The Effect of Family Voice Interventions on Delirium Incidence and Duration in Adult ICU Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Delirium is a common and serious complication in patients on intensive care units (ICUs). Family voice interventions may support orientation, reduce sensory deprivation and mitigate delirium, but their efficacy remains unclear. Aim: The primary aim was to systematically evaluate the effects of family voice interventions on the incidence and duration of delirium in adult ICU patients. Methods: We searched PubMed, CINAHL, Embase, Cochrane Library and APA PsycNet and grey literature from inception to present. Eligible randomized controlled trials (RCT) included adults (≥ 18 years) in ICU settings receiving family voice interventions via live or recorded voices of family members. Primary outcomes were delirium incidence and duration, assessed using validated tools. Quality assessment was conducted by using RoB 2.0 and Grade. Meta-analyses were performed using RevMan 9.5.1. Results: Out of 438 titles, seven RCT with a low to high risk of bias including 582 patients were analysed. Certainty of evidence was moderate. Meta-analysis evaluating family voice interventions versus usual care showed a significant reduction in delirium incidence (OR: 0.39 [CI: 0.26, 0.58], p < 0.001; χ2 = 3.09, I2 = 0%, p = 0.54) and duration (MD −0.90 days CI [−1.28, −0.53], χ2 = 0.69, I2 = 0%; p = 0.71). Conclusions: Family voice interventions may aid in preventing and reducing delirium in critically ill patients, potentially supporting patient recovery and improving family psychological well-being. Given the moderate certainty of evidence, more robust research is necessary. Relevance for Clinical Practice: Critically ill patients and families should be educated about delirium. Clinicians should integrate families in the prevention and treatment of delirium by using live or recorded re-orienting voice interventions.