Creating Meanings Through Online End-of-Life Discussions: Qualitative Text Analyses of Death Discussions on Trending...

As an unavoidable topic for humankind, mentioning death is considered disrespectful and unlucky in Asia. Refusing to discuss death could lead to unhealthy perspectives about the topic and could negatively impact sociocultural well-being. Instead of face-to-face discussions about death, posting and sharing about personal views on the topic in social media could provide a more acceptable approach in such societies, as social media platforms have gradually become spaces for health-related discussions and information. With few studies which have examined how death topic discourse is occurring in Asia, there is clearly a gap in understanding how this facet of health communication is being narrated in Asia's digital societies and theoretically grounding insights. Understanding how people discuss and perceive death on social media can have significant values in health and palliative education and policy shaping death perspectives. We applied two-round text-based analysis of 540 responses to death-related questions on Zhihu, a popular Q&A platform with mainly young users in China. Results revealed that although death topics were becoming more common in social media discourse, death as a topic was still perceived by many with negative affective responses. Religion also appears to influence discourse. Consistent with the Confucianism and Buddhist's view of life, subgroups of users also depicted death as natural, causal, and cyclic process in life. The perceptions of death as meaning reflections pervade the responses. Respondents reflected on the meaning of life to be "fulfillment of oneself because death is inevitable." Others interpreted the meaning of relationships through narrations about the death of loved ones and friends. Some explored the meaning of existence by stating that "death proofs that we have ever existed." The theme corresponds to Social Constructionist Model of Grieving where individuals generate and appropriate meaning through the grief of death. Our findings revealed meaning-making as an essential component in the perspectives of death in China. Death taboo has been softened in social media, and young adults can reflect on death from a scientific and philosophical stance. Chinese death education should facilitate active death discussion and assist meaning-making process through reflective thinking about death. The findings provide implications and recommendations for palliative care education and clinical doctor-patient communications pertaining to rapport building and intra-family health communication.