The Impact of Continuous Deep Sedation Until Death on Grief and Post-Traumatic Growth in Bereaved Spouses: A Cross-Sectional Study

Abstract

Background

The death of a spouse due to cancer is highly distressing. While most adapt, a significant minority may develop Prolonged Grief Disorder (PGD) or experience Post-Traumatic Growth (PTG). Palliative sedation, particularly Continuous Deep Sedation Until Death (CDSUD), is used to alleviate refractory suffering, yet its psychological impact on bereaved spouses remains unclear.

Aims

This study examined whether exposure to CDSUD and alignment between end-of-life care and patient preferences influenced grief and PTG in bereaved spouses.

Methods

A cross-sectional analysis was conducted using data from the AFTERSEDATIO project. Twenty-eight bereaved spouses (mean age = 64; 57% women) of cancer patients who received palliative care in French hospitals completed self-report questionnaires 3 months post-loss (T0). Measures included the Traumatic Grief Inventory–Self Report, General Health Questionnaire, and Post-Traumatic Growth Inventory. Analyses included t-tests, Wilcoxon, and chi-square tests; the significance threshold was set at α = .10.

Results

No significant differences in grief, mental health, or PTG were observed between spouses whose partners received CDSUD (n = 21) and those who did not (n = 7). However, higher grief and distress were reported when patients had not explicitly requested sedation. Greater PTG—especially in personal strength, spirituality, and new possibilities—was associated with the absence of a stated wish to avoid suffering.

Conclusions

While CDSUD itself did not significantly affect bereavement outcomes, the findings suggest that spouses’ perceptions of alignment between the patient’s end-of-life wishes and the care received may influence their adjustment to loss, underscoring the importance of clear communication and shared decision-making in palliative care.