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Peer reviewed original qualitative research published in English.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were extracted using Covidence systematic review software. Methodological quality was reviewed against the Critical Appraisal Skills Program (CASP) Qualitative Checklist. Thematic synthesis was used to develop analytical themes. Confidence in the Evidence from Reviews of Qualitative Research (GRADE\u2010CERQual) framework was applied to findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 3429 records identified, 29 met criteria for final inclusion. Studies included a range of settings (intensive care, medical and surgical wards) and family carer types (spouse, daughter, parent and friend). Three primary themes <jats:italic>Shared Caregiving<\/jats:italic>, <jats:italic>Partnership and Support<\/jats:italic>, <jats:italic>Communication for Shared Understanding<\/jats:italic> and three cross\u2010cutting contextual themes <jats:italic>Care Transitions<\/jats:italic>, <jats:italic>Family Carer Context and Hospital Context<\/jats:italic> were identified. Family carers have mixed experiences of involvement in delirium care and prevention. Family carer engagement in care impacted perceptions of care quality and their own self\u2010efficacy. Where person\u2010centred care expectations were not met, some family carers adopted compensatory or care contingency strategies. Information sharing and timely support from hospital staff who understood the carer context supported carer involvement. Supportive physical environments and addressing power imbalances allowed greater engagement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Family carers often wish to be involved in delirium prevention and care, but need to be recognised as individuals, listened to, informed and supported to optimise their contribution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Impact<\/jats:title><jats:p>The review findings can guide health professional and decision makers to optimise family carer involvement in delirium care programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Protocol Registration<\/jats:title><jats:p>PROSPERO [CRD42020221854].<\/jats:p><\/jats:sec><jats:sec><jats:title>Reporting<\/jats:title><jats:p>ENTREQ.<\/jats:p><jats:p>No Patient or Public Contribution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.16990","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T12:05:04Z","timestamp":1706529904000},"page":"1320-1345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Understanding family carer experiences and perceptions of engagement in delirium prevention and care for adults in hospital: Qualitative systematic review"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-0136","authenticated-orcid":false,"given":"Karen","family":"Lee\u2010Steere","sequence":"first","affiliation":[{"name":"School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Queensland Australia"},{"name":"Eat Walk Engage Program, Internal Medicine and Aged Care Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0242-2165","authenticated-orcid":false,"given":"Alison","family":"Mudge","sequence":"additional","affiliation":[{"name":"Eat Walk Engage Program, Internal Medicine and Aged Care Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacki","family":"Liddle","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Queensland Australia"},{"name":"Occupational Therapy Department Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Bennett","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123090"},{"key":"e_1_2_14_3_1","unstructured":"ACI Aged Health Network. 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