Exploring the Needs and Barriers for Death Education Curriculum in Higher Education in Mainland China
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Universiti Malaysia Sarawak
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Death education remains underdeveloped in higher education institutions in Mainland China due to cultural taboos, limited policy guidance, and insufficient curricular integration. This study aimed to examine the current status, educational needs, and implementation barriers of death education in Mainland Chinese universities, and to evaluate the impact of a structured, culturally sensitive death education curriculum on students’ psychological well-being and professional preparedness. A convergent parallel mixed-methods design was employed. Quantitative data were collected through structured questionnaires administered to 406 students and 392 faculty members selected using stratified and purposive sampling strategies. The instruments included a self-developed questionnaire assessing perceptions, attitudes, knowledge, and barriers, as well as validated scales: the Death Attitude Profile-Revised (DAP-R), the Coping with Death Scale (CDS), and the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B). In addition, qualitative data were obtained through semistructured interviews and focus group discussions to explore experiential perspectives and contextual factors. A quasi-experimental pre-test–post-test design involving 160 students was conducted to evaluate the effectiveness of the proposed curriculum intervention. Quantitative data were analyzed using descriptive statistics, difference analysis, and factor analysis, while qualitative data were examined through thematic coding. The findings revealed significant knowledge gaps, particularly in grief and bereavement literacy, alongside generally positive but culturally constrained attitudes toward death education. Institutional barriers such as insufficient policy support and cultural taboos were identified as major challenges to curriculum integration. The quasi-experimental results demonstrated statistically significant improvements in students’ death attitudes, coping competence, and professional preparedness following participation in the structured curriculum. The integration of qualitative and quantitative findings supported the development of a culturally adaptive curriculum framework encompassing cognitive understanding, emotional processing, practical competence, and value reflection. This study contributes empirical evidence for the feasibility and transformative potential of death education in Mainland Chinese higher education. The findings provide theoretical, (iv) methodological, and practical insights for culturally responsive curriculum design and institutional policy development.