Caring beyond the operating field: social determinants in surgical Nursing.

Abstract

Introduction: In the surgical setting, social determinants of health directly influence surgical outcomes, from indication to postoperative recovery, reflecting social inequalities that require critical nursing attention.

Objective: To reflect, in light of a narrative review, on the influence of social determinants of health on surgical outcomes and their implications for perioperative Nursing.

Content synthesis: This is a theoretical-reflective essay grounded in a structured narrative review conducted in the PubMed database between April and June 2025. Twenty-six articles were included. The analysis was carried out through an integrative thematic synthesis organized according to the Dahlgren and Whitehead model. The findings indicate that incorporating social determinants broadens the scope of nursing practice across different levels. At the macro level, it involves political and institutional engagement, participation in policy formulation, and equitable resource management. Regarding mesodeterminants, expanded social assessment, individualized care planning, articulation with community networks, and culturally sensitive health education stand out. At the micro level, individualized clinical assessment, psychosocial support, humanized care, postoperative planning, and the use of technologies to support continuity of care are included. This approach strengthens comprehensiveness and social justice within the surgical context.

Conclusion: Integrating social determinants of health into Nursing practice in the surgical setting strengthens patient safety, improves quality of care, and contributes to reducing health inequities.