Social media usage and online professionalism among registered nurses: A cross-sectional survey
Abstract
Background Owing to its convenience and easy accessibility, social media is increasingly popular among healthcare professionals and has become a useful tool in the healthcare industry. Doctors' social media use patterns and online professionalism have been thoroughly studied. Various unprofessional behaviors such as excessive self-disclosure, violations of patient privacy and improper social media posts, were observed. However, studies exploring nurses' social media use and online professionalism are lacking.Objectives The objective of this study was to understand the social media use and online professionalism of Chinese registered nurses.Design A cross-sectional survey was adopted.Settings Eight nursing conferences and one continuing-education program that took place in Sichuan, China.Participants Convenience sampling was applied to select nurses who had obtained their Chinese nursing certificates, who were aged 18 years and above, and who worked in clinical settings. The final sample consisted of 658 registered nurses.Methods Data were collected through the on-site distribution of an anonymous researcher-designed questionnaire. The questionnaire consisted of 41 items that focused on demographic and professional information, social media use and online professionalism. Medians, averages and percentages were used to describe the social media use patterns and online professionalism of Chinese registered nurses.Results All participants in this study were social media users and 84.5% of them believed that social media had positively influenced their clinical practice. WeChat was the most frequently used form of social media, which was used among 93.5% of the subjects. Common reasons for social media use included receiving messages from work, networking, receiving news and relaxing. Approximately 56% of the participants spent one to three hours on social media daily. Most of the participants had reposted medical knowledge on social media and had subscribed to at least one medical social media account. Additionally, 67.2% of the sample disclosed that they "often" communicate work-related information with colleagues via social media. Roughly 50% of the sample insisted that their facilities had social media guidelines. Registered nurses' professionalism was also assessed. Around half of the participants had received "friend request" from patients, while 63.5% of the sample acknowledged that there were no patients on their most frequently used social media platforms. About 7.6% of the respondents had "sometimes" posted identifiable patient information, which was much lower than the reported 32.5% rate of witnessing colleagues' disclosure of identifiable patient information. Fully 50.3% of the participants indicated that they had witnessed improper posts by colleagues.
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Exceptions were 95.4% of family medicine residents and physicians in Saudi Arabia reported having a social media account and checking them at least once a day, 93.4% of medical doctors in a Singapore hospital, and 100% of Chinese registered nurses owned a social media account.
“The exceptions were 3 studies: family medicine residents and physicians in Saudi Arabia where 95.4% of participants reported having an SM account and checking them at least once a day [79], 93.4% of medical doctors in a Singapore hospital [100], and 100% of Chinese registered nurses owned an SM account [107].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Significant gender differences in social media use were established in several studies.
“Significant gender differences were established in several studies [71,79,91,95,105,107].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Irfan et al's study showed females using social media more for professional purposes, and Wang et al's study, among registered nurses, was similar.
“Irfan et al’s [79] study showed females using SM more for professional purposes, and Wang et al’s [107] study, where the study population was registered nurses, was similar.”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Breaches of patient privacy were a concern for many different types of health care professionals.
“Breaches of patient privacy was a concern for many different types of HCPs [34,43,47,57,91,94,97,107,111,119].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
13.4% of Chinese registered nurses (n=88) in Wang et al's study confessed they had sometimes posted anonymous patient information on social media.
“In Wang et al’s [107] study, 13.4% of Chinese registered nurses (n=88) confessed that they had “sometimes” posted anonymous patient information on SM.”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
49.5% of Chinese nurses reported never witnessing colleagues' inappropriate social media posts.
“When asked about colleagues’ online professionalism, half (50.3%) of the participants indicated that they had “sometimes” witnessed their colleagues’ inappropriate SM posts and 49.5% reported “never” [107].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
50.3% of Chinese nurses indicated they had sometimes witnessed their colleagues' inappropriate social media posts.
“When asked about colleagues’ online professionalism, half (50.3%) of the participants indicated that they had “sometimes” witnessed their colleagues’ inappropriate SM posts and 49.5% reported “never” [107].”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Among nurses in China, 7.6% reported that they had sometimes posted identifiable patient information on social media.
“Among nurses in China, 7.6% reported that they had “sometimes” posted identifiable patient information on SM.”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Social media have enabled the creation of communities for support.
“Besides providing the opportunity for connecting with others and sharing experiences [38,39,46,53,69,72,78,106-108], SM have enabled the creation of communities for support.”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
Compromising confidentiality concerns were described in numerous studies in this review, especially about breaches of patient privacy or possible risks of violating HIPAA online.
“Compromising confidentiality concerns were described in numerous studies in this review [34, 43, 47, 57, 91, 94, 97, 107, 111, 119], especially about breaches of patient privacy or possible risks of violating HIPAA online.”
From Dangers and Benefits of Social Media on E-Professionalism of Health Care Professionals: Scoping Review (2021) · cites this paper as [107]
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Vukušić Rukavina, T., Viskić, J., Machala Poplašen, L., Relić, D., Marelić, M., Jokic, D., & Sedak, K. (2021) · Journal of Medical Internet Research · doi:10.2196/25770 · Cited by 199 · see citing works
“Breaches of patient privacy was a concern for many different types of HCPs [34,43,47,57,91,94,97,107,111,119].”
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- Authors
- Wang, Z., Wang, S., Zhang, Y., & Jiang, X.
- Affiliations
- Sichuan University (CN)
- Third People's Hospital of Chengdu (CN)
- Chengdu University of Traditional Chinese Medicine (CN)
- Corresponding author
- Jiang, Xiaolian
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 98
- Pages
- 19-26
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2952610210
- Cited by
- 80
- References
- 50
- Citations by year
- 2026: 11 · 2025: 2 · 2024: 11 · 2023: 14 · 2022: 19 · 2021: 16 · 2020: 3 · 2019: 4
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Social Media in Health Education
- Health Sciences › Nursing › Leadership and Management › Healthcare Education and Workforce Issues
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- social media use, online professionalism, registered nurses, professional boundaries, patient privacy, health information disclosure, WeChat, Chinese nurses
- MeSH terms
- Professionalism, Adolescent, Adult, China, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nurse-Patient Relations, Nursing Staff, Self Disclosure, Privacy, Young Adult, Social Media
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