Clinical nurse instructors (CNIs) play a crucial role in integrating theory with clinical practice in nursing education; however, the impact of CNIs' instructional time on the quality of clinical practicums remains unclear. This cross-sectional study aimed to examine the association between nursing students' perceptions of clinical practicum quality and the number of CNI instruction days in Japan. Participants included 60 third-year nursing students and 4 CNIs from two hospital wards. Following the completion of the practicum, students completed the "Student Evaluation Scale for the Teaching-Learning Process in Nursing Practicum (SESTLP-NP)," whereas CNIs reported their instruction days during the practicum. Logistic regression analysis revealed significant associations between CNI instruction days and total SESTLP-NP scores (odds ratio [OR]: 29.39; 95% confidence interval [CI]: 2.46-351.01). Key SESTLP-NP subscales associated with CNI instruction days included "CNI-Student Interaction (OR: 4.03; 95% CI: 1.59-10.18)," "use of clinical practicum records (OR: 2.58; 95% CI: 1.23-6.47)," and "Student-human resources relationship (OR: 3.07; 95% CI: 1.29-7.31)." The findings suggest that the more days a CNI provided instruction, the more likely students were to be satisfied with their practicum experience. Nursing managers should consider adjusting shift schedules to maximize CNI availability and instructional time during the practicum.

Objective: To understand the factors that allow older adults to promote self-care is important. The purpose of this study was to reveal important risks related to the self-care support needs of older adults with diabetes through multiple regression, and to describe recommendations to enhance their independent mobility and self-care through the assessment of support needs, with respect to self-care concerns and anxiety about vulnerability. Methods: We conducted exploratory factor analysis (EFA) with primary vulnerability-related covariates. The correlation between several clinical features and the risk of insufficient self-care was examined. Multivariate linear regression estimated the independent variables for understanding vulnerability. Results: A total of 632 older Japanese adults with diabetes excluding two incomplete responses were analyzed. The EFA established a valid five-factor solution with 18 items ([hope for group education], [barrier to meal preparation], [vulnerable life], [hope for personal education], and [emergency preparedness and response]). Predictors for the five-factor solution reflected individual-level factors and were female sex (β = .023, p = .022), living alone (β = .064, p = .000), absence of a contact person once a week (β = .042, p = .043), level of care need (β = .038, p = .008), and available emergency medical care (β = −.023, p = .001). Conclusions: Social support networks were significantly related to vulnerability and disease control in older adults with diabetes. Realizing the high diabetes risk associated with vulnerability is important for outpatient intervention.

Objective: This cross-sectional study aimed to investigate rehabilitation practices in intensive care units (ICUs) for patients with acute respiratory failure and other diagnoses and examine the association with specialist staffing and team activities, adjusting for patient characteristics and organizational structures. Methods: Nurse managers in ICUs across Japan participated in a questionnaire survey on rehabilitation practices for individual patients and organizational variables. The highest degree of rehabilitation practice (using the ICU mobility score >1) on the survey day was measured for each patient. Results: A total of 92 nurse managers completed the questionnaire, and data from 405 inpatients were analyzed. Approximately 40% of the patients did not receive rehabilitation on the survey day, and 50% of the patients admitted to the ICU for more than 2 days (n = 295) did not receive early rehabilitation within 2 days of ICU admission. Mixed-effects multivariate analysis showed that a higher degree of rehabilitation on the survey day was associated with the adoption of mandatory critical care consultation for patients admitted to the ICU by dedicated physicians (adjusted odds ratio: 1.88, 95% confidence interval: 1.06-3.30). The outcomes were not associated with the presence of dedicated physical therapists in the ICU, the number of nurses specialized in critical care per 10 ICU beds, or the measured team activities. Conclusions: Our results indicate that ICU rehabilitation practices may be insufficient in Japan. A higher degree of ICU rehabilitation on the survey day was associated with the participation of ICU physicians in the treatment of ICU patients.