Cross-cultural adaptation for international nursing students from the Belt and Road Initiative in China: A follow-up survey study.

Background: and Purpose: As the number of international students from Belt and Road Initiative countries continues to increase in China, it is essential to find methods to improve cross-cultural adaptation in the host country, a crucial aspect of the experiences of international nursing students. Therefore, this study aimed to investigate the change in cross-cultural adaptation of international nursing students during the first year in China. Methods: Data collection was conducted for international nursing students (n = 108) between September 2019 and August 2020, focusing on sociocultural adaptation, academic adaptation, and academic performance of international nursing students using validated questionnaires. Results: The mean score at the follow-up time verified an increased level of sociocultural and academic adaptation and academic performance. Academic adaptation is a complete mediator between sociocultural adaptation and academic performance at two-time points, and the size of the mediation effect accounted for 95.9 % of the total effect in six months and 99.0 % in one year. Conclusions: The findings emphasized the importance of sociocultural and academic adaptation in cross-cultural adaptation and suggest that educational institutions should provide learning environments supporting these factors to ensure academic success.