A Feasibility Study of Death Education Intervention for Family Caregivers of Advanced Cancer Patients

Inclusion Criteria for patients:

* Age 18 years or older;
* The patient with pathologically confirmed stage III or IV cancer;
* The patient has initiated any systemic anti-cancer therapy (e.g.,chemotherapy, immunotherapy, targeted therapy, endocrine therapy) and has completed the first treatment administration/cycle and commenced the next planned administration/cycle;
* The patient is assessed by the doctor as having an estimated life expectancy of ≥3 months; and
* The patient is aware of their advanced cancer diagnosis.

Exclusion Criteria for patients:

-The patient has no primary family caregiver during the study period.

Inclusion Criteria for family caregivers:

* Age 18 years or older;
* The caregiver is identified by the patient as the primary family caregiver (e.g., spouse, adult child, parent, or other relative);
* The caregiver has been regularly involved in caregiving for the patient in the past month, and is expected to continue providing support over the next two months (e.g., daily care, accompaniment, involvement in medical communication/decision-making, and financial support);
* Since taking on the primary caregiving role, the caregiver reports the frequency of talking about death/dying with the patient as "Never" or "Rarely" (from: Never / Rarely / Sometimes / Often / Very often);
* The caregiver perceives a need for guidance and support in communicating with the patient about death-related matters; and
* The caregiver has basic Chinese literacy (reading and writing) to understand the intervention content and complete written tasks.

Exclusion Criteria for family caregivers:

* Paid or professional caregivers who receive financial compensation for providing caregiving services;
* The caregiver provides financial support only, without regular contact with the patient;
* The caregiver has significant cognitive impairment that would affect understanding the intervention and completing the study;
* The caregiver has severe psychiatric symptoms that would affect understanding the intervention and completing the study;
* The caregiver has significant communication difficulties that would affect understanding the intervention and completing the study;
* The caregiver is unable to complete the 4-week intervention due to physical limitations (e.g., mobility restrictions preventing attendance at intervention sessions);
* The caregiver has practical constraints that would prevent completion of the 4-week intervention or follow-up assessments (e.g., expected prolonged travel during the intervention period or inability to complete assessments as scheduled); and
* The caregiver is currently receiving other structured psychological intervention or psychotherapy that is likely to affect study outcomes.