Social-emotional well-being in the context of health care: concept analysisObjective: to analyze the concept of socio-emotional well-being in the context of health care
Method: concept analysis theoretical study based on the method of Walker and Avant, organized into eight stages, through scoping review. Seven data sources were searched, resulting in the selection of seven studies for the literature corpus.
Results: social-emotional well-being is characterized by essential attributes such as emotional balance, perceived social support, feeling of control over one’s life, and emotional regulation skills. Antecedent factors included resilience, social support, self-knowledge, supportive environment, emotional stability, autonomy and decision-making and positive interpersonal bonds. Consequent factors included improved quality of life, increased social engagement, reduced psychosocial symptoms, and better performance in daily activities.
Conclusion: the study showed that social-emotional well-being is a multifaceted concept that transcends individual mental health, encompassing social, emotional and cultural dimensions. Integrating social-emotional well-being into health care requires interdisciplinary approaches that consider individual and social factors, promoting holistic and patient-centered health care.
Descriptors:
Mental Health; Quality of Life; Delivery of Health Care; Concept Formation; Personal Satisfaction; Patient-Centered Care.
Highlights:
(1) Social-emotional well-being is multifaceted and multidimensional. (2) Social-emotional well-being contributes toward the improvement of quality of life. (3) Having emotional balance is key to dealing with emotions adaptively. (4) Social support contributes directly to emotional resilience. (5) Measuring social-emotional well-being involves a conceptual and methodological challenge
Objetivo: analisar o conceito do bem-estar socioemocional no contexto do cuidado em saúde.
Método: estudo teórico de análise de conceito orientado pelo método de Walker e Avant, organizado em oito etapas e operacionalizado mediante revisão de escopo. A busca se deu em sete fontes de dados, resultando na seleção de sete estudos para compor o corpus literário.
Resultados: o bem-estar socioemocional é caracterizado por atributos essenciais como equilíbrio emocional, percepção de suporte social, sensação de controle sobre a própria vida e habilidades de regulação emocional. Os antecedentes incluíram resiliência, suporte social, autoconhecimento, ambiente favorável, estabilidade emocional, autonomia e tomada de decisão, além de vínculos interpessoais positivos. Como consequentes, observaram-se melhora na qualidade de vida, aumento do engajamento social, redução de sintomas psicossociais e melhor desempenho em atividades cotidianas.
Conclusão: o estudo mostrou que o bem-estar socioemocional é um conceito multifacetado que transcende a saúde mental individual, abrangendo dimensões sociais, emocionais e culturais. Sua integração ao cuidado em saúde requer abordagens interdisciplinares que contemplem fatores individuais e sociais, promovendo um atendimento holístico e centrado no paciente.
Descritores:
Saúde Mental; Qualidade de Vida; Atenção à Saúde; Formação de Conceito; Satisfação Pessoal; Assistência Centrada no Paciente
Destaques:
(1) O bem-estar socioemocional é multifacetado e multidimensional. (2) O bem-estar socioemocional contribui para a melhoria da qualidade de vida. (3) Ter equilíbrio emocional é fundamental para lidar com emoções de forma adaptativa. (4) O suporte social contribui diretamente para a resiliência emocional. (5) A mensuração do bem-estar socioemocional envolve desafio conceitual e metodológico.
Objetivo: analizar el concepto de bienestar socioemocional en el contexto del cuidado en salud.
Método: estudio teórico de análisis de concepto guiado por el método de Walker y Avant, organizado en ocho etapas y operativizado mediante una revisión de alcance. La búsqueda se realizó en siete fuentes de datos, lo que dio como resultado la selección de siete estudios para conformar el corpus literario.
Resultados: el bienestar socioemocional está caracterizado por atributos esenciales como el equilibrio emocional, la percepción de apoyo social, la sensación de controlar la propia vida y habilidades de regulación emocional. Los antecedentes incluyeron resiliencia, apoyo social, autoconocimiento, entorno favorable, estabilidad emocional, autonomía y toma de decisiones, así como vínculos interpersonales positivos. Como resultado, se observaron mejoras en la calidad de vida, un mayor compromiso social, una reducción de los síntomas psicosociales y un mejor desempeño en las actividades cotidianas.
Conclusión: el estudio mostró que el bienestar socioemocional es un concepto multifacético que trasciende la salud mental individual y abarca dimensiones sociales, emocionales y culturales. Su integración en la atención sanitaria requiere enfoques interdisciplinarios que consideren los factores individuales y sociales, promoviendo una atención holística y centrada en el paciente.
Descriptores:
Salud Mental; Calidad de Vida; Atención a la Salud; Formación de Concepto; Satisfacción Personal; Atención Dirigida al Paciente
Destacados:
(1) El bienestar socioemocional es multifacético y multidimensional. (2) El bienestar socioemocional contribuye a una mejor calidad de vida. (3) Tener equilibrio emocional es esencial para gestionar las emociones de forma adaptativa. (4) El apoyo social contribuye directamente a la resiliencia emocional. (5) Medir el bienestar socioemocional implica desafíos tanto conceptuales como metodológicos.
Introduction
Well-being has been given increasing relevance in the health care field, especially as consideration as to care extends beyond purely biological aspects and begins to encompass emotional and social dimensions1. This holistic perspective favors more humane and person-centered practices, with a direct impact on the quality of the care provided.
