Public Opinions about Palliative and End-of-life Care during the COVID-19 Pandemic: A Twitter-based Study.

Abstract

Palliative and end-of-life care (PEoLC) played a critical role in relieving suffering and providing grief support in response to the heavy toll caused by the COVID-19 pandemic. However, little is known about public opinion concerning the PEoLC during the pandemic. Given that social media has the potential to collect real-time public opinions, analysis of this evidence is vital to guide future policymaking. To use social media data to investigate real-time public opinions toward PEoLC during the COVID-19 crisis, and explore the impact of the vaccine programme on public opinions about PEoLC. A Twitter-based study exploring tweets across three English-speaking countries - the United States, United Kingdom and Canada. From October 2020 to March 2021, 7,951 PEoLC-related tweets with geographical tags were retrieved and identified from a large-scale COVID-19 Twitter data set through Twitter API (Application Programming Interface). Topic modelling realized through a PMI-based co-occurrence network and Louvain Modularity was utilized to examine latent topics across countries and across two time periods (pre- and post-vaccination periods). Commonalities and regional differences between PEoLC topics in the United States, United Kingdom and Canada were identified specifically: (i) Cancer care and care facilities were of common interest to the public across three countries during the pandemic; (ii) The public expressed positive attitudes towards the vaccine and highlighted its protection to PEoLC professionals; (iii) Whilst Twitter users shared their personal experiences about PEoLC in the online community during the pandemic this was more prominent in the United States and Canada. The implementation of the vaccine program raised the profile of the vaccine discussion, however, this did not influence public opinions about PEoLC. Public opinions on Twitter reflected a need for enhanced Palliative and End-of-Life Care (PEoLC) services during the COVID-19 pandemic. The insignificant impact of the vaccine programme on public discussion on social media indicated that public concerns toward PEoLC continued to persist even after vaccination efforts. Insights gleaned from PEoLC public opinions could provide some clues for policymakers on how to ensure high-quality PEoLC during public emergencies. In this post-COVID-19 era, PEoLC professionals may wish to continue to examine social media and learn from online public discussion to ease the long-lasting trauma caused by this crisis and prepare for public health emergencies in the future. Besides, our results showed social media's potential in acting as an effective tool to reflect public opinions in the context of PEoLC.