Components and effects of psychosocial support interventions for relatives of patients with delirium in hospitals, systematic review

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.