Understanding well-being implies recognizing that mental health is not restricted to the absence of disorders, but involves emotional balance, psychological well-being and the ability to face the challenges of everyday life. Thus, it is intrinsically associated with each individual’s ability to cope with stress, work productively and contribute to their community2-3.
The World Health Organization (WHO)4 defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their community.” This concept encompasses emotional, psychological and social dimensions, directly influencing how people think, feel, act, cope with stress, build interpersonal relationships and make healthy decisions, which are essential and inseparable components of well-being3.
Over time, the concept of well-being has evolved from a view restricted to the absence of disease to more complex approaches, such as subjective well-being and psychological well-being, which consider, respectively, personal satisfaction and the full actualization of human potential3. This evolution shows that both the experience of positive emotions and the pursuit of purpose and growth are essential for a fulfilling life. However, the complexity of well-being goes beyond these individual dimensions, also incorporating social and relational aspects5.
Within this broader context, the concept of social-emotional well-being has arisen as an integrative perspective, emphasizing the interaction between social and emotional factors. This construct encompasses the ability to cope with daily challenges, develop resilience and maintain healthy relationships6. This perspective reflects a deeper and more multifaceted understanding of this phenomenon, conceiving social-emotional well-being as a balance between emotional regulation, the establishment of social relationships and a sense of purpose in life7. These approaches reinforce the understanding of social-emotional well-being as a multidimensional construct, essential to the integral development and quality of life (QoL) of individuals.
Despite the increasing use of the concept of social-emotional well-being in the literature, there is still no consensus on its definition, which limits its theoretical and practical application. The complexity of this construct requires researchers and health care professionals to consider subjective experiences, cultural aspects, social influences and family dynamics when developing health care promotion and prevention strategies.
In addition, the variety of terminologies used in the literature shows the need for a uniform definition, fundamental to guide both clinical practice and research. In this context, it is essential to clarify the concept of social-emotional well-being, which underlies the objective of this study: to analyze the concept of social-emotional well-being in the context of health care.
Method
Study type
Concept analysis theoretical study based on the model proposed by Walker and Avant8 through scoping review9. Concept analysis is a systematic approach widely used in nursing research to clarify complex concepts and broaden their application in clinical practice10.
The model8 comprises eight stages: 1) concept selection, which consists of choosing the phenomenon to be studied; 2) determination of objectives, when the purposes of the analysis are defined; 3) identification of possible uses, which explores how the concept is employed in the literature; 4) definition of essential attributes, which establishes the main characteristics of the concept; 5) identification of a model case, which exemplifies the concept in a clear and representative manner; 6) analysis of other cases, including borderline, related, and contrary cases, to show differences and similarities; 7) identification of antecedent and consequent factors, which precede and result from the concept; and 8) definition of empirical benchmarks, which are indicators used to measure the concept in practice.
To support this analysis, we incorporated a scoping review9 (stage 3), registered in the Open Science Framework (https://osf.io/h5zr6/) under DOI 10.17605/OSF.IO/H5ZR6, which supported the subsequent stages of the model.
Data collection
For formulation of the research question, we used the PCC mnemonic: Population - Unspecified; Concept - Social-emotional well-being; Context - Health care. Based on these definitions, the following guiding question was established: How is the concept of social-emotional well-being approached in the context of health care? The searches were performed in November and December 2024, with the primary strategy developed in conjunction with a professional librarian and adjusted for the eight data sources [PubMed, EMBASE (Excerpta Medica dataBASE), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus (Elsevier), Virtual Health Library (VHL) and Google® Scholar, combined with Boolean operators AND and OR (Figure 1).
Selection criteria
The delimited inclusion criteria were: studies accessible in full, published between 2014 and 2024, a period defined to cover recent productions, in Portuguese, Spanish and English; which contained the expression “social-emotional well-being” in the title, abstract or keywords, to ensure the relevance of the articles to the central theme of the research. The following studies were excluded: letters to the editor, editorials, abstracts and opinion studies and duplicates.
All identified articles were exported to the Rayyan® review manager. Two reviewers blindly evaluated titles, abstracts, and descriptors based on the eligibility criteria. Disagreements were resolved by a third reviewer. In addition to selection in the databases, a manual search was performed in the reference lists of the included studies.
Study selection, data processing and analysis
The search found 13,728 studies, of which 1,883 were duplicates. After screening titles, abstracts and keywords related to the term social-emotional well-being, 11,785 were excluded. There were 60 studies left for full reading, of which 53 were discarded for not meeting the inclusion criteria. Only articles that explicitly addressed the concept of social-emotional well-being were considered, resulting in seven studies included in the final review.
After selection, the studies were organized as follows: author and year, country, population and sample, main objective, concept of social-emotional well-being in the context of health care, and observed dimensions, as illustrated in Figure 2. The essential social-emotional well-being attributes were defined through the following question: What are the fundamental characteristics that define social-emotional well-being? To identify its antecedent factors, the following question was asked: What events precede social-emotional well-being? Finally, to determine its consequent factors, the following question was considered: What events result from social-emotional well-being?
Use of artificial intelligence
The authors declare the use of ChatGPT (https://chatgpt.com) for preparation of Figure 5, which presents a conceptual diagram illustrating the relations between factors associated with social-emotional well-being. The data and figure were edited by the authors for improvement and enhancement.
