The Impacts of Social Media Usage on Health Professionals’ Healthcare Services

Background: The use of social media is mounting as the number of social media outlets, platforms and applications available continue to upsurge. Health professionals are welcome to use social media in their personal lives, and share workplace experiences despite its risk as it offers instantaneous posting opportunities. The aim of this study was to assess social media usage and its impacts on health professionals’ healthcare services at Debre Tabor Referral Hospital in Ethiopia. Methods: A descriptive cross-sectional study design was used to conduct the study at Debre Tabor Referral Hospital in Ethiopia from November 2020 to January 2021. An open online-based questionnaire was used to gather the necessary data for the study. It was distributed among three-hundred-fty-eight health professionals who were opted through comprehensive sampling. Hence, descriptive statistics such as frequencies and percentages were employed to analyze the data. Results: Almost all (97.5%) health professionals were aware and willing to use social media networks. 63.4% of the respondents agreed on the positive uses of social media for professional development via medication clarication, updates from medical conferences and socializing with colleagues. However, only 15.1 % of the participants strongly agreed that using social media networks negatively affected healthcare services by hatred the quality of health information. Conclusion: The nding of this study disclosed that the participants were aware and willing to use social media networks for their professional purposes. The study also found that social media can be used as a source of reference. It is a good tool for professional development and disseminate healthcare news. Nonetheless, using social media networks negatively affected health professionals’ healthcare services by venomous the quality of health information, damaging their image and professional honor.


Introduction
Nowadays, social media is not merely shaping people's culture; it has actually become their culture. People in this day and age engage on daily basis in a media environment that integrates print media, audio-visual media, telecommunication and, most increasingly, the Internet. In other words, people across the globe have become closer to one another than ever, yet spatial distances have little in uence on communication and information exchange among people, of course, as long as access to new media technologies is available.
However, having access to the media technology does not necessarily mean using these media or having access to the content of these media. 17 Among the electronic media technologies now available in the new media environment, the social media are perhaps the most in uential ways of communication entertained across the world. 18 Social media is a form of electronic communication that build on the ideological and technological foundations of Web 2.0. It allows users to share, create and discuss the online deeds such as information, opinions, personal experiences, images and video clips. Social media countenances, generally, the creation and exchange of user generated content. It is not only a means of communication but also a space where people socialize. 3,7,15 There now exist dozens of social networking websites available online, among which Facebook, Twitter, YouTube, Instagram, Blog, WhatsApp and LinkedIn have become the most visited social networking sites in the world. 10,11 Social media users are augmented year to year. Globally, there are 3.8 billion social media users in January 2020. This number is increased by more than 9% so that there were 321 million new users since this time last year. In Ethiopia, there were 6.20 million social media users in January 2020. Between April 2019 and January 2020, the number of social media users in Ethiopia increased by 237, 000 (4%). Social media penetration in Ethiopia stood at 5.5% in January 2020. In Ethiopia, among social networking sites, Facebook has been the leading highly visited social networking site. There were 6, 137, 000 Facebook users in Ethiopia in January 2020. This accounted for 5.3% of its entire population. This clearly shows how the number of social media users in the country has been intensely increasing over the years. 22,23 Social media, unambiguously, offer many bene ts for health professionals; it helps to share experience in the workplace. However it is important to also understand that, if managed poorly, social media can bring threats. A risk of using social media is that there is a possibility the contents on the platforms are created by external stakeholders as well and can be either positive or negative. 2 Besides, when the employee is responsible for the content on social media platforms has no guidelines for content creation or answering questions, she/he will post whatever he/she might think suitable. Then the risk is that the followers of the platform could think these 'personal messages' represent the corporate view and this could result negatively. 8, 13,16 Healthcare industry and medical information organizations should be aware of the fact that there is a chance followers will nd non-credible health information on the platform, for non-health professionals can also contribute on these platforms. 4,20,17 A few studies have been conducted in Ethiopia on the bearings of social media only in Ethiopian higher education students' lives and learning. 14,19 However, local studies have not been conducted, yet, on social media usage in healthcare services. As much as this area grasps researchers' attention in developed countries though it has been unexplored area in developing countries like Ethiopia.
This study, therefore, aimed at exploring the impacts of social media usage on health professionals' healthcare services with particular reference to Debre Tabor Referral Hospital in Ethiopia. To this end, thus, the study attempted to address the following basic research questions. 1) To what extent are health professionals' aware of the uses of social media to healthcare services? 2) What are the positive and negative impacts of social media usage on healthcare services?

Methods And Materials Study Design
A descriptive cross-sectional study design was used to conduct the study. Many contemporary research scholars argue that descriptive cross-sectional research design is particularly convenient to investigate problems in complex social contexts. 5 Quantitative method was chosen because it could provide in-depth information concerning social media usage and its impacts on health professionals healthcare services.
Hence, the quantitative data were collected, analyzed and interpreted in the study through questionnaire, and the data were analyzed statistically using prevalence and percentage via SPSS software version 20.0.

Context and Participants
The study was conducted at Debre Tabor Referral Hospital with health professionals, which is found in South Gondar Zone in Amhara Regional State in Ethiopia. Nurses, physician, pharmacist, allied health personnel and others were the target participants of this study. There were three hundred-fty-eight health professionals in the referral hospital from November 2020 to January 2021. All of them (358) were selected by specialty through comprehensive sampling for the open online-based questionnaire.

