Nursing, Clinical and Surgical Nursing Department. São Paulo, Brazil. How to cite this article: Amaral DR, Rossi MB, Lopes CT, Lopes JL. Nonpharmacological interventions to improve quality of life in heart failure: an integrative review. Rev Bras Enferm [Internet]. 2017;70(1):187-98. DOI: http://dx.doi.org/10.1590/0034-7167-2016-0112Submission: 04-01-2016Approval: 09-07-2016 ABSTRACT Objective: to identify articles that assessed the effectiveness or effi cacy of nonpharmacological interventions to improve quality of life of people with heart failure in the literature. Method: an integrative literature review was performed in Lilacs, MedLine and SciELO databases, including randomized or nonrandomized clinical trials and quasi-experimental studies published between 2003 and 2014, in Portuguese, English or Spanish. Results: twenty-three studies were included. The categories of nonpharmacological interventions that improved quality of life of people with heart failure were: Remote health monitoring, Instructions on health practices, Physical activity follow-up and Traditional Chinese Medicine practices. Conclusion: these results can guide the selection of interventions to be implemented by health professionals that treat people with heart failure. Future systematic reviews with meta-analyses are needed in order to identify the most effective interventions for improving these individuals' quality of life. Descriptors: Clinical trials; Heart failure; Quality of Life; Review; Nursing. RESUMO Objetivo: identifi car, na literatura, artigos que avaliaram a efetividade ou efi cácia de intervenções não farmacológicas para melhorar a qualidade de vida de pessoas com insufi ciência cardíaca. Método: revisão integrativa de literatura realizada nas bases de dados Lilacs, MedLine e SciELO, incluindo ensaios clínicos randomizados ou não randomizados e estudos quaseexperimentais publicados entre 2003 e 2014, em português, inglês e espanhol. Resultados: foram incluídos 23 estudos. As categorias de intervenções não farmacológicas que melhoraram a qualidade de vida de pessoas com insufi ciência cardíaca foram: Monitoramento remoto da saúde, Orientação sobre práticas de saúde, Acompanhamento de atividade física e Práticas de Medicina Tradicional Chinesa. Conclusão: estes resultados podem direcionar a seleção de intervenções a serem implementadas por profi ssionais de saúde que cuidam de pessoas com insufi ciência cardíaca. Futuras revisões sistemáticas com metanálise são necessárias para identifi car as intervenções mais efi cazes para melhorar a qualidade de vida desses indivíduos. Descritores: Estudos de Intervenção; Insufi ciência Cardíaca; Qualidade de Vida; Revisão; Enfermagem. RESUMEN Objetivo: identifi car, en la literatura, artículos que evaluaron la efectividad o efi cacia de intervenciones no farmacológicas para mejorar la calidad de vida de personas con insufi ciencia cardíaca. Método: revisión integrativa de literatura realizada en las bases de datos Lilacs, MedLine y SciELO, incluyendo ensayos clínicos aleatorios o no...

PURPOSE: The aim of this study was to identify the incidence, characteristics, and factors associated with medical adhesive–related skin injuries (MARSI). DESIGN: Prospective cohort study. SUBJECTS AND SETTINGS: The sample comprised 136 children in the postoperative period after congenital heart surgery. The study setting was in a 31-bed pediatric surgical intensive care unit (ICU) of a university hospital in Sao Paulo, Brazil. METHODS: Patients were followed from admission, with daily skin assessments, until the onset of MARSI or ICU discharge. Outcomes were compared by Fisher's exact test, Pearson's χ2 test, Mann-Whitney test, Brunner-Munzel test, and Welch 2-sample t test. RESULTS: The incidence of MARSI was 60.3%, with 85 injuries in 82 patients. The highest occurrence was on postoperative day 2 (27 wounds; 31.8%). The most frequent medical adhesive associated with MARSI was transparent film dressing (n = 74; 86.6%). Factors associated with MARSI were age (P = .000), number of devices inserted (P = .000), Braden Q Scale score (P = .005), duration of surgery (P = .021), cardiopulmonary bypass duration (P = .000), duration of mechanical ventilation (P = .000), and length of ICU stay (P = .000). Children who developed MARSI received more blood components (P = .039), vasopressors (P = .000), and corticosteroids (P = 0.000); required longer sedation (P = .000); and had more edema (P = .001). CONCLUSION: This high incidence indicates the need for greater awareness and prompt action in response to MARSI. Polyurethane transparent film without concurrent use of a skin barrier product should be avoided.