Results
The results are presented following the concept analysis stages according to Walker and Avant8.
Selection and objective
“Well-being” is often defined as a state of physical, mental and social balance, in which the individual feels healthy, comfortable and in harmony with himself and the environment. This state involves emotional and psychological aspects, such as happiness, security and fulfillment, as well as physical components, such as health and vitality5.
Additionally, well-being can extend to the social context, encompassing healthy interpersonal relationships and a sense of belonging to the community. In general, it represents the condition of being well holistically, including the absence of suffering, a good QoL and the ability to face challenges adaptively and positively5.
Although the WHO provides no specific definition for “social-emotional well-being,” the concept appears to be closely related to mental health, as it involves the ability to deal with emotions, establish healthy interpersonal relationships, and maintain emotional balance. According to the Australian Institute of Health and Welfare17, social-emotional well-being is described as an essential part of mental and social well-being, which goes beyond the absence of disease and includes the ability to maintain positive relationships, manage emotions and participate actively in the community, encompassing emotional resilience, a sense of belonging, and social support.
The lack of consensus in the definitions of social-emotional well-being shows its complexity and reinforces the need for a clear and contextualized conceptualization. This lack of consensus limits its application in research and interventions, hindering comparisons and generalizations. Establishing a definition that is consistent, flexible, and applicable to different contexts is essential to consolidate the concept, guide effective caregiving practices, and promote social-emotional well-being broadly and meaningfully.
Identification of possible uses of the concept
This section identifies the possible uses of the concept of well-being, based on the seven studies selected in stage three, which explore its applications, characteristics and practical implications in different contexts.
A study1 conducted in Turkey used the concept of social-emotional well-being to investigate how stress and work overload experienced by health care mothers during the COVID-19 pandemic affected the emotional and behavioral balance of their children. The study noted that the children’s social-emotional well-being was compromised, resulting in higher rates of anxiety, depression, and behavioral issues. Thus, the concept of social-emotional well-being was applied to understand how external factors, such as parental stress, impact children’s mental health and reinforce the need for policies to support families in crisis situations.
In a different context, a study15 in Singapore and Australia indirectly addressed social-emotional well-being by validating a utility index for patients with diabetic retinopathy. Although the primary focus was on health-related QoL, the study showed that vision loss can lead to social isolation and depression, impacting the patients’ social-emotional well-being. In this case, the concept was used to emphasize the importance of considering emotional and social aspects in the treatment of chronic conditions.
In the United States of America (USA), a study16 explored the experiences of parents of children with fetal alcohol spectrum disorder (FASD), using the concept of social-emotional well-being to understand how stress and emotional overload affect the mental health of parents. The study showed that several parents face feelings of guilt, stress, and isolation, compromising their emotional balance. Here, the concept was applied to emphasize the need for psychological and practical support for parents, promoting a healthier family environment.
In Australia, a study14 addressed the impact of the COVID-19 pandemic on the QoL of older adults receiving community care, using the concept of social-emotional well-being to explore how social isolation and interruption of services affected the mental health of older adults. The study showed that many older adults reported loneliness and depression, underscoring the importance of strategies to maintain social contact and emotional support. In this context, the concept was applied to emphasize the need for integrated approaches that consider both physical and emotional care.
Another study13, a collaboration between Australia, Switzerland, the USA and the UK, focused on the social-emotional well-being of adults with hearing loss. The concept was used to discuss how hearing loss can lead to social isolation and depression, thus impacting QoL. The study recommended the introduction of social-emotional well-being promotion strategies, such as psychological counseling and social support, in audiological rehabilitation programs. The concept was applied to show the importance of a holistic approach in the treatment of chronic conditions.
In the USA, a study12 analyzed family engagement among residents of adult foster care homes, using the concept of social-emotional well-being to explore how the reduced family contact during the pandemic affected the mental health of the residents. The study showed that several residents reported feelings of abandonment and loneliness, showing the importance of family engagement for emotional balance. In this case, the concept was applied to reinforce the need for policies that strengthen family bonds and promote social-emotional well-being.
In New Zealand, a study11 assessed the results of a community-based physical activity program among parents and daughters, using the concept of social-emotional well-being to explore how social interaction and physical activity impact the mental and emotional health of the participants. The study showed that the program promoted significant improvements in social-emotional well-being, strengthening family bonds and reducing stress. The concept was applied to emphasize the importance of programs that integrate physical activity and social interaction to promote mental health.
By analyzing these studies, it is reinforced that social-emotional well-being is a multidimensional concept, essential for QoL in different phases and contexts. From the impact of the pandemic on child mental health to the challenges faced by older adults and adults with chronic conditions, emotional and social balance arises as a crucial factor for human development.
Essential attributes
Defining essential attributes is a fundamental step in concept analysis, as these characteristics clarify the essence of the concept, enabling its recognition, differentiation and validation of its applicability in different contexts8. Analysis of the selected studies showed the essential attributes of social-emotional well-being.
Emotional balance
Emotional balance refers to the ability to deal with emotions in a stable and adaptive manner, minimizing negative impacts of anxiety, stress, and sadness. It is essential for maintaining mental health and directly influences how individuals cope with everyday challenges14,16.
