A family approach to delirium: a review of the literature

Abstract

Objectives: The literature was reviewed to gather original research on a family approach to delirium and determine its applicability to current practice. The review had the following objectives: (1) evaluate the current state of research into delirium management (prevention, identification, or treatment of delirium) with family approaches or involvement, (2) identify gaps and areas that require investigation, and (3) determine a future course of research.

Method: A comprehensive search of original research was conducted in six major databases using seven keywords in 2012.

Results: The literature search yielded a total of 2160 articles. Criteria for eligibility were met by a total of 11 articles. The articles were evaluated in regards to purpose, sample, research design, level of evidence, variables, and results.

Conclusion: The literature review revealed that this topic is emergent and requires substantial additional research. The aspects of delirium care that researchers investigated were diverse and included bedside interventions (n = 3), screening strategies (n = 4), family education (n = 2), and care that employed multiple components (n = 2). Delirium outcomes improved significantly in two high-quality studies: one multi-component intervention and one bedside intervention program. Other noteworthy findings of lower quality studies warrant further examination. The review of the articles did not determine if the involvement of families in delirium management improves patient outcomes; however, the review revealed potential for program development and future courses of research.

Keywords:

• caregivers
• confusion
• professional–family relations
• family-centered care
• delirium

I appreciate the assistance in article rating provided by Anita Esquerra-Zwiers, MSN, RN, Hope College Nursing Department, and Nancy Innella, MSN, RN, Trinitas School of Nursing. I would also like to thank Dr. Marquis D. Foreman, PhD, RN, FAAN, Rush University College of Nursing, for his guidance and edits of early drafts.