Graduate School of Nursing Dissertations



Publication Date


Document Type

Dissertation, Doctoral


Graduate School of Nursing

Dissertation Committee Chair

Nancy Morris, PhD, RN


unmet social needs, social determinants of health, primary care, primary care registered nurse, critical caring theory

Subject Categories

Health Services Administration | Medicine and Health | Nursing | Primary Care



The purpose of this study was to explore how primary care registered nurses address unmet social needs in patients.


  • Explore how RNs in a safety-net, primary care setting develop an awareness of and address patient's unmet social needs.
  • Describe how information about unmet social needs are integrated into nursing assessment and intervention activities, and are shared with other members of the health care team.
  • Describe the challenges primary care RNs face when addressing unmet social needs.


Critical caring theory provided the framework for this study.


This study used a descriptive, qualitative design. Semi-structured interviews were conducted with seventeen nurses working in 11 different safety-net primary care clinics within a hospital-based system.


Three major themes emerged. Key findings included the importance of the nurse-patient relationship, the establishment of trust, and a caring, nonjudgmental approach to patients with unmet social needs. Nurses used knowledge of unmet needs to coordinate patient care, provide social support, and work collaboratively with care team members to refer patients to resources within the health care system and in the community.


Unmet social needs contribute to adverse health outcomes, and addressing social and medical needs is critical to eliminating health inequities and reducing health care costs. In this study, primary care nurses described relationships with patients that allowed for the sharing of sensitive information, leading the nurse to identify and address unmet social needs that could impact patient health.

Rights and Permissions

Copyright © 2018 Natale

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.



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