Nurse Knowledge and Practices in Primary Care Contributing to Health Promotion: A Systematic Review and Mixed Synthesis

Health promotion in primary care has been explored mainly in the practices of extended health teams, without focusing specifically on nursing professionals. Systematic reviews respond to the need to ensure that decisions affecting people's lives rest on updated and comprehensive evidence. Objective To identify the specific knowledge and practices of nursing professionals in primary health care that contribute to health promotion, together with the factors that facilitate or hinder their implementation, in order to strengthen the distinctive role of nursing in health promotion within primary health care. Method Systematic review with mixed synthesis. Seven databases were searched (BIREME Virtual Health Library, PubMed–MEDLINE, Embase, the Cochrane Library, EBSCO/Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, and American Psychological Association PsycInfo), combining health sciences descriptors and medical subject headings through Boolean operators and complemented by manual searching of reference lists. Only primary studies in Spanish, English, and Portuguese were included, with no time restriction. Methodological quality was assessed with the JBI Critical Appraisal tools according to study design. Qualitative findings were integrated through meta-synthesis, and confidence in each finding was assessed with GRADE-CERQual. Results Eight primary studies (seven qualitative and one quantitative) were included, conducted in Brazil and Colombia, together with one Brazil–Spain comparative study. The meta-synthesis identified eight findings; the most supported were individual and group health education practices and structural limitations and organisational barriers (six of eight studies each), followed by community care with social participation, solid clinical knowledge, and interprofessional teamwork (five of eight each). The approach assigned high confidence to one finding, moderate confidence to five, and low confidence to two. Across the included studies, nurses demonstrated a solid clinical foundation, while their command of the socio-environmental approach to health promotion appeared comparatively less developed, with practice tending to remain anchored in the biomedical model. Conclusions Nurses in Latin America held a solid clinical foundation but showed training needs regarding the socio-environmental approach. The successful practices identified—health education, interprofessional teamwork, community action, and empowerment—offer a potential model for training future primary health care nursing professionals in the countries studied.