Available online 7 August 2023, 151722

Author links open overlay panel, , , AbstractObjective

Evaluate relatives' experience of delirium due to an acute health event in a loved person and to compile practical suggestions for health care professionals from these synthesized results.

Background

Delirium resulting from an acute health event places patients at increased risk for prolonged hospitalization and mortality. A delirium episode also affects family members who may assist in the diagnosis and recovery from this condition.

Inclusion criteria

Qualitative studies of family members or other caregivers who witnessed patient delirium in a clinical setting were included if they had appropriate verbatim evidence. Studies dealing exclusively with delirium in the context of dementia, cancer, palliative care, or drug dependence were excluded, and if quotes could not be clearly allocated to relatives.

Methods

A systematic review of qualitative studies adapted from the Joanna Briggs Institute meta-aggregation approach. A systematic literature search was conducted in CINAHL complete®, MEDLINE®, and several dissertation databases in September 2022.

Results

Eight qualitative studies based on semi-structured interviews were included. In total 75 findings from 105 relatives were aggregated into 13 categories. Finally, three synthesized findings reveal suggestions for health care professionals: providing information adequately, communication and integration during health care and understanding relatives' perspective on delirium experience.

Conclusion

The identified burdens and needs of relatives should be considered by health care professionals to enhance the delirium experience for them, thus improving patient care by involving relatives with a better understanding.

Section snippetsBackground

Delirium episodes in patients recovering from an acute health event or an extensive surgery procedure are common in hospitals (Gao et al., 2022; Muzzana et al., 2022; Salluh et al., 2015). Often, such an episode occurs within the first week after the event (Popp, 2017). Delirium affects not only the health of patients. It is also associated with a high level of stress for relatives and professional caregivers, both sharing the common goal of “doing the right thing” for the patients' recovery

Design

Qualitative research takes the view from the people concerned of a phenomena and thus it can contribute to a broadening of the perspective and a promotion of the different understandings of reality (Flick et al., 2019). For the synthesis of qualitative research published in the field of our research question, we chose the meta-aggregation approach, as described by the Joanna Briggs Institute (JBI). This approach is a structured and comprehensible way of identifying, critically analyzing and

Study selection

From 746 identified references, 15 duplicates were removed. After screening title and abstract 731 references were excluded which did not meet the inclusion criteria. Finally, 16 references were checked in full text and eight were identified to be suitable for the synthesis. The other 8 were excluded because they were not primary studies but literature reviews (Bélanger & Ducharme, 2011; Day, Higgins, 2015a; Mossello et al., 2020; O'Malley et al., 2008; Partridge et al., 2013; Shrestha & Fick,

Summary of findings

Overall, we derived three syntheses allowing practical implications for HCP to understand and support relatives of patients with delirium. The first synthesis highlights a great uncertainty associated with rapidly changing conditions. What is routine for HCP can be completely new and very upsetting for relatives, and an empathic understanding of the feelings involved can serve as a first step toward trustful collaboration. The second synthesis focuses on the need for information in terms of

Conclusion

This meta-aggregation synthesized existing evidence exploring the burdens and needs of relatives who witness delirium in a loved one in an acute clinical care setting. The findings indicate that family members are a distinct vulnerable group with their own needs for integration and information. Incorporating the three summary findings into future research and practice will improve two-way communication among HCP and help relatives overcome their potential lack of knowledge. HCP can help meet

Declaration of competing interest

None.

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