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72]
Social media in healthcare: Advantages and
challenges perceived by patients at a teaching
hospital in Eastern Province, Saudi Arabia
Mona Faisal Al‑Qahtani, Alaa Khalid Alsaffar1, Abrar Radhi Alshammasi1, Ghufran Sadeq Alsanni1,
Zahra Tawfeq Alyousef1, Mishael Fahad Alhussaini1
Departments of Public Health and 1Health Information Management and Technology, College of Public Health, Imam AbdulRahman
Bin Faisal University, Dammam, Saudi Arabia
Address for correspondence:
Dr. Mona Faisal Al‑Qahtani,
ABSTRACT
Department of Public Health, College
of Public Health, Imam AbdulRahman
Bin Faisal University, P. O. Box 2435
Dammam 31441, Saudi Arabia.
E‑mail: malqahtani@iau.edu.sa
INTRODUCTION
Social media has been defined as “a group of Internet‑based
applications that build on the ideological and technological
foundations of Web 2.0, which allows the creation
and exchange of user‑generated content.”[1] According
to McCay‑Peet and Quan‑Haase, [2] social media are
“web‑based services that allow individuals, communities,
and organizations to collaborate, connect, interact, and
build community by enabling them to create, co‑create,
modifies, share, and engage with user‑generated content
that is easily accessible.” Different researchers have defined
social media sites differently, but their definitions refer to
the same meaningful function, i.e., social media refer to
web‑based or online applications based on the Internet used
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DOI:
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116 © 2018 Saudi Journal for Health Sciences | Published by Wolters Kluwer - Medknow
Original Article
Aims: This study aimed to determine the types of, the frequency of, and reasons for social
media usage by patients. In addition, this study attempts to explore patients’ perceptions
of the advantages and main challenges associated with using social media in healthcare.
Subjects and Methods: This was a cross‑sectional study. Questionnaires were distributed
to a convenience sample of 400 patients at a teaching hospital in Eastern Province,
Saudi Arabia. The data were analyzed by performing descriptive and inferential statistics.
Results: Of the 400 patients, 377 patients used social media. Females were more frequent
users (60.7%) of social media than males (39.3%). Young patients were more frequent users
of social media than older patients. Most patients used social media daily. The patients
reported that the main purpose of their usage of social media was to care for their own health.
The main advantage was to enable patients to learn about the symptoms of their illness and
the method of treatment. A small percentage of patients believed that using social media in
healthcare might breach the confidentiality and security of their information, which was the
main challenge associated with using social media in healthcare. Conclusion: Social media
is revolutionizing healthcare delivery, and its benefits overcome its drawbacks.
Key words: Healthcare, patients, social media
to create and share information, photos, and videos and to
exchange ideas by users, enabling the users to interact with
each other and establish online relationships.[3,4] According
to the International Medical Informatics Association’s[5]
classification, 13 different types of social media platforms
exist: social networks, professional networks, thematic
networks, microblogs, blogs, wikis, forums or listserv, social
photo and video sharing tools, collaborative filtering tools,
multiuser virtual environments, social applications and
games, integration of social media with health information
technologies, and other (e.g., FriendFeed). The most
commonly used applications include Facebook, YouTube,
Snapchat, Instagram, and Twitter.[6] Social media can be
This is an open access journal, and articles are distributed under the terms of
the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License,
which allows others to remix, tweak, and build upon the work non‑commercially,
as long as appropriate credit is given and the new creations are licensed under
the identical terms.
For reprints contact: reprints@medknow.com
How to cite this article: Al-Qahtani MF, Alsaffar AK, Alshammasi AR,
Alsanni GS, Alyousef ZT, Alhussaini MF. Social media in healthcare:
Advantages and challenges perceived by patients at a teaching hospital in
eastern province, Saudi Arabia. Saudi J Health Sci 2018;7:116-20.
