An inclusive workplace is where everyone is supported to thrive and succeed regardless of their background. Supportive working conditions and general self-efficacy have been found to be important for nurses' perceived competence and well-being at work, however, in the context of being a nurse in a new country, research is limited. Moreover, knowledge is lacking about whether different paths to a nursing license are related to nurses' perceived competence and well-being when working. To examine determinants and experiences of nursing competence and well-being at work (thriving and stress) among internationally and domestically educated nurses. A longitudinal descriptive and correlational design with a mixed-methods convergent approach was used. A longitudinal study was conducted between January 2019 and June 2022 with two groups of internationally educated nurses who had completed a bridging program or validation to obtain a Swedish nursing license and one group of domestically newly educated nurses. Data were collected on three occasions: Time1 at the end of the nursing licensure process (n = 402), Time2 after three months (n = 188), and Time3 after 12 months (n = 195). At Time3, 14 internationally educated nurses were also interviewed. Data were analyzed separately and then interpreted together. Multiple regression models showed that greater access to structural empowerment ( = 0.70, 95 % CI [0.31; 1.08]), better cooperation ( = 3.76, 95 % CI [1.44; 6.08]), and less criticism ( = 3.63, 95 % CI [1.29; 5.96]) were associated with higher self-rated competence at Time3, whereas the variable path to a nursing license was non-significant (R = 49.2 %). For well-being, greater access to structural empowerment ( = 0.07, 95 % CI [0.02; 0.12]), better cooperation ( = 0.36, 95 % CI [0.07; 0.66]) and being domestically educated ( = 0.53, 95 % CI [0.14; 0.92]) were associated with higher thriving at work (R = 25.8 %). For stress, greater access to structural empowerment ( = −0.06, 95 % CI [−0.09; −0.02]), better cooperation ( = −0.30, 95 % CI [−0.51; −0.10]), and less criticism ( = −0.28, 95 % CI [−0.46; −0.05]) were associated with having symptoms less frequently while being domestically educated was associated with having stress symptoms more often ( = 0.44, 95 % CI [0.07; 0.81]) (R = 43.3 %). Higher general self-efficacy at Time1 was associated with higher self-rated competence at Time2 ( = 4.76, 95 % CI [1.94; 7.59]). Quantitative findings concurred with findings from interviews with internationally educated nurses. However, qualitative findings also highlighted the importance of previous education, working experience, the new context, and communication abilities. Both quantitative and qualitative data showed that working conditions were important for nurses' self-rated competence and well-being at work. Although communication difficulties, previous education, and working experience were not statistically significant in the multiple regression models, in the interviews these factors emerged as important for internationally educated nurses' competence and well-being.

中文翻译：

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获得瑞典护理执照后的自评专业能力和工作幸福感：针对国际和国内受过教育的护士的纵向混合方法研究


包容性的工作场所是每个人都得到支持成长和成功的地方，无论其背景如何。研究发现，支持性工作条件和一般自我效能对于护士的工作能力和幸福感很重要，但是，在新国家担任护士的背景下，研究有限。此外，人们还不清楚获得护理执照的不同途径是否与护士在工作时的能力和幸福感有关。研究国际和国内受过教育的护士的护理能力和工作幸福感（成长和压力）的决定因素和经验。使用了混合方法收敛方法的纵向描述性和相关性设计。 2019 年 1 月至 2022 年 6 月期间，对两组接受过国际教育的护士和一组新近接受过国内教育的护士进行了一项纵向研究，这些护士已完成过渡计划或验证以获得瑞典护士执照。在三个时间点收集数据：护理执照流程结束时的时间 1 (n = 402)、三个月后的时间 2 (n = 188) 和 12 个月后的时间 3 (n = 195)。 Time3还采访了14名受过国际教育的护士。数据分别分析，然后一起解释。多元回归模型显示，获得结构授权的机会更多（= 0.70，95 % CI [0.31；1.08]），合作更好（= 3.76，95 % CI [1.44；6.08]），批评更少（= 3.63，95 % CI） [1.29；5.96]）与时间 3 时较高的自评能力相关，而获得护理执照的可变路径并不显着（R = 49.2 %）。对于福祉，更多地获得结构性赋权（= 0.07，95% CI [0.02；0.12]），更好的合作（= 0.36，95% CI [0.07； 0.66]）和在国内受过教育（= 0.53，95 % CI [0.14；0.92]）与更高的工作成就感相关（R = 25.8 %）。对于压力，更多地获得结构性赋权（= -0.06，95 % CI [-0.09；-0.02]），更好的合作（= -0.30，95 % CI [-0.51；-0.10]），以及更少的批评（= - 0.28, 95 % CI [−0.46; −0.05]) 与较少出现症状有关，而在国内接受教育则与较频繁出现压力症状有关 (= 0.44, 95 % CI [0.07; 0.81]) (R = 43.3 % ）。时间 1 时较高的一般自我效能感与时间 2 时较高的自评能力相关（= 4.76，95 % CI [1.94；7.59]）。定量研究结果与对受过国际教育的护士访谈的结果一致。然而，定性研究结果也强调了以前的教育、工作经验、新环境和沟通能力的重要性。定量和定性数据都表明，工作条件对于护士的自评能力和工作幸福感很重要。尽管沟通困难、既往教育和工作经验在多元回归模型中并不具有统计显着性，但在访谈中，这些因素对于受过国际教育的护士的能力和福祉显得非常重要。