The relevance of emotional balance is evident in different contexts. A study14 that followed older adults in community care during the pandemic used mental health scales and semi-structured interviews to analyze the relation between emotional balance and QoL. The results indicated that older adults with higher emotional balance had lower levels of loneliness and depression, demonstrating the relevance of this attribute for social-emotional well-being, especially in situations of vulnerability.
Beyond the individual impact, emotional balance also influences the family environment. A study16 on parents of children with or at risk of FASD found that the emotional balance of parents directly impacts the well-being of families. Parents with higher emotional control showed better adaptation to the difficulties faced, contributing to the emotional health of all family members. These findings reinforce that emotional balance strengthens the individual and plays a crucial role in interpersonal relationships and family dynamics.
Perceived social support
Perceived social support is related to the feeling of support received from family members, friends and communities. It plays a central role in emotional resilience and coping with difficulties, fostering a sense of belonging and security. In addition, feeling supported is directly associated with confidence and emotional stability11,13.
Perceived social support is a determining factor for emotional well-being, especially in vulnerable groups. In patients with hearing loss, feeling supported reduced stress levels and facilitated adaptation to limitations, as demonstrated by a study using questionnaires and psychological tests13. In the family context, support was essential for the social-emotional well-being of foster care home residents, while its absence, especially during the COVID-19 pandemic, was associated with higher stress and emotional difficulties12.
Beyond the family environment, community support also plays a key role. A study that analyzed the participation of parents and children in a community physical activity program demonstrated that social support strengthened family bonds and promoted the feeling of belonging, thereby contributing to the participants’ social-emotional well-being11.
Feeling of control over one’s life
The feeling of control over one’s life is related to the perceived autonomy and ability to make decisions that influence one’s well-being. This attribute is strongly associated with self-confidence, independence and personal satisfaction15.
The perceived control over one’s life has shown a significant impact on adaptation to adverse conditions. A study15 with patients with diabetic retinopathy, conducted through discrete choice experiments and QoL reports, observed that those who felt in command of their own health-related decision-making reported higher satisfaction and a more positive adaptation to the chronic condition. This shows the importance of feeling in control for emotional well-being and resilience in the face of complicated health conditions.
In a similar context, a study14 with older adults under community care during the COVID-19 pandemic showed the relevance of autonomy in emotional health. Those who maintained a feeling of control over their lives had less anxiety and better QoL, suggesting that the ability to manage one’s life, especially in times of major uncertainty, is critical to maintaining emotional health.
Emotional regulation skills
Emotional regulation skills involve the ability to recognize, understand and manage emotions adaptively, enabling individuals to face challenges without developing disproportionate stress or anxiety responses13.
The relevance of this attribute was shown in different populations. A study16 with parents of children with FASD, based on interviews and emotional regulation scales, indicated that those with higher command of these skills had better adaptation to complex challenges, favoring psychological balance and resilience.
In addition, a review13 on the impact of hearing loss on adult social-emotional well-being showed that emotional regulation plays an essential role in adapting to hearing loss. Patients who showed greater ability to manage their emotions faced the challenges of the condition in a more positive manner, showing that the development of these skills can mitigate the negative impacts of physical limitations on QoL. Figure 3 shows the essential attributes under consideration.
These attributes are fundamental to social-emotional well-being and are manifested in different contexts. Perceived social support strengthens the sense of belonging and connection, while the feeling of control over one’s life promotes autonomy and reduces anxiety. Emotional balance enables one to deal with stressors adaptively, positively impacting mental health. In addition, emotion regulation skills enable individuals to manage their emotions effectively, preventing disproportionate reactions and promoting overall well-being.
Model case
Cases are examples used to illustrate and clarify the concept under study. They help differentiate the concept from related terms and show how it can be applied in different contexts8.
The model case represents the complete manifestation of the concept of social-emotional well-being. L.P.M., 45 years old, a university professor recently diagnosed with early-stage breast cancer, has since the diagnosis had anxiety attacks that intensify at night. She initiated professional follow-up with psychotherapy, regular practice of guided meditation and participation in a community arts group in the community. Over the course of eight months, she developed essential attributes of social-emotional well-being. L.P.M. exhibits the ability to deal with complex situations associated with treatment, maintains significant bonds with family members and colleagues, perceives herself supported in her social network and expresses feelings of hope for the future. In addition, she presents a healthy regulation of emotions in the face of stressing situations, manages to re-signify her experience of illness, and maintains a satisfactory level of engagement in daily activities. As a result, she presents reduced emotional distress, better performance in daily activities, and higher QoL. This case reflects the full manifestation of the concept of social-emotional well-being.
Analysis of other cases
Borderline case
The borderline case contains some but not all of the essential attributes of the concept8. L.G.P., 42 years old, diagnosed with depression triggered by labor stressors, initiated follow-up with cognitive-behavioral therapy and drug treatment. As a complement, they began to perform regular physical activities and dedicate themself to leisure practices that afford them pleasure. Despite the initial improvement, with more positive coping and a feeling of greater control over their own life, they still present emotional instability (depressed mood, irritability, anxiety) and difficulties in emotional regulation, especially in the face of work-related demands. Although depressive symptoms have decreased, significant psychological fluctuations persist. Therefore, this is a borderline case, in which some social-emotional well-being attributes are present, but not in an integral way.
