The Effects of Family Voice Intervention on Delirium in Adult Critical Care Patients: A Systematic Review and Meta‐Analysis

Background Family voice interventions have emerged as a non‐pharmacological approach for delirium prevention; however, evidence regarding their effectiveness remains inconsistent. Aim The aim of this study was to evaluate the effectiveness of family voice interventions in reducing delirium among adult intensive care unit (ICU) patients. Study Design We conducted a systematic review and meta‐analysis. A comprehensive literature search was conducted across PubMed, EMBASE, CINAHL and the Cochrane Library from inception through 4 March 2025. Study quality was assessed using the Cochrane Risk of Bias II tool, with analyses performed using Comprehensive Meta‐Analysis version 4.0. Results Six randomised controlled trials (reported across seven publications) involving 598 adult ICU patients were included. Family voice interventions significantly reduced delirium incidence (OR = 0.282, 95% CI: 0.126–0.630, p = 0.002) and duration (Hedges' g = −1.929, 95% CI: −2.980 to −0.879, p < 0.001). No significant effects were observed for mechanical ventilation duration (Hedges' g = −0.826, 95% CI: −1.696 to 0.044, p = 0.063) or ICU length of stay (Hedges' g = −0.534, 95% CI: −1.371 to 0.303, p = 0.211). Subgroup analysis showed multicomponent interventions significantly reduced both delirium incidence (OR = 0.178, 95% CI: 0.046–0.681, p = 0.012) and duration (Hedges' g = −1.888, 95% CI: −2.917 to −0.859, p < 0.001), while single‐component interventions showed no significant effects. Conclusions Family voice interventions effectively reduce delirium incidence and duration in adult ICU patients, with multicomponent approaches demonstrating superior efficacy. Relevance to Clinical Practice Critical care nurses may incorporate family voice interventions as a practical alternative within delirium prevention strategies. Although direct family presence is generally regarded as the preferred form of engagement, recorded voice messages can provide a feasible and meaningful option to enhance patient orientation and emotional connection when families cannot always be present. Protocol Registration The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42025628074)