Psychological Safety of Culturally and Linguistically Diverse Nurses in Healthcare Work Environments—Systematic Review of Mixed‐Methodology

Background
The international mobility of nurses is a significant component of healthcare systems worldwide, resulting in the global recruitment and adaptation of culturally and linguistically diverse nurses into diverse work environments. CALD nurses face integration challenges, which can potentially compromise their well-being and adjustment to the new setting. Psychological safety is a key component to promoting individual well-being and effective organisational integration.

Objective
This systematic review aimed to identify the current evidence on the psychological safety of culturally and linguistically diverse nurses in healthcare work environments and the factors associated with it.

Methods
This systematic review was conducted using JBI guidelines. PiCo/PEO format was utilised for inclusion and exclusion criteria, including English/Finnish, without time limitations. The screening process was conducted by two independent researchers, with a third researcher resolving the conflicts. The PRISMA checklist was utilised in reporting. Data were analysed using content analysis for qualitative and data synthesis for quantitative.

Data Sources
CINAHL, PubMed, ProQuest, Scopus and Medic. Search period: 24.10.2024–23.1.2025.

Results
The systematic review yielded 15 qualitative, one mixed-methods and one quantitative article. The content analysis produced 270 codes, 67 subcategories, seven categories and two main categories. Professional growth and acceptance captured inclusion, professional competence and support from colleagues and managers in creating job satisfaction. Marginalised disempowerment reflected factors linked to low psychological safety, contributing to reduced job satisfaction in the workplace.

Conclusion
Healthcare organisations should confront existing inequities on psychological safety in culturally diverse healthcare environments that are structured around professional inequalities to create equitable spaces for CALD nurses. More research is needed to understand psychological safety experiences from the CALD nurse perspective, exploring the equitability of facilitating factors amid systemic disadvantages in the healthcare workplace.

Patient or Public Contribution
No patient or public involvement.

Trial Registration
Prospero registration: CRD42024581860