Contrary case
The contrary case exemplifies the “not the concept,” that is, the total or almost total absence of the essential attributes of the concept8. C.O.R., 38 years old, who has recently moved from the countryside to São Paulo-SP, presents anxiety and depression disorders. Although he consulted a psychiatrist, he neither followed medical recommendations nor sought additional psychological or therapeutic follow-up. He manifests recurrent episodes of irritability, depressed mood, anxiety and feeling of lost control. He lives isolated and without support networks, remaining much of the time secluded in his room, without engaging in social or leisure activities. In this context, anxiety and depression symptoms are aggravated by the lack of social support and adequate coping strategies. Thus, low QoL is observed, with the absence of the essential attributes of social-emotional well-being.
Related case
The related case illustrates a situation that is associated with the concept of social-emotional well-being8. G.T., 28 years old, a sixth-year medical student, presents with chronic stress, insomnia and emotional instability for much of the school period. They believe they have an anxious and depressive syndrome. However, after the end of the tests, there is a significant improvement in the situation, due to the reduction of stress and the resumption of physical activities, leisure practices and social interaction with friends. This case is related to the concept, but does not fully cover its essential attributes, as there is no search for professional evaluation and therapeutic follow-up, essential for the complete development of social-emotional well-being.
Antecedent and consequent factors
Antecedent factors refer to the causes or circumstances that precede the promotion of social-emotional well-being8. The analysis of the studies showed that several factors contribute to the development of this concept.
Resilience
The ability to overcome adversity and adapt to challenging circumstances plays an essential role in emotional balance and maintenance of social-emotional well-being15. More resilient individuals tend to have greater control over their own lives and develop more effective strategies to cope with stressful situations, which favors their adaptation to different contexts and contributes toward improving QoL15.
Social support
Emotional and practical support offered by family members, friends or community networks has a direct impact on reducing stress and strengthening well-being. The presence of a support network is a contributing factor when facing challenges and promotes a feeling of belonging, thus favoring emotional stability14. In addition, environments that foster social interaction strengthen interpersonal bonds and create favorable conditions for healthy social-emotional development13.
Self-knowledge
People with a higher degree of self-knowledge deal better with daily challenges, avoiding impulsive or disproportionate responses. This factor is directly associated with the development of resilience and the strengthening of emotional skills, contributing toward a better adaptation to different life circumstances16.
Favorable environment
A context that provides emotional security, social support, and access to adequate resources directly influences social-emotional well-being. Supportive environments promote greater emotional stability and facilitate the creation of positive interpersonal relationships. The presence of spaces that encourage healthy interactions and provide continuous support helps strengthen emotional regulation and the ability to face challenges16.
Emotional stability
Maintaining a balanced emotional state in the face of adverse situations is an essential factor for social-emotional well-being. Emotionally stable individuals have greater control over their actions and reactions, which favors a more positive adaptation to different circumstances15. This stability is related to the ability to regulate emotions and face challenges rationally and resiliently.
Autonomy and decision-making
The perceived control over one’s own life is directly associated with social-emotional well-being. Having autonomy to make decisions, especially in managing one’s own health and organizing daily life, reduces anxiety levels and promotes greater personal satisfaction. Feeling in command of one’s own choices boosts self-confidence and provides a greater feeling of actualization and purpose15.
Positive interpersonal bonds
Healthy relationships and meaningful social interactions are fundamental for social-emotional well-being. Interpersonal bonds based on trust and mutual support afford emotional security and contribute toward building a sense of belonging14. Environments that foster these connections strengthen the perception of social support and promote greater emotional stability over time.
The consequent factors of social-emotional well-being refer to the outcomes that arise as a consequence of this state8.
Improved quality of life
Social-emotional well-being contributes to a more balanced general state, directly reflected in QoL. Individuals who show greater emotional stability and adequate social support face challenges with more resilience, exhibit greater personal satisfaction, and maintain a more positive outlook on life. This is noticeable in the adaptation to chronic health conditions, in coping with family difficulties and in the management of day-to-day stress14.
Increased social engagement
People who experience a balanced emotional state tend to seek and maintain social connections more actively, participating in community activities, establishing stronger bonds with family members and friends, and developing a sense of belonging. This interaction favors the exchange of support and creates a virtuous cycle in which social contact reinforces emotional well-being11.
Reduced psychosocial symptoms
The ability to regulate emotions effectively and the presence of a reliable support network enables individuals to better cope with adverse situations while minimizing negative mental health impacts. In vulnerable groups, such as older adults, chronically ill individuals or those facing significant changes in their lives, the presence of social-emotional well-being can be a determining factor for the prevention of psychological disorders13.
Improved performance in daily activities
Individuals with higher emotional balance exhibit greater motivation, concentration and adaptability, which is reflected in better performance in the school, work and family interactions. Children and adults with high social-emotional well-being have greater engagement in their tasks and a more positive approach to challenges, favoring a more productive and efficient functioning1.
The consequent factors of social-emotional well-being show its broad benefits, encompassing emotional, social and functional aspects. Psychological stability favors active participation in social life and the maintenance of good QoL, creating a positive cycle in which emotionally balanced individuals tend to develop healthier relationships and face challenges more confidently. Thus, fostering and strengthening social-emotional well-being becomes an essential strategy to improve the mental health and general well-being of the population.