Data Collection Tools
Questionnaire was used as a data gathering instrument because of its suitability for gathering imperative data for this study. To the data collection process, online-based English language questionnaire was created using Google forms. 21 The items of the questionnaire were customized to meet our study objectives. Before submitting the nal questionnaire, a pilot test was conducted. The content and face validity of the questionnaire items were rst reviewed by two instructors from College of Health Sciences, and a journalism and communication instructor in the department of English Language and Literature at Debre Tabor University. On the basis of the comments from these reviewers, the contents of the questionnaires were revised before they were ready to be tested via a pilot study. Various literature in research methods suggest that researchers are believed to bene t much from ascertaining the face validity of questionnaires by using some participants of their research for a pilot study. 9 Thus, a pilot study involving participants was conducted before the actual administration of the questionnaires.

Results
A sample size of three hundred-fty-eight participants was collected. A total of 358 health professionals completed the online Google Forms survey. The results are illustrated in Tables 1-4 in which sociodemographic data, awareness of social media usages, and the impacts of social media usage on healthcare services are obtainable, consecutively. Besides, Figures 1-3 show the awareness of social media usage of the health professionals at Debre Tabor Referral Hospital. 17 (4.7) As disclosed in Table 1, 55.9% of the respondents were males, and a majority of (91.6%) the total sample size of the participants were aged between 20-44 years. Besides, more than half (66.5%) of the respondents had a bachelor degree, and the highest number of participants were nurses with response rate of 43.3%. In relation to conjugal status, 65.1% of the participants were engaged, yet 30.4% of them were not engaged. As it is shown, Table 2 is about health professionals' awareness on social media usage. A great majority, 97.5%, of the respondents were engrossed in using social media in their personal lives and workplace. 90.2% of the respondents replied that Facebook was the most widely visited and utilized social media networking site.   As it can be revealed in Table 3, we can detect that more than half of the respondents, 63.4%, agreed that social media use had an a rmative impact on health professionals' healthcare services. On the other hand, Table 4 is about the deleterious impacts of social media use on healthcare services so that 15.1% of the participants strongly agreed that using social media negatively affected healthcare services which were given by healthcare professionals' at Debre Tabor Referral Hospital.
The interviewees said that smartphone (mobile) was the utmost device used by them. And they tried to perform the online activities such as listening to music, watch online video, play games, visit social networks and others via smartphone, computer, laptop and tablet.

Discussion
Healthcare professionals used different mechanisms in order to boost healthcare services in hospitals and health centers as well. Social media is one of the mechanisms used by them. These days the most commonly utilized method of communication is social media networking. It is being used by individuals belonging to every walk of life. Almost a decade ago, social media was widely accepted by public. 1,6,12 There are numerous online networking platforms such as Facebook, Twitter, Instagram, YouTube, LinkedIn, and etc. Figure 1 indicates the different corporate social media networking types.
The rst research question scrutinized the health professionals' awareness on social media use. Results disclosed that few of them (2.5%) were not aware and willing to use social in their work-place and personal lives, whereas almost all (97.5%) health professionals were aware and willing to use the social media networking sites. Facebook, Telegram, YouTube, WhatsApp and LinkedIn were the most communal social media networking sites used by the health professionals, 41.0%, 30.0%, 13.0%, 11.0% and 5.0%, respectively.
More than half, 67.9%, of the participants revealed that they have started using social media networking sites more than ve years with more than four hours (65.9%) per day. From the data it can be deduced that health professionals were aware and willing to use the social media networking sites for various purposes such as personal lives, occupation, etc.
The second research question in the study is sought to determine the positive and negative impacts of social media usage on health professionals' healthcare services at Debre Tabor Referral Hospital. Social media has merits in order to strengthen healthcare services in hospitals. On the other hand, if social media is used unfairly or mistakenly, it threatens humans' life potentially. It was implied that the health professionals were blissful in using social media sites, for they helped them in medication clari cation, professional development, client relationships, socializing with colleagues and updates from medical conferences. In a nutshell, they can be used as source references.
The study disclosed ( Table 3) that more than half, 63.4%, of the respondents agreed on the uses of social media in healthcare services in hospitals or health centers. Besides, 35.4% of the respondents strongly agreed that using social media is essential for the health providers to strengthen their healthcare services.
But, 1.1% of them neither agreed nor disagreed on social media use for healthcare services. In relation to this, 0.1% and 0.04% of the participants disagreed and strongly disagreed, respectively, on the social media usage employed by health professionals for healthcare services.
In the study, is pursued to determine the negative impacts of social media usage on health professionals' healthcare services at Debre Tabor Referral Hospital in Ethiopia. Social media negatively affects the health professionals' healthcare services if it is used fraudulently. But, if social media is employed impartially, the merit is in excess of the demerit. 4,10 As it is revealed in Table 4, only 15.1% of the participants agreed on the deleterious impacts of social media used by health professionals' in their healthcare services. Furthermore, 35.8% of them strongly agreed that using social media negatively affected health professionals' and their healthcare services; it hatred the quality of health information, ruptured patient privacy and spoiled the health workers professional image. However, 16.0% and 20.6% of the health providers disagreed and strongly disagreed, respectively, on the deleterious impacts of social media usage. Generally, from the data, we can deduce that despite its deleterious impacts, social media is very helpful to strengthen and fasten the healthcare services.

Conclusion
The outcome of this study disclosed that the health professionals were cognizant and alacritous to use social media in their healthcare services. The most important result of this study was the nding that more than the majority of the participants were in agreement with social media use in the provision of healthcare services. In this sense, social media can be used as a source of reference; it is a good tool for medication clari cation, client relationships and socializing with colleagues. It is a good tool for professional development. Besides, social media is helpful to disseminate healthcare news. Nonetheless, using social media networks negatively affected health professionals' healthcare services by venomous the quality of health information, damaging their image and professional honor. This implied that provisions need to be taken to evade ruptures of patient Declarations Disclosure The authors have not declared any con ict of interests.