A critical assessment of factors influencing the perceived professional benefit of internet nurses

We investigated the perceived professional benefit of nurses engaged in internet nursing services of Internet Cooperative Hospitals in Nanjing, China, and explored factors influencing nurse assessment.


| INTRODUCTION
The rapid development of internet technology and with an investment from the Chinese government, the National Health Commission issued a pilot program named "Internet + Nursing Services" in February 2019. 1 The program identified 6 provinces and/or municipalities as pilot areas for "Internet + Nursing Services," to encourage the exploration of nurse lead services. The goal was to rely on the new technologies and achievements to establish a new innovative internet model of nursing services, and to potentially show unique advantages of the platform . 2 The perceived professional benefit is a positive experience related to professional emotions produced by continuous development based on positive psychology. The sense of perceived professional benefit of nurses refers to the positive emotional experience of nurses when they feel the benefits of the profession of nursing and the recognition that the profession of nurses can promote their all-round growth. 3 This study explored the perceived professional benefit of nurses dedicated to online nursing, analyzed the influence of diverse factors on nurses' perceived professional benefit, and provided basis for the Xiaoxu Li and Yichang Zhu contributed equally to this study.

| Data collection procedure
We obtained permission from the Nanjing Nursing Association, the nursing deans and nursing department directors of various Internet hospitals, and Internet nurses, prior to distributing the questionnaire using the Questionnaire Star platform, which relies on WeChat. After agreeing to informed consent, the purpose and confidentiality of the study and data outcome were explained. Each participant was recorded using a unique IP address. A total of 310 questionnaires were collected, including 300 used in this study, an effective recovery rate of 96%.

| Data analysis
Excel was used to sort out the collected data, and SPSS 22.0 software was used for statistical analysis. Descriptive statistics such as x AE s , frequency and constituent ratio were used for the measurement data.
t test and analysis of variance were used to compare the scores of nurses' occupation acquisition. Multiple linear regression analysis was used to analyze the factors influencing the occupation benefit of nurses working in Internet plus nursing. P < .05 was deemed statistically significant.

| Participants characteristics
The 300 Internet nurses surveyed had an average of 12.9 ± 7.2 (years) of clinical nursing work, of which the minimum was 1 year and the maximum was 38 years, and Internet + nursing service time varied from 1 month to 5 years. 90.7% of nurses showed no extra income, and only 6.9% of nurses had increased extra income (100-1000 yuan), while 2.6% of nurses had a monthly extra income greater than 1000 yuan (see Table 1).

| The scores of internet nurses' perceived professional benefits
The results of this study showed that the total score of the professional benefit of nurses engaged in Internet + nursing work was 121.21 ± 14.97 points, and the items were equally divided into 4.18 ± 0.51 points. The scores of each dimension are shown in

| Comparison of perceived professional benefit scores of Internet nurses with different characteristics
The following measures significantly (P < .05) influenced score: age, marital status, children's education, organizational affiliation, positional title, monthly night shift, leaders' attitudes toward Internet + nursing work, and personal attitude toward internet + nursing work, while hospital level, department, education level, gender, and scientific research had no statistically significant effect (P > .05). Single-factor analysis of the perceived professional benefit of nurses working in Internet + nursing is summarized in Table 3.

| Multiple regression analysis on Influencing Factors of Internet nurses' perceived professional benefit
Single factor analysis was based on age, marital status, children's education, organizational affiliation, positions, titles, monthly night shift, leaders' attitude and personal attitude towards internet + nursing work, and multiple linear stepwise regression analysis was used. Analysis results are shown in Table 4.

| DISCUSSION
The perceived professional benefit score measured in this study was 121.21 ± 14.97, and the average score of five categories ranged from 3.86 to 4.45, which is in agreement with T A B L E 1 Demographic information of internet nurses in this study (n = 300) In all dimensions of perceived professional benefit, the highest score of 4.45 ± 0.57 was in the category of nurse-patient relationship.
After medical treatment, patients had increased demand for nursing service, and nurses were more integrated in the complete process of patient care promoting a more harmonious relationship between nurses and patients.
The second is professional growth with a score of 4.32 ± 0.57.
With the continuous development of information technology, the internet has brought great innovation and new opportunities and challenges to the medical and nursing industry. Nurses have the ability to expand professionally to continue to learn and train. This is supplemented by direct training experience from patients who put forward real-time suggestions on the network platform.
Positive occupational perception scored the lowest at 3.86 ± 0.68, which was consistent with the research results of Zhao .6 It suggests that nurses have insufficient understanding of the influence of their works done using the internet, and may also involve a deficiency of nurses' welfare, human resource allocation, and work autonomy due to the current medical system. [7][8][9] Nursing managers can intervene to provide occupation resources,

| CONCLUSION
This study demonstrated that perceived professional benefit was influenced by diverse factors. We recommend that targeted intervention measures be used to ensure that nursing managers provide opportunities and platforms for nurses who actively participate in online nursing services.

| LIMITATION
The research used convenience sampling rather than random sampling.
Moreover, the chosen samples were concentrated in Nanjing, resulting in a lack of representation, which affected the accuracy of the results.

ACKNOWLEDGMENTS
This research was supported by the Jiangsu Cancer Hospital, China.

CONFLICT OF INTEREST
The authors declare no potential conflict of interest.