Figure 4 shows the antecedent and consequent factors of social-emotional well-being.
Antecedent and consequent factors of social-emotional well-being. Curitiba, PR, Brazil, 2025
Figure 5 presents a conceptual diagram that illustrates the relations between factors associated with social-emotional well-being, organized into three levels: antecedent factors, attributes and consequent factors.
Discussion
Definition of empirical frameworks
Empirical frameworks are the measurement tools that demonstrate the occurrence of the concept, requiring the identification of observable indicators, measurement methods and manifestation patterns8.
The analyzed studies provide evidence on how social-emotional well-being is manifested and influenced by external factors, providing a more structured understanding of its fundamental characteristics. However, its measurement still faces conceptual and methodological challenges, as there is no instrument that fully captures the complexity of the experiences associated with this concept.
Mental health and well-being are multidetermined constructs, informed by biological, social and cultural factors that influence the perception, emotional experience, and coping and social interaction strategies of individuals. As each cultural context defines its own parameters for what constitutes mental health, sensitivity to these nuances is imperative for the relevance and effectiveness of any intervention. This inherent complexity requires the development of assessment instruments capable of apprehending its multiple dimensions, enabling a comprehensive and properly contextualized measurement of the concept2.
The reviewed studies adopted standardized instruments to assess different dimensions of social-emotional well-being, including QoL, social support, and emotional well-being. The Lubben Social Network Scale (LSNS-6) was used to measure perceived social support, focusing on family and friend support networks. In turn, the EQ-5D-5L (EuroQoL-5D-5L) assessed health-related quality of life (HRQoL) in five dimensions: mobility, self-care, pain/discomfort, usual activities, and anxiety/depression symptoms14.
Other instruments were applied to measure specific aspects of social-emotional well-being in different populations. The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) scale, for example, was used to assess the social and emotional health of children aged up to three years1. In the context of hearing aid, questionnaires such as the Patient Health Questionnaire-4 (PHQ-4), the Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL), the Social Participation Restrictions Questionnaire (SPaRQ) and its reduced five-item version (SIM), in addition to the Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S), were recommended to investigate the impact of hearing loss on social-emotional well-being13.
In addition, a multicenter study15 incorporated social-emotional well-being into the development of the Disease-Related Utility Index (DRU-I), a scale aimed at assessing hearing-related QoL. In this scale, social-emotional well-being was considered one of the five central dimensions of patient QoL. However, the complexity of this construct requires a more in-depth approach, addressing its multiple dimensions and factors, providing a more comprehensive and accurate evaluation.
Importantly, none of the reviewed studies developed or applied a scale that objectively measures social-emotional well-being. The adopted tools assess correlated aspects, such as depression and anxiety symptoms and life satisfaction, but do not capture the construct comprehensively and specifically. This shows a gap in the literature regarding the direct measurement of social-emotional well-being.
The analysis of the reviewed studies shows that social-emotional well-being is a multidimensional construct, influenced by several factors, such as adaptation to stress12, quality of interpersonal relationships15 and social support14. In addition, concepts such as emotional resilience16, self-esteem13, family support11 and social adaptation1 are fundamental to promote social-emotional well-being, especially in adverse contexts, such as public health crises and chronic diseases. These factors have a significant impact on the mental health of individuals of different age groups and are essential for designing more effective and personalized interventions.
Thus, integrating social-emotional well-being promotion strategies into health care practices and public policies is crucial, recognizing the complexity and interdependence of factors that support mental and emotional health throughout life18. The interventions should be adapted to the specific needs of each population, ensuring that emotional aspects are effectively incorporated into approaches geared toward health care and QoL.
A central point that emerges from the analysis is that, despite the different contexts in which it can be investigated - such as palliative care19, therapeutic diets20, chronic diseases21 or experiences of cultural minorities22-24 -, social-emotional well-being, in all cases, appears as a mediator of adaptation to illness and adversity. This reinforces the idea that health cannot be understood only in biomedical terms, but must also be understood as a phenomenon that integrates emotional processes, social relations and structural conditions of life.
Another relevant aspect is the relational dimension of social-emotional well-being. Studies in indigenous populations22-24 and clinical settings19 show that the quality of social connections, community support and cultural valorization play a central role in preserving social-emotional well-being. This perspective broadens the understanding of the construct, dissociating it from an individualized reading and associating it to an ecosystemic view, in which family, community and culture are determinants.
The discussion also indicates the importance of health equity as a determining factor of social-emotional well-being. Studies21,25 during the COVID-19 pandemic show how social determinants - such as income, access to services and social support - directly affect social-emotional well-being. These findings reinforce that public policies need to consider that social vulnerability translates not only into worse clinical outcomes, but also into greater emotional and social suffering, supporting the interdependence between structural inequality and mental health.
In this context, it is essential to recognize that the concept of well-being varies significantly between individuals and communities, informed by factors such as sociocultural context, personal experiences and collective values. Far from being a static or universal concept, well-being is configured as a dynamic and situated construction, whose understanding requires the integration of multiple perspectives. This semantic variability underlines the importance of approaches that take into consideration the particularities of each group26.
