Death-Education as Institutional Support for Deathcare Workers: A Delphi Study in Italy

Deathcare workers are exposed to death and bereavement, yet education for this workforce remains limited in Italy. We conducted a two-round anonymous online Delphi survey to prioritize components of a death education programme for Italian deathcare workers. Experts rated candidate aims, content, teaching strategies, delivery options, and evaluation outcomes on a seven-point scale using predefined consensus thresholds; free-text comments were summarized descriptively. Consensus-supported aims focused on reducing stigma and social invisibility, strengthening professional identity and meaning, improving communication with bereaved families, and supporting coping and self-care. Key domains prioritized communication, relational processes, occupational risk and protective resources, with practice-oriented topics including culturally diverse grief and rituals, ethics and boundaries, moral distress, and relational challenges. Feasibility consensus was clearest for ethics and boundaries, small-group delivery, and facilitation by a mental health professional; co-facilitation with an experienced deathcare practitioner was judged highly suitable. Priority outcomes included improved communication, reduced emotional distress, adaptive coping, strengthened meaning and identity, and participant satisfaction. Findings provide an evidence-informed blueprint for programme implementation and evaluation, and highlight that scaling requires organizational buy-in, protected time, and institutional recognition, implications for other settings where deathcare labor remains marginalized.