Abstract
To develop a scientifically sound and feasible death education program tailored to the needs of family caregivers of patients with advanced cancer, aimed at guiding clinical practice and enhancing the effectiveness of death education. Family caregivers serve as crucial social support for patients with advanced cancer. Beyond bearing heavy caregiving responsibilities, they must also manage negative emotions arising from the patients' advanced illness or death. Family caregivers' levels of death anxiety may even exceed those of the advanced cancer patients themselves. Death education can transform individuals' attitudes toward death, alleviate death anxiety, reduce fear of death, and promote awareness and understanding of life. Currently, death education for family caregivers of patients advanced cancer receives limited attention, and comprehensive death education programs tailored to this group are lacking. An initial draft of a death education program, specifically tailored to address the needs of family caregivers providing care for patients with advanced cancer, was systematically developed through a quantitative survey, semi-structured interviews and literature review. The program was then refined through two rounds of Delphi expert consultation and pilot testing. The two rounds of Delphi expert surveys distributed 18 and 15 questionnaires, respectively. The valid response rates were 83% and 100%, with expert authority coefficients of 0.858 and 0.870, and Kendall's coefficient of concordance of 0.234 and 0.272 (P < 0.001). After Delphi expert consultation and pilot testing, the final program comprised 5 primary items, 17 secondary items, and 54 tertiary items. In the pilot test, the recruitment rate was 83% and the completion rate was 70%, providing preliminary evidence of the program's acceptability and feasibility. By systematically integrating quantitative survey findings, qualitative interview findings, literature review evidence, Delphi expert consultation, and pilot testing, this study developed a death education program specifically designed to meet the needs of family caregivers of patients with advanced cancer. The program development process was scientifically sound and reliable, and the program content was comprehensive and targeted. The pilot test provided preliminary evidence of acceptability and feasibility; however, further validation in larger samples and real-world clinical settings is needed.