It should be noted that the analyzed studies show that social-emotional well-being should be understood as a multidimensional and dynamic construct, involving life experiences, cultural contexts and social conditions3. At the same time, these analyses indicate an important gap: the lack of specific instruments that directly measure this dimension. This methodological limitation does not invalidate the theoretical advances, but indicates the need for the development of more comprehensive measures that capture the complexity of the construct and provide inputs for health care practices and public policies geared toward promoting integral health20,24-25.
A limitation of this concept analysis lies in the lack of terminological and conceptual standardization in studies on social-emotional well-being. The employed definitions and terminologies show a diversity that hinders the comparison of results between different studies, compromising the construction of a cohesive conceptual foundation. Furthermore, the adopted time frame may have excluded relevant studies published outside the analyzed period, limiting the scope of the review. Similarly, the use of only Google® Scholar as a source of gray literature may have limited access to complementary perspectives.
Conclusion
Social-emotional well-being is a multidimensional construct that goes beyond individual mental health, encompassing social, emotional and cultural interactions. Factors such as social support, interpersonal relationships, socio-cultural context and living conditions directly influence its manifestation and perception by individuals, showing the need for an integrated and contextualized understanding of the concept.
This concept analysis contributes toward consolidating the understanding of social-emotional well-being, supporting the design of health care public policies and interventions that integrate emotional, social and cultural aspects. Recognizing that the concept varies between different contexts and populations enables the promotion of more effective strategies geared toward integral health and QoL.
Data Availability Statement:
All data generated or analysed during this study are included in this published article.
References
-
1 Us MC, Boran P, Yalçın SS, Savcı RG, Kural B, Özdemir DF. Social-emotional and behavioural problems in young children of healthcare worker mothers during the COVID-19 outbreak: a case-control study. BMC Psychiatry. 2024;24(1):407. https://doi.org/10.1186/s12888-024-05801-4
» https://doi.org/10.1186/s12888-024-05801-4 -
2 Gautam S, Jain A, Chaudhary J, Gautam M, Gaur M, Grover S. Concept of mental health and mental well-being, its determinants and coping strategies. Indian J Psychiatry. 2024;66(Suppl2):83-8. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_707_23
» https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_707_23 -
3 Budler LC. Well-being unveiled: a concept analysis of mental, psychological, and subjective well-being. Health Sci Rep. 2025;8(9):e71149. https://doi.org/10.1002/hsr2.71149
» https://doi.org/10.1002/hsr2.71149 -
4 World Health Organization. Mental health [Internet]. Geneva: World Health Organization; 2024 [cited 2024 Jan 14]. Available from: Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
» https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response - 5 Ryff CD, Boylan JM, Kirsch JA. Eudaimonic and hedonic well-being. In: Lee MT, Kubzansky LD, VanderWeele TJ, editors. Measuring well-being: interdisciplinary perspectives from the social sciences and the humanities. New York, NY: Oxford University Press; 2021. p. 92-135
-
6 Murray L, Levickis P, McFarland L, Eadie P, Lee-Pang L, Quach J, et al. Supporting young children’s social-emotional wellbeing in early childhood education and care: perspectives from the sector. Educ Sci. 2025;15(5):569. https://doi.org/10.3390/educsci15050569
» https://doi.org/10.3390/educsci15050569 -
7 Park CL, Kubzansky LD, Chafouleas SM, Davidson RJ, Keltner D, Parsafar P, et al. Emotional well-being: what it is and why it matters. Affect Sci. 2023;4(1):10-20. https://doi.org/10.1007/s42761-022-00163-0
» https://doi.org/10.1007/s42761-022-00163-0 - 8 Walker LO, Avant KC. Strategies for theory construction in nursing. 6th ed. Upper Saddle River, NJ: Pearson; 2019. 272 p.
-
9 Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: scoping reviews. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI manual for evidence synthesis [Internet]. Adelaide: JBI; 2024 [cited 2024 Jan 10]. Available from: https://doi.org/10.46658/JBIMES-24-09
» https://doi.org/10.46658/JBIMES-24-09 -
10 Hellman AN. The concept analysis: an effective and important starting point in nursing research. J Radiol Nurs. 2024;43(1):11-4. https://doi.org/10.1016/j.jradnu.2023.12.001
» https://doi.org/10.1016/j.jradnu.2023.12.001 -
11 Ashton LM, Rayward AT, Pollock ER, Kennedy SL, Young MD, Eather N, et al. Twelve-month outcomes of a community-based, father-daughter physical activity program delivered by trained facilitators. Int J Behav Nutr Phys Act. 2024;21(1):101. https://doi.org/10.1186/s12966-024-01648-w
» https://doi.org/10.1186/s12966-024-01648-w -
