Psychological Security and Social Well-Being Among Women Attending Comprehensive Health Centers in East Guilan, Iran: A Cross-Sectional Study.

Primary healthcare (PHC) refers to the first level of contact within health systems, where care is delivered close to people’s communities and everyday environments. It is characterised by accessibility, continuity and coordination of care and plays a central role in promoting health, preventing disease and managing chronic conditions (). In PHC settings, care provision extends beyond clinical treatment to include links with community resources and attention to social determinants of health (). Effective coordination of care, involving collaboration between professionals, services and sectors, is essential to ensure continuity and quality in responding to population needs (). In this context, nurses working in PHC are key professionals, acting as community-based practitioners with a comprehensive view of the individual () and the ability to establish therapeutic relationships that support an integrated approach to users’ needs (; ). People accessing PHC, including older adults, often present complex and multifactorial needs (), encompassing physical, emotional, social and relational dimensions (). In this study, the term older adults refers to individuals aged 65 years and over, consistent with international public health definitions of ageing populations (). This population group was selected due to the increased prevalence of chronic conditions, social isolation, functional decline and complex psychosocial needs, which frequently require integrated and community-based responses (; ; ). The presence of chronic conditions, persistent pain, loss of mobility and functionality decline requires interventions aimed at promoting autonomy and alleviating symptoms (; ). At the same time, factors such as social isolation, loneliness, unemployment, grief and stress have a direct impact on health and well-being () and often remain unaddressed without a holistic assessment (). These needs are intrinsically linked to the social determinants of health, including living conditions, access to support networks, educational level and community integration (Al-Habbal et al., 2025). In this context, social prescribing has emerged as an innovative strategy that enables health professionals to refer individuals to a range of non-clinical, community-based interventions such as walking or gardening groups, swimming programmes, cultural initiatives, emotional support groups or volunteering (; ; ; ). These interventions have the potential to simultaneously address physical needs (such as pain management or maintaining mobility), emotional needs (such as psychological well-being and self-esteem) and social needs (such as a sense of belonging and integration) (; ). In addition, social prescribing can function as mechanisms to support the balance between individual resources and environmental challenges, promoting the maintenance of autonomy and a sense of identity (). Emerging evidence suggests that social prescribing contributes to improvements in well-being, social connectedness and self-management, particularly among individuals with complex health and social needs (; ; ). However, the existing evidence base remains heterogeneous, with variations in intervention design and outcome measures, which can limit the strength of conclusions regarding its effectiveness and long-term impact (; ). The practice of social prescribing is especially relevant in vulnerable populations, particularly older adults, who often experience accumulated physical and psychosocial frailties ().