Public Perspectives on Palliative and Hospice Care: Social Media Content Analysis Using Topic Modeling and Multiclass Sentiment Analysis (Preprint)

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Abstract
BACKGROUND Palliative care enhances dignity and quality of life for patients with serious illnesses by managing distressing symptoms and supporting families. However, inadequate awareness and misconceptions often hinder patients and their families from accessing these services. Understanding of public perspectives on palliative and hospice care can facilitate the development of targeted educational resources and awareness campaigns. As social media becomes an important source of health information, analyzing such publicly available web-based sources can yield valuable insights into perceptions of palliative and hospice care. OBJECTIVE This study analyzed public perspectives posted on a popular social media platform in South Korea to understand perceptions, challenges, needs, and sentiments related to palliative and hospice care. METHODS Data were collected from Naver Knowledge iN, a popular web-based public forum in South Korea, encompassing 34,501 texts posted between 2002 and 2024. After applying inclusion and exclusion criteria, 9072 relevant perspectives were analyzed. Contextualized topic modeling was used to identify themes, and the optimal model was selected based on coherence, diversity scores, and expert feedback. In addition, multiclass sentiment analysis using a fine-tuned Korean bidirectional encoder representations from transformers (KoBERT) model classified sentiments into 6 categories. The multiclass sentiment model’s performance was evaluated using accuracy, precision, recall, and F1-score. RESULTS Social media discussions on palliative and hospice care have increased steadily over time. Topic modeling identified 9 themes, with “ethical and legal concerns” and “medical care in hospitals” peaking in recent years, suggesting growing public interest in these areas. “Emotional and psychological support” emerged as the predominant theme, reflecting a significant need for psychosocial assistance among patients and their families. Sentiment analysis revealed that “sadness,” “anxiety,” and “neutral” were common emotions across many topics. Notably, themes such as “emotional and psychological support,” “disease treatment outcomes and prognosis,” “medical care in hospitals,” “financial issues,” and “symptom management” were predominantly associated with “sadness,” while “administrative and volunteer services,” “ethical and legal concerns,” and “nutrition management” were more closely linked with “anxiety.” CONCLUSIONS This study highlights public concerns about palliative and hospice care in South Korea, including ethical dilemmas, caregiving burden, and emotional distress. Findings underscore the need for communication strategies that address informational, emotional, and psychological needs. Culturally sensitive, interactive communication tools, such as artificial intelligence–powered chatbots and public education campaigns, may help dispel misconceptions and promote timely, informed decisions about palliative and hospice care.

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