Aim

This PhD study aims to investigate patient pathways of socially marginalized patients and the social nursing initiative in somatic hospitals.

Background

Socioeconomic health disparities remain a global challenge driven by systemic inequalities that limit access to healthcare for marginalized populations. Individuals experiencing homelessness, substance abuse, mental illness, or prostitution face substantial barriers to social participation and medical services. These challenges, often combined with chronic diseases and multimorbidity, contribute to poor health outcomes and reduced life expectancy. Despite their complex health needs, socially marginalized individuals tend to underutilize healthcare services, delaying or avoiding care due to structural and social barriers. Furthermore, hospital staff often lack the knowledge, skills, and confidence required to provide appropriate care for these patients.

In response, Denmark has introduced an in-hospital social nursing initiative designed to enhance care for socially marginalized patients. Social nurses possess specialized knowledge and experience in addressing both medical and social concerns while working collaboratively with healthcare professionals to optimize treatment outcomes. Until now, limited knowledge exists on the social nursing initiative and its impact on socially marginalized patients’ pathways.

Methods

This PhD study comprises five sub-studies:

1. A qualitative study on patients’ experience of social nursing: This study aims to explore socially marginalized patients’ experiences with the in-hospital social nursing initiative.
2. A qualitative study on patients’ experience of the social nurses’ impact on hospital transitions and trajectories: This study explores (1) the perspectives of socially marginalized patients on the transition from hospital to home and (2) how these patients experience the importance of social nursing on patient trajectories after hospital discharge.
3. A qualitative study on health perceptions: This study aims to explore the health perceptions of socially marginalized patients and how they perceive themselves in a frame of healthcare.
4. A systematic literature review of interventions bridging social and healthcare: This study aims to explore how interventions can bridge social and healthcare delivery for socially marginalized patients in the transition between the hospital and community healthcare services.
5. A cohort study describing the population of patients receiving social nursing: This study aims to describe the population of patients who receive social nursing during hospital admission and which services they receive from a social nurse.

Perspectives

Expanding knowledge on social nursing initiatives for socially marginalized patients and their healthcare trajectories is important for addressing health inequities. These studies will generate valuable insights into the role of social nursing in improving care experiences and health outcomes for socially disadvantaged populations. The findings are expected to inform future healthcare interventions to optimize patient pathways and enhance support systems for individuals facing social vulnerabilities.