{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:07:39Z","timestamp":1784700459401,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Death education is relevant to end-of-life nursing care, yet community nurses in primary care often receive little structured preparation in this area. This study developed a WeChat public platform-based death education program through expert consultation and evaluated changes in community nurses\u2019 attitudes toward death and death coping skills before and after the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a prospective before-and-after study in 10 community health centers in Chengdu, China, using a single-group design. The program was developed through two rounds of Delphi consultation and delivered through the WeChat public platform over 2\u202fmonths. Participants completed the Death Attitude Profile-Revised (DAP-R) and Coping with Death Scale (CDS) before and after training. For paired pre-post comparisons, variables with normally distributed difference scores were examined with paired-samples\n                      <jats:italic>t<\/jats:italic>\n                      -tests, and variables with non-normal difference scores were examined with Wilcoxon signed-rank tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven experts completed both Delphi rounds, with response rates of 100% and authority coefficients of 0.922 and 0.929, respectively. The final program comprised five modules and 32 items. A total of 129 community nurses completed the two-month WeChat-based death education program and both the pretest and posttest assessments. After training, fear of death and death avoidance scores were lower (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). In contrast, natural acceptance (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.054), approach acceptance (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.339), and escape acceptance (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.082) showed no statistically significant change. The CDS mean item score increased from 4.02\u202f\u00b1\u202f0.67 to 4.20\u202f\u00b1\u202f0.60 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001;\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.72). Self-acceptance of death, death-coping ability, expression of death-related thoughts, life reflection, and ability to discuss death improved (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Funeral handling ability (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.119) and coping with loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.141) did not change significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The WeChat-based program was associated with reduced fear and avoidance of death and improvements in several dimensions of perceived death-coping ability. The absolute increase in the overall CDS mean item score was modest, and the single-group design prevents causal attribution. Controlled studies with longer follow-up and performance-based outcomes are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1839677","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:56:33Z","timestamp":1784699793000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of WeChat public platform-based education and training on community nurses\u2019 attitudes toward death and death coping skills: a prospective multicenter single-group pre-post study"],"prefix":"10.3389","volume":"14","author":[{"given":"Chi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, West China Hospital, Sichuan University\/ West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyan","family":"Peng","sequence":"additional","affiliation":[{"name":"School of Nursing and Health Care, Leshan Vocational & Technical College","place":["Leshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinting","family":"Yang","sequence":"additional","affiliation":[{"name":"Wound Therapy Center, West China Hospital, Sichuan University\/ West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Li","sequence":"additional","affiliation":[{"name":"West China Hospital, West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","volume-title":"China Statistical Yearbook 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