Table 2 Barriers coding tree of themes and illustrative quotations

Apprehension at navigating conversations

Challenge of sensitively navigating conversations about death

I don’t want to sound insensitive (Participant 249, F, 25–34 years)

Concern over ability of others to facilitate conversations about death

Bringing up the topic either makes others uncomfortable or dismiss it with a short "Sorry for your loss” (Participant 847, F, 18–24 years)

Emotional responses to death talk

Conversations hindered by own emotions

I get upset about it—don't want to make people uncomfortable (Participant 862, F, 18–24 years)

Perceived risk of arousing challenging emotions in others

Fear of making others uncomfortable or upset (Participant 18, F, 35–44 years)

Unacceptance of death talk in different social contexts

Societal norms sustain lack of integration of death talk

It's just not done here, I am not sure why (Participant 333, F, 35–44 years)

Cultural beliefs can deter openness about death

The discomfort of others regarding the topic. I am viewed as very strange for wanting to discuss “such negative topic”, but it’s important to me. I have a different philosophy and spirituality than those I love, which they struggle with (Participant 398, F, 55–64 years)

Perception that known others are unwilling to engage in death talk

My family don’t want to talk about it (Participant 259, F, 70–74 years)

Perception that death should only be discussed with family and close persons

I don’t like to share my personal feelings with people I am not close to (Participant 494, F, 35–44 years)