RESUMO
PURPOSE: This study aimed to present an evidence-based conclusion through a systematic meta-analysis to distinguish clinical signs and symptoms associated with the presence of group A beta-hemolytic streptococcus, as confirmed by throat culture or rapid test, from those in cases without culture confirmation. METHODS: The study protocol has been published in PROSPERO (CRD42023450854). Studies published between January 1, 2013 and August 15, 2023 were scanned in seven databases. The methodological quality of the articles was assessed using The Joanna Briggs Institution (JBI) Cross-Sectional Studies and Cohort Studies checklist. Effect size calculations were made using fixed effects and random effects models. RESULTS: A total of 22 articles were included in the systematic review, with 14 included in the meta-analysis. The prevalence of streptococcal pharyngitis in these studies ranged from 7.3 to 44.1%. According to the meta-analysis results, a significant association was observed between GAS test positivity and the presence of tonsillar exudate, palatal petechiae, tonsillar hypertrophy, dysphagia, fever, and cervical lymphadenopathy (p < 0.05). No significant relationship was found between GAS test positivity and symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain (p > 0.05). CONCLUSION: The findings of the meta-analysis suggest that, in addition to the Centor criteria, palatal petechiae, dysphagia, and tonsillar hypertrophy are noteworthy indicators of GAS infection. Contrary to previous studies, our meta-analysis indicates that symptoms such as headache, sore throat, cough, absence of cough, hoarseness, scarlatiniform rash, tonsillar erythema, vomiting, rhinorrhea, and abdominal pain may not be associated with streptococcal infection. Further research is needed to elucidate these findings.
RESUMO
The purpose of this cross-sectional study was to examine factors associated with nurses' resilience during the COVID-19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor-Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID-related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID-19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience.