In this study, social media is defined as the use of electronic communication platforms, such as YouTube, Facebook, WhatsApp, Snapchat, and Telegram, to network and share information. Social networking sites offer various features for users, including connecting with friends and colleagues, sharing hobbies, and enhancing teaching practices [7] . Popular platforms utilized globally, including by nurses, encompass Facebook, WhatsApp, Twitter, Instagram, and YouTube [8] - [10] .

The use of social media by hospitals and medical personnel has significantly increased, transforming the dynamics between patients and healthcare organizations. Social media serves as a tool to discuss health issues, promote social collaboration, and engage stakeholders, thereby enhancing interpersonal relationships and encouraging active participation in health-related matters [10] [11] .

Social networking is one of the most widely used categories of social media platforms, allowing users to share information and interact with loved ones [12] . Facebook, with over 2.96 billion active users, emphasizes connections between friends and family, while LinkedIn, with over 950 million users, focuses on professional networking (Meta, 2024; LinkedIn, 2024). Users on LinkedIn can showcase their achievements, job history, education, and skills, potentially leading to job opportunities [13] .

Content sharing involves the exchange of documents, videos, and images. Platforms like YouTube and Instagram enable users to share diverse media formats. YouTube allows users to enjoy and upload videos and music, sharing them with friends and the global audience (YouTube, 2024). While YouTube supports comments, it lacks a dedicated discussion board for deeper interaction and community engagement [10] .

Digital publishing permits professionals to share their knowledge and concepts freely. Blogging remains a preferred and contemporary method of web publication, enabling individuals to engage with their audience through posts and comments, fostering discussions [9] (Martinez & Dwyer, 2023). Microblogging platforms, like Twitter, allow users to share brief updates (280 characters or fewer) with followers, promoting the instant dissemination of ideas and information (Twitter, 2024). Twitter has over 450 million users, aiming to empower users to share ideas and information in real time (Twitter, 2024).

Health organizations leverage social media to amplify messages from traditional media and engage consumers in content co-creation [14] . This strategy involves modifying communication techniques to include audience input, fostering collaboration, and building trust. Social media provides opportunities to integrate public health information into everyday online conversations and share useful tools for health promotion [15] .

As social media becomes essential for reaching younger populations, who often abandon traditional media, it allows patients and caregivers to communicate, share experiences, and create support groups, enhancing the dissemination of health information [16] . Healthcare professionals utilize social media to share information, discuss policies, promote healthy lifestyles, and connect with various audiences, which can lead to improved health outcomes and professional networking [17] .

Educational institutions emphasize the importance of teaching future medical professionals about social media in health communication. Social media platforms are increasingly utilized for spreading health information and engaging the public, particularly among youths and teenagers [18] . Despite its potential, there is limited research on the effectiveness of social media in public health communication. Organizations such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recognize its importance but often lack evidence on meaningful audience engagement through these platforms [19] .

Moreover, social media’s capability to monitor conversations and receive real-time feedback enhances research and surveillance in public health [20] . Effective health communication via social media involves listening to and addressing audience needs, building trust, and integrating these methods with traditional communication approaches [21] . Influencers play a crucial role in promoting health issues and persistently engaging with target audiences [22] .

Social media empowers users to create and share content, encouraging participation and storytelling, which strengthens health communication efforts. By revolutionizing health communication, social media facilitates interaction, Knowledge sharing, and the achievement of common goals. It serves as a cost-effective platform for user expression and content distribution, offering numerous opportunities for public engagement in health communication [23] .

Perceived usefulness and ease of use are fundamental factors influencing the acceptance and use of technology, as described by the Technology Acceptance Model (TAM) [24] . Perceived usefulness refers to the belief that using new technology will enhance performance. For nurses, this translates to recognizing social media as a tool that can improve nursing care and productivity, thereby positively impacting medical facility outcomes [25] . When nurses perceive social media as a means to enhance their professional practices, they are more likely to view it as a valuable and efficient tool for their work [26] .

A notable trend from the literature indicates that social media serves as a significant information source for registered nurses. Six out of nine studies reviewed underscore its utility, despite concerns about the reliability of information. For instance, Schroeder reported that nursing publications actively utilize Twitter to disseminate research findings and updates, facilitating real-time information sharing among nurses [27] . Furthermore, the integration of social media into various stages of the nursing process has been shown to enhance diagnostic competency and patient assessments [28] . Innovative practices, such as secure intranet wikis, have also emerged, allowing nurses to collaboratively create and refine evidence-based patient care resources [29] .

Research by Vukušić et al. demonstrates that nurses globally leverage social media for both personal and professional growth, highlighting its dual role [30] . Notably, platforms like LinkedIn are pivotal for career advancement, enabling nurses to network and access opportunities internationally. This online networking fosters a sense of community, ultimately improving job satisfaction, patient safety, and organizational loyalty [31] . Additionally, social media has proven effective for nurses to stay informed about industry events and policy discussions, as illustrated by campaigns led by the NSW Nurses and Midwives Association advocating for improved nurse-to-patient ratios [32] . However, the exploration of how these platforms influence professional identity remains underdeveloped, warranting further investigation.

Hoyle et al. explored the impact of social media on registered nurses’ interpersonal skills, revealing that frequent engagement enhances both verbal and nonverbal communication, thus increasing patient engagement [33] . Furthermore, healthcare organizations are adopting platforms like YouTube for educational outreach, addressing the need for patient-centered care [34] . Although some studies suggest that social media may reduce face-to-face interactions, they also highlight its potential to facilitate ongoing communication, enabling nurses to adapt care based on patient feedback and public sentiment [35] . The dynamic interaction between social media and patient needs is a crucial area for further research.

The concept of perceived ease of use, as articulated by Shu (2023), plays a critical role in the adoption of social media among nurses [36] . Research indicates that nurses are more likely to embrace user-friendly platforms, which enhances their overall performance and engagement. Dzandu et al. (2023) found that a positive perception of ease directly influences users’ motivation to learn and effectively utilize new technologies [37] . However, further examination is needed to understand how varying levels of digital literacy among nurses impact their perceptions and subsequent engagement with these platforms.

Social media’s integration into the nursing profession is relatively recent, and the evidence regarding its utilization by nurses remains limited. Andrejco notes that while a significant majority of registered nurses are active users of social media, studies by Kung and OH reveal that 94% of 410 registered nurses frequently engage with social media, indicating its pervasive role in modern nursing practice [38] . Despite this, Vukušić et al. highlight that social media’s integration varies significantly across different professional fields, including nursing [30] . Furthermore, there are substantial discrepancies in how hospitals implement and regulate social media, leading to inconsistencies in practice and potential ethical dilemmas [39] .

Nurses encounter unique ethical challenges when using social media, particularly regarding patient confidentiality and the potential for disparaging colleagues. The balancing act between personal and professional lives on social media can create ambiguity regarding appropriate content sharing [40] . Additionally, frequent social media engagement may impair nurses’ emotional recognition and responsiveness during patient interactions, adversely affecting their professional behavior [41] . Distractions caused by social media usage can lead to critical errors, such as medication mishaps and communication breakdowns during patient handoffs, posing serious risks to patient safety. Mariano et al. found that heightened social media use among nurses decreased patient engagement and care quality, as patients reported feeling neglected when nurses were distracted by their devices [42] . This dynamic resulted in significant communication gaps and diminished patient involvement in treatment decisions.

The absence of comprehensive guidelines for nurses’ social media use in clinical settings presents a notable challenge. Vukušić et al. and Schroeder emphasize the lack of consistent rules governing social media usage, leading to an increased risk of misuse and unprofessional conduct [27] [30] . The inconsistency in policies across healthcare facilities further complicates matters, resulting in varied standards of professional behavior among nurses. Establishing uniform, evidence-based guidelines globally is crucial for maintaining professionalism in nursing and ensuring safe, effective patient care [43] . Additionally, there is a pressing need for research into how these guidelines can be effectively communicated and implemented within healthcare settings to foster a culture of responsible social media use among nurses.

The study employed a mixed-method approach using quantitative and qualitative techniques within a descriptive cross-sectional design, chosen due to time constraints and academic purposes. Data was collected in two phases: first, questionnaires were distributed to the target population; second, focused group discussions (FGDs) and key informant interviews (KIIs) were conducted on social media use for health information. An exploratory descriptive qualitative strategy was used to understand nurses’ adoption of social media for nursing care within the technology adoption model framework, assessing its usefulness, ease of use, and behavior. This approach provided a comprehensive understanding of the factors influencing nurses’ social media adoption and directly informed the study’s objectives.

The study population consisted of all frontline nurses across various clinical departments, including the emergency room, outpatient department, children’s ward, male ward, female ward, theater special ward, and public health unit, allowing for meaningful insights related to the study questions.

Nurses were included if they provided informed consent, had been on duty for at least a year, and were present during the study period, ensuring sufficient engagement with the institution’s social media accounts.

The study excluded rotational nurses with less than six months of tenure, voluntary personnel, and students on internships or attachments to maintain a focus on experienced nursing professionals.

A stratified sampling technique was used to gather diverse viewpoints from participants. Nurses were selected for their potential to provide insightful information on social media use. Ward and unit managers helped identify participants meeting the inclusion criteria. A total of 313 nurses participated in the study, ensuring information saturation and addressing the research questions effectively.

Data was collected using a questionnaire, chosen for its ability to handle a large sample size and provide both qualitative and quantitative data quickly. Researchers distributed the questionnaires, addressing any respondent queries. The survey gathered information on nurse demographics, social media usage, health information sourced, reasons for seeking health information, and challenges faced. Out of 385 distributed questionnaires, 313 responses were received, achieving an 81.30% response rate, which is adequate for analyzing the study’s objectives.

To gain deeper insights, two focus group discussions (FGDs) were conducted, each with eight and nine participants. These sessions explored users’ preferences for social media platforms, engaging content, and encountered challenges. A moderator facilitated discussions using a guide. Topics included favorite health information sources, reasons for using social media, types of sourced information, and the pros and cons of these platforms. The FGDs provided qualitative data, recorded with a digital audio recorder.

Numeric data was analyzed using SPSS version 22, with quantitative descriptive statistics employed to describe and interpret the data, displayed via frequency tables and charts. Qualitative data was analyzed using thematic analysis with NVivo software. Researchers transcribed recorded interviews verbatim, cross-referenced with audio recordings, and incorporated field notes to ensure accuracy. This rigorous analysis allowed for a thorough exploration of the study questions regarding health-related content, benefits, and risks of social media use among nurses.

Approval was obtained from the relevant department head at a university’s School of Nursing and Midwifery. Permission was also granted by a local hospital and the municipal health directorate. Respondents provided verbal consent and were informed they could withdraw at any time. Participant confidentiality was maintained by anonymizing names and keeping all information private, adhering to ethical guidelines for human research.

Validity measures how accurately a tool measures what it is intended to, while reliability assesses the consistency of the measurement [44] . The questionnaire was carefully developed to ensure validity, aligned with study objectives, and reviewed by the research supervisor. A pretesting approach was used to ensure reliability and consistency. Ten individuals outside the study region completed the questionnaire, which was reviewed by the supervisor and a statistician for reliability. This process reinforced the credibility of the findings.

Some participants hesitated to provide information due to confidentiality concerns or uncertainty about the study’s purpose, potentially posing significant implications for the generalizability and reliability of the findings. This issue was addressed by ensuring clear communication about the study’s purpose and strengthening assurances regarding participant confidentiality to encourage open and honest responses.

A total of 313 Nurses participated in the study. The majority of the respondents are female, accounting for 64.9% of the sample, while 35.1% are male. This suggests that the nursing profession in this sample is predominantly female, which aligns with general trends observed in nursing demographics globally.

The largest age group is between 31 - 35 years, comprising 39.9% of the respondents, followed by those aged 36 - 40 years at 30.0%. The younger group of 23 - 25 years represents only 5.1%, and the oldest group, 41 - 45 years, accounts for 9.9%. This indicates that the nursing workforce in this sample tends to be more experienced and likely to be in their mid-career stages, with fewer younger nurses or new entrants.

The majority of respondents have a degree qualification, representing 64.9% of the sample. 24.9% of the nurses have a diploma, while 10.2% have pursued further studies to obtain a master’s degree.

This reflects a strong emphasis on higher education within the nursing profession, with a significant portion having attained a bachelor’s degree or high.

The most common nursing grade is Nursing Officer, making up 39.9% of the sample, followed by Senior Nursing Officers at 30.0%. Staff Nurses account for 20.1%, and Midwifery Officers make up 9.9%. This shows a significant representation of higher-ranking officers (Senior Nursing Officer and Nursing Officer), which indicates that many nurses in this sample hold positions of responsibility.

Nurses with 4 - 7 years of experience form a significant portion of the sample, at 34.8%, while those with 8 - 11 years represent the largest group at 39.9%. Those with 1 - 3 years of experience make up 9.9%, while 12 - 15 years of experience represent 10.2% of the sample. Nurses with 16+ years of experience are the smallest group, making up 5.1%. This data suggests that the sample consists mostly of mid-career nurses with substantial experience (4 - 11 years), while those at the beginning or end of their careers are fewer, as depicted in Table 1 .

The study found that nurses primarily used Facebook, WhatsApp, and Twitter. LinkedIn and Google+ were also frequently used for health-related information. All respondents had used social media at least once. Additionally, nurses mentioned using Google as a health information source. The main platforms included YouTube, Twitter, Facebook, WhatsApp, and Google, as presented in Figure 1 .

Even before informing anyone, I “Google” any health concerns I may have, especially those that are quite personal. I go to Facebook or WhatsApp when I need advice or personal experiences. FGD-01-Male is the source.

Respondents who believed they had access to social media platforms at the very least and used them to get information shared similar views. According to one of the interviewees, this is driven by the need to broaden their coverage and do comparisons from other sources:

We use our memberships in Facebook groups and WhatsApp groups to get information, but we don’t use Twitter because it doesn’t allow for the inclusion of long-form content like symptoms and diagnoses. FGD_01_Male is the source.

The goal of the study was to pinpoint the types of health information that nurses obtain via social media. A 5-point Likert scale was used to determine and evaluate this data. Table 2 below displays the outcomes.

Source: Field data, 2024.

The study found that most respondents used social media to explore patient experiences (mean = 3.36), health problems (mean = 3.23), and second opinions (mean = 3.22). However, there was less agreement on using social media for symptoms (mean = 2.83), diagnoses (mean = 2.61), drug information (mean = 2.42), research or therapy (mean = 2.30), and insurance (mean = 2.24).

It is revealed from the study that 39.3% of participants researched disease symptoms online, a trend supported by focus group discussions. Nurses and students frequently use social media to quickly find information on symptoms and avoid unnecessary clinic visits. As one participant put it:

‘‘I am aware of organizations where participants exchange information about sex, including symptoms of STDs, pregnancy symptoms, and reproductive health information’’.

‘‘In the hopes that someone would clarify what they mean or suggest, students search for signs of illnesses they believe they may be experiencing or share symptoms they notice in their bodies. As a result, fewer trips to the clinic are necessary (Source: FGD_02_Female)’’.

The study shows that, 47.6% of respondents used social media to look up health-related issues, driven by widespread internet access and the abundance of available information. Commonly searched topics included HIV/AIDS, chronic illnesses, weight loss, STDs, and reproductive health.

The study found that 59.4% of participants used social media to check patients’ experiences. This use was supported by focus group discussions, which highlighted that social media, designed for interaction, helps in sharing and discussing medical information. Respondents often sought insights on recovery times, side effects, and treatments from support groups and used social media to compare their experiences with others when they felt misunderstood by their doctors.

Accordingly, a respondent stated that: ‘‘We attempt to learn as much as we can about what other people went through in comparable situations, such as how long it takes to heal, whether the sickness has any side effects, and how to treat it. You may be aware of support groups for those living with specific illnesses, like HIV/AIDS or cancer’’.

The study found that 55% of participants used social media to seek a second opinion on their health issues, often to validate an initial diagnosis due to the high cost of seeing multiple doctors.

Interestingly, 29.4% of respondents sought diagnostic information, 20.8% looked for therapy details, and 28.5% searched for medication information. This was often for non-life-threatening issues, with students typically relying on medical practitioners for more detailed information on therapy and medication.

A five-point Likert scale, as shown in Table 3 and Figure 2 below, was used for analysis and interpretation of the survey data replies.

Social media facilitates greater interaction on health-related issues (48.6%), with a mean score of 3.18. Users appreciate the broad audience and quick responses, as well as the less judgmental environment compared to traditional settings (Source: FGD_01_Male, FGD_02_Female).

Source: Field Data, (2024).

Respondents noted a significant increase in access to health information (62.9%) due to social media, with a mean score of 3.61. Social media makes information readily available and affordable, allowing users to access sensitive topics easily and anonymously (Source: FGD_01_Male, FGD_02_Female).

Social media facilitates greater interaction on health-related issues (48.6%), with a mean score of 2.9. Social media platforms provide personalized information by leveraging algorithms that track user behaviors, preferences, and interactions. Using pseudonyms enhances user experience by providing relevant health information, news, and resources directly suited to their needs (Source: FGD_02_Female).

Emotional support (53.6%) ranked second (mean score of 3.33) as a reason for using social media. Users seek support from others with similar experiences and find comfort and hope through shared stories and encouragement (Source: Female FGD_02).

Respondents valued the anonymity offered by social media, which allows them to discuss sensitive topics without fear of stigma. Using pseudonyms helps users seek information on private issues like STDs and abortion (Source: FGD_02_Female).

Social media is a cost-effective alternative to paid health consultations. With smartphones and free Wi-Fi available, students find it an accessible way to obtain information on personal and sensitive topics (Source: FGD_02_Female).

The study identified several challenges students faced when using social media for health information. The main issues were unreliability (58.2%), loss of privacy (55.5%), inaccurate information (44.1%), risks of sharing personal data (31.3%), and information overload (29.5%). Responses were evaluated using a Five-point Likert scale (see Table 4 and Figure 3 ).

Source: Field Data, 2024.

Again, 55.5% of respondents highlighted insufficient privacy as a major concern. Social media often lacks robust privacy controls, making personal health information accessible to others if not properly secured.

On the other hand, 58.2% of participants reported difficulty in finding trustworthy information. The challenge lies in verifying the accuracy of content on social media, which can be misleading or incorrect.

Additionally, 29.4% of participants identified information overload as a major challenge. The vast amount of varying information online can lead to confusion and misdiagnosis, as different sources provide conflicting advice. One focus group member noted the difficulty of sifting through diverse opinions and sources to find reliable information.

Furthermore, 44.4% of respondents reported encountering inaccurate health information. Misinformation and unverifiable content are prevalent on social media, with users’ often providing misleading advice based on personal experiences. This contributes to the spread of unreliable health information.

Not only but also, 31.3% of participants expressed concern about disclosing too much personal information while seeking help on social media. Engaging in health-related discussions often requires sharing sensitive details, which can be uncomfortable and risky.

Some participants mentioned the high cost of data and slow network speeds as obstacles to accessing health information online. Despite available school Wi-Fi, the cost of data bundles and connectivity issues were significant barriers for some.

Distractions on social media were noted as a challenge, with users often diverted by unrelated content. This can hinder the search for health information, as highlighted by a respondent who experienced frequent interruptions while browsing.

The study highlights the significant benefits of social media for nurses, emphasizing its role in sharing and receiving clinical guidelines and health information. Nurses found social media more effective than traditional methods like notice boards and books for disseminating clinical protocols. This supports previous research suggesting that social media provides a valuable communication channel for discussing and exchanging health information [45] . Additionally, the findings align with the European Association of Urology’s initiative to use Twitter for sharing clinical procedures [46] .

Nurses view social media as a valuable tool for professional development, including discourse, education, and training, aligning with findings by Adjei et al. and Maloney et al. [47] [48] . It offers a modern avenue for continuous learning and improves communication and referral networks within medical facilities. Platforms like SMS and WhatsApp facilitate discussions and sharing of patient information, such as scans and X-rays. However, some participants expressed concerns about technological issues, such as poor network and information overload, which could hinder nursing tasks. Despite these challenges, nurses find social media easy to use and navigate, aligning with Deng et al. and Mitzner et al. on technology adoption [49] [50] .

Participants highlighted several risks associated with social media use in nursing. They expressed concern about the spread of inaccurate or misleading information, which can be prevalent due to the unregulated nature of social media. This erroneous content, often shared by medical practitioners, can mislead patients and the public.

Another significant risk is the potential breach of patient privacy and confidentiality. Sharing patient information without consent, including photos or personal details, can violate patient dignity and undermine trust. This concern aligns with findings from Ahmed et al. and Lefebvre et al. noting that such breaches may be inadvertent or intentional [51] [52] .

Additionally, social media use can lead to distractions and task interruptions, impacting nurses’ decision-making and increasing the likelihood of errors. Overdependence on social media can also lead to addiction, diverting time and focus from nursing duties.

Despite these risks, participants generally viewed social media positively for its role in professional development and staying current with nursing topics, though some noted the time-consuming nature and ethical dilemmas involved. The study suggests that while nurses are well-positioned to use social media effectively, they must navigate these risks carefully.