Components and effects of psychosocial support interventions for relatives of patients with delirium in hospitals, systematic review
Clinical Snapshot
PICO Framework
| P — Population | Adult relatives of hospital patients with delirium |
| I — Intervention | Psychosocial support interventions (information provision via flyers, videos, websites, telephone calls, and mentoring) |
| C — Comparator | Standard care or no intervention |
| O — Outcomes | Relatives' delirium knowledge, psychological outcomes (anxiety, depression), burden and support needs |
Bottom Line
This systematic review identified eight studies examining psychosocial support interventions for relatives of hospitalized patients with delirium. While some interventions showed promise for improving relatives' delirium knowledge, effects on psychological outcomes like anxiety and depression were unclear. The evidence base is limited by small study numbers, poor intervention reporting, and mixed results. Interventions typically involved information provision through various media and mentoring support. The authors appropriately conclude that more high-quality effectiveness studies are needed with better intervention reporting and accompanying process evaluations. Currently, the evidence is insufficient to recommend specific psychosocial support interventions, though the identified components (education, information provision, mentoring) represent reasonable approaches that warrant further rigorous evaluation. Clinicians should be aware that family members of delirious patients experience significant distress and may benefit from structured support, but optimal intervention design remains unclear.
Key Findings
P Value: Significant effects in 4 of 6 studies for delirium knowledge
Effect Size: Not quantified - narrative synthesis only
Primary Outcome: Relatives' delirium knowledge and psychological outcomes
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported
Clinical Application
Limited by poor intervention reporting and lack of process evaluations in primary studies Relevant to Australian hospitals but implementation guidance limited. Could inform development of family support programs within existing healthcare frameworks Relatives of hospitalized patients with delirium across various hospital settings including ICU
Abstract
BACKGROUND: Relatives of patients with delirium are often confronted with patients' challenging behaviours such as hyperactivity, aggression, or hallucinations. As a result, feelings of anxiety and depression episodes have been described. The aim is to identify psychosocial support intervention for relatives of patients with delirium in hospitals, describe components and effects, and identify research gaps. METHODS: Systematic review based on PRISMA, including psychosocial support intervention studies addressing burden and support needs of adult relatives of hospital patients with delirium. We searched the databases Medline, Web of Sience, CINAHL, Livivo, PsycINFO, and Cochrane Library in 07/2024 and reference lists. We assessed reporting using TIDieR and CReDECI2 and methodological quality using ROB-1 and the JBI tool for quasi-experimental studies. We performed narrative syntheses. RESULTS: We identified eight intervention studies addressing relatives of patients with delirium in different settings. Intervention components included provision of information using flyers, videos, web-sites, or telephone calls, and mentoring in the intensive care unit. Reporting of interventions was mostly poor. No study reported a process evaluation. Four of six studies showed a significant difference in relatives' delirium knowledge. For relatives' psychological outcomes, no clear effects were shown. Overall, study quality was limited. CONCLUSIONS: More effectiveness studies are needed with better reporting of intervention components, ideally addressing psychological aspects. Feasibility and acceptance of new interventions should be described within accompanying process evaluations. TRIAL REGISTRATION: https://osf.io/7jbsk .
References
- 1.Grebe, M., Dichter, M. N., Dano, R., & Köpke, S. (2026). Components and effects of psychosocial support interventions for relatives of patients with delirium in hospitals, systematic review. BMC Geriatrics. https://doi.org/10.1001/jama.2010.1013
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