Facilitating acculturation of internationally educated nurses: A meta-synthesis of social integration strategies.

Abstract

To explore the social integration strategies adopted by internationally educated nurses during acculturation and to elucidate their role in facilitating successful adaptation to their host countries. With their remarkable resilience, internationally educated nurses navigate numerous challenges in their acculturation process in the host country. While the importance of effective social integration strategies in the acculturation and subsequent retention of internationally educated nurses is well known, the specific strategies adopted by these nurses have not been extensively explored. This study aims to fill this gap with its unique and significant focus on these strategies. Eight electronic databases were searched for English articles from inception to October 2023 to ensure a comprehensive review. The quality of the included studies was appraised using the Critical Appraisal Skills Program checklist. A meta-synthesis was performed using Sandelowski and Barroso's two-step approach, and a thematic analysis was performed according to Braun and Clarke's framework. This review included experiences of 258 internationally educated nurses across 16 primary studies and has yielded the overarching theme of 'fostering a sense of belonging'. The overarching theme is supported by three themes: (1) cultivating social capital, (2) employing effective communications, and (3) engaging with the community. Internationally educated nurses' social integration is a complex process that leverages support networks, establishing connections and overcoming communication barriers. However, the most crucial element is the active involvement of the host community, which plays a significant role in internationally educated nurses' acculturation journey. This review has highlighted the importance of social integration in internationally educated nurses' acculturation journey. Interventions such as having a supportive social network, providing a customised communication programme, organising engagement activities and granting overseas home leave are practical strategies that can enhance this journey.