12 Tunalilar O. Family involvement among Oregon adult foster home residents, 2018-2023. J Am Med Dir Assoc. 2024;25(8):105009. https://doi.org/10.1016/j.jamda.2024.03.120
» https://doi.org/10.1016/j.jamda.2024.03.120 -
13 Timmer BHB, Bennett RJ, Montano J, Hickson L, Weinstein B, Wild J, et al. Social-emotional well-being and adult hearing loss: clinical recommendations. Int J Audiol. 2024;63(6):381-92. https://doi.org/10.1080/14992027.2023.2190864
» https://doi.org/10.1080/14992027.2023.2190864 -
14 Siette J, Dodds L, Seaman K, Wuthrich V, Johnco C, Earl J, et al. The impact of COVID-19 on the quality of life of older adults receiving community-based aged care. Australas J Ageing. 2021;40(1):84-9. https://doi.org/10.1111/ajag.12924
» https://doi.org/10.1111/ajag.12924 -
15 Fenwick EK, Bansback N, Gan ATL, Ratcliffe J, Burgess L, Wong TY, et al. Validation of a novel diabetic retinopathy utility index using discrete choice experiments. Br J Ophthalmol. 2020;104(2):188-93. https://doi.org/10.1136/bjophthalmol-2019-313899
» https://doi.org/10.1136/bjophthalmol-2019-313899 -
16 Pruner M, Jirikowic T, Yorkston KM, Olson HC. The best possible start: a qualitative study on the experiences of parents of young children with or at risk for fetal alcohol spectrum disorders. Res Dev Disabil. 2020;97:103558. https://doi.org/10.1016/j.ridd.2019.103558
» https://doi.org/10.1016/j.ridd.2019.103558 -
17 Australian Institute of Health and Welfare. Australia’s welfare 2023 in brief [Internet]. Canberra: AIHW; 2023 [cited 2025 Sep 2]. Available from: Available from: https://www.aihw.gov.au/reports/australias-welfare/australias-welfare-2023-in-brief
» https://www.aihw.gov.au/reports/australias-welfare/australias-welfare-2023-in-brief -
18 Dudgeon P, Carlin E, Derry K, Alexi J, Mitchell M, Agung-Igusti RP. Evaluating a social and emotional well-being model of service piloted in Aboriginal community controlled health services in Western Australia: an Aboriginal participatory action research approach. BMJ Open. 2023;13(10):e075260. https://doi.org/10.1136/bmjopen-2023-075260
» https://doi.org/10.1136/bmjopen-2023-075260 -
19 López-Salas M, Yanes-Roldán A, Fernández A, Marín A, Martínez AI, Monroy A, et al. End-of-life care needs in cancer patients: a qualitative study of patient and family experiences. BMC Palliat Care. 2024;23:157. https://doi.org/10.1186/s12904-024-01489-1
» https://doi.org/10.1186/s12904-024-01489-1 -
20 Orr E, Whitney R, Nandeesha N, Kossoff EH, RamachandranNair R. Ketogenic diet: parental experiences and expectations. J Child Neurol. 2024;39(1-2):45-54. https://doi.org/10.1177/08830738241227066
» https://doi.org/10.1177/08830738241227066 -
21 Myers C, Waldron C, Bennett K, Cahir C. The impact of the COVID-19 pandemic on women living with and beyond breast cancer: a qualitative study of women’s experiences and how these varied by social determinants of health. BMC Cancer. 2023;23:867. https://doi.org/10.1186/s12885-023-11351-x
» https://doi.org/10.1186/s12885-023-11351-x -
22 Glover K, Leane C, Nikolof A, Gartland D, Cahir P, Mensah FK, et al. Cohort profile: the Aboriginal families study - a prospective cohort of Aboriginal children and their mothers and caregivers in South Australia. BMJ Open. 2024;14(8):e082337. https://doi.org/10.1136/bmjopen-2023-082337
» https://doi.org/10.1136/bmjopen-2023-082337 -
23 Dawson AP, Warrior E, Pearson O, Boyd MA, Dwyer J, Morey K, et al. Exploring self-determined solutions to service and system challenges to promote social and emotional wellbeing in Aboriginal and Torres Strait Islander people: a qualitative study. Front Public Health. 2023;11:1206371. https://doi.org/10.3389/fpubh.2023.1206371
» https://doi.org/10.3389/fpubh.2023.1206371 -
24 Brodie T, Pearson O, Cantley L, Cooper P, Westhead S, Brown A, et al. Strengthening approaches to respond to the social and emotional well-being needs of Aboriginal and Torres Strait Islander people: the Cultural Pathways Program. Prim Health Care Res Dev. 2021;22:e35. https://doi.org/10.1017/S1463423621000402
» https://doi.org/10.1017/S1463423621000402 -
25 Featherstone C, Sharpe RA, Axford N, Asthana S, Ball S, Husk K. Barriers to healthcare and their relationship to well-being and social support for autistic adults during COVID-19. Prim Health Care Res Dev. 2022;23:e79. https://doi.org/10.1017/S1463423622000755
» https://doi.org/10.1017/S1463423622000755 -
26 Huang L, Kern ML, Oades LG. Chinese international students’ conceptualizations of wellbeing: a prototype analysis. Front Psychol. 2022;13:939576. https://doi.org/10.3389/fpsyg.2022.939576
» https://doi.org/10.3389/fpsyg.2022.939576
-
*
Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant # 303955/2022-8, Brazil.
-
How to cite this article:
Ribeiro CO, Kalinke LP, Salgado NFOG, Nogueira LA, Pinto DL, Barroso TMMDA. Social-emotional well-being in the context of health care: concept analysis. Rev. Latino-Am. Enfermagem. 2026;34:e4798 [cited month year day ]. Available from: URL .https://doi.org/10.1590/1518-8345.8071.4798
Edited by
-
Editora Asociada:
Maria Lúcia Zanetti
Source: OpenAI *QoL = Quality of life