Beyond trauma: Understanding death encounters in Chinese community health

Encounters with patient death, often seen as traumatic for health professionals, may also drive post-traumatic growth and systemic improvement. This study explores how such experiences transform community health professionals (CHPs) in China. Employing a constructivist grounded theory approach, we conducted a year of non-participant observation and 23 semi-structured interviews with CHPs in Shenzhen. Our analysis produced a psychological-professional-systems model of transformation, which is substantiated by three themes: first, these encounters fostered emotional resilience and deeper human connection, enhancing psychological endurance and relational care; second, CHPs redefined their professional identity, expanding their roles to provide holistic support aligned with person-centred public health; third, witnessing death prompted ethical reflection, shaped by systemic tensions between individual adaptation and structural support. While contextually Chinese, these findings offer transferable insights for workforce resilience and trauma-informed care, highlighting strategies such as resilience training, flexible care models, and ethics-based debriefing.