Social Justice in Nursing: A Critical Interpretive Synthesis.

Abstract

While social justice is widely upheld as a foundational value and responsibility within nursing, this concept remains poorly articulated and lacking in a clear and cohesive definition. In particular, prior conceptualizations of social justice within nursing have been critiqued as lacking a strong theoretical foundation and being insufficiently critical in orientation. Resultantly, guidance for nurses in engaging in social justice action is scant, and ultimately, the profession is challenged in truly taking up social justice as a central aim. As such, this critical interpretive synthesis aims to explore and synthesize how social justice is conceptualized within the nursing literature, and apply critical theoretical approaches to re-conceptualize social justice to guide nursing theory, research, and practice. To comprehensively review the literature on social justice (and the related concept of equity) in nursing, CINAHL and Medline (Ovid) databases were searched using nursing, social justice, and equity keywords. Following title/abstract and full text screening of 1428 references, N = 216 were retained for analysis, utilizing critical interpretive synthesis approaches through a critical social theory lens. Through a critical thematic analysis of the nursing literature, this review identifies that concepts of social justice and equity were often conflated in the nursing literature, and that dominant conceptualizations advance notions of social justice as distributive justice and as fairness. Engaging with these dominant conceptualizations through a critical lens illustrates that a re-conceptualization of social justice is necessary to establish conceptual clarity and more meaningfully support nurses in engaging with social justice through theory and practice. As such, this review presents the following re-conceptualized definition of social justice: As a guiding principle for nursing, social justice is a process of recognizing and remediating inequities at individual and structural levels towards a state of equity.