nursing practice: holistic nursing, caring science, person-centered care, social justice, ethics of care, and the social determinants of health. Collectively, these perspectives emphasize that effective nursing extends beyond disease management to include the social conditions that influence health, recovery, and quality of life. Based on the synthesis, a conceptual framework was developed to demonstrate the progression from philosophical foundations to nursing actions, interdisciplinary collaboration, social service integration, and improved patient and population outcomes.

Conclusion: Integrating social services into nursing practice represents a philosophical evolution rather than simply an organizational or operational change. The convergence of holistic, ethical, and person-centered philosophies provides a robust theoretical foundation for strengthening collaboration between nursing and social services. Implementing this approach has the potential to enhance patient outcomes, reduce health inequities, improve continuity of care, and support more equitable and sustainable healthcare systems. The proposed conceptual framework offers a foundation for future research, nursing education, healthcare policy, and clinical practice aimed at advancing integrated, person-centered care.