[Downloaded free from http://www.saudijhealthsci.org on Monday, March 18, 2019, IP: 197.211.57.72]
Al‑Qahtani, et al.: Social Media in healthcare
used in various sectors, such as the marketing, business,
governmental, and healthcare sectors.[4]
In the healthcare sector, social media help support
patient‑provider communication. Social media allow nurses
to access information in real time; share research findings
in research settings; share skills, knowledge, and education;
and discuss medical issues.[7] The main motivations for using
social media in healthcare settings by healthcare providers,
hospitals, physicians, and other health staff are as follows:
marketing, communicating with patients and coworkers,
disseminating health education, raising awareness, obtaining
information regarding the most current medical studies,
reducing medical‑care costs, and improving the quality
of care.[1,8‑10] Several healthcare organizations use social
media to deliver healthcare interventions to change patient
behavior (e.g., help smokers change their lifestyle or decrease
anxiety in women undergoing mammography).[11] In addition,
social media are used as online “virtual communities” in
which a group of individuals who share similar interests meet
“virtually” to discuss their experiences, exchange advice,
provide emotional support and offer self‑help suggestions.[12]
Moreover, social media are used to manage diseases and
sustain health goals, such as losing weight, living with back
pain, or coping with disease.[13,14]
Previous studies have highlighted the main advantages
of using social media in healthcare, such as increasing
interactions among patients; expanding, sharing and
tailoring information; enhancing communication between
patients and physicians; increasing accessibility to health
information; providing emotional and social support;
enhancing professional development; potentially influencing
health policy; and contributing to public health studies,
services and surveillance.[9,15,16] Despite these advantages,
several challenges could limit users from using social media
in healthcare. These challenges are related to the privacy and
confidentiality of patient health information, professionalism,
lack of time, risks of spreading inaccurate health‑related
information, and cultural issues that could influence the
extent to which physicians are willing to communicate with
their patients.[15,17‑22]
However, in Saudi Arabia, knowledge regarding the nature
of social media usage by patients for health‑related issues is
limited. Therefore, the objectives of the current study are:
(a) to determine the types of, the frequency of, and reasons
for social media usage by patients and (b) to explore patients’
perceptions of the advantages and main challenges associated
with using social media in healthcare.
SUBJECTS AND METHODS
A cross‑sectional design was used in this study. A convenience
sample of 400 patients was recruited from a teaching hospital
in Eastern Province, Saudi Arabia. The study was conducted
Saudi Journal for Health Sciences - Volume 7, Issue 2, May-August 2018 117
between March 2017 and May 2017. A paper‑based
questionnaire was developed based on a literature review to
meet the objectives of the current study. The questionnaire
was validated by two experts in the field. The questionnaire
consists of 15 questions related to the type and frequency
of social media usage, the purpose/reasons for using social
media, the advantages of using social media, and the main
challenges associated with using social media in healthcare.
In addition, demographic data including gender, age, and
level of education were assessed.
Ethical approval and consent to participate
This cross‑sectional study was approved by the Institutional
Review Board (IRB‑2017‑087‑CPH) of Imam Abdulrahman Bin
Faisal University, Saudi Arabia. All the participants provided
written informed consent after being assured that the
study information was classified and that participation was
anonymous and voluntary.
Statistical analysis
The statistical package for social science (SPSS version 21,
IBM, Chicago, Illinois, USA) was used. The mean and standard
deviation were computed for descriptive continuous data,
whereas the frequency and percentage were computed for
the categorical data analysis. Microsoft Excel was used for
the graphical presentation of the data.
RESULTS
In total, 377 of the 400 patients (94%) indicated that they
use social media. Of these 377 patients, 309 patients (82%)
reported using social media for health‑related issues. As
shown in Table 1, the percentage of female respondents was
61%, while male respondents constituted only 39% of the
sample. In total, 37.1% of the patients were younger than
30 years, 33% of the patients were aged between 30 and
38 years, and 30.2% of the patients were older than 38 years.
Nearly half the patients (49.3%) had a bachelor’s degree, 33.4%
of the patients had a high school degree, and only 7.2% of
Table 1: Characteristics of the participants
Characteristics n (%)
Age
<30 140 (37.1)
30‑38 123 (32.6)
>38 114 (30.2)
Gender
Male 148 (39.3)
Female 229 (60.7)
Educational level
High school 126 (33.4)
Bachelor’s 186 (49.3)
Higher education 27 (7.2)
Other 38 (10.1)
SD: Standard deviation
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Al‑Qahtani, et al.: Social Media in healthcare

the patients had a higher education degree. Nearly all the
participants (95%) used social media daily.
As shown in Figure 1, the patients used one or more social
media applications. However, the most frequently used
social media application was Snapchat (46.2%), followed by
Instagram (35.3%). Meanwhile, Facebook was used by only
20.7% of the patients.
As shown in Figure 2, most patients (60.5%) used social media
to increase their awareness of health‑related issues, followed
by self‑education (45%). Nearly one‑fourth of the patients used
social media for communication, and only 9% of the patients
used social media for marketing.
As shown in Table 2, most respondents (72%) agreed that
using social media is useful for achieving better health,
and 49% of the participants agreed that using social media
is useful for obtaining knowledge about healthcare.
A high proportion of the respondents (71%) agreed that
using social media enhanced their understanding of their
own health conditions and helped them learn about
their symptoms and treatment. Nearly two‑thirds of the
patients reported that using social media is useful for
sharing experiences with other patients suffering from the
same health condition. Most patients (74%) believed that
social media applications have the potential to improve
doctor‑patient communication. However, only 44% of the
respondents reported that “When communicating with my
healthcare provider, he/she usually responds to me.” When
the patients were asked about their opinion regarding
whether a challenge in using social media in healthcare is
the potential breach of confidentiality and the security of
their information, only 19% agreed that they were concerned
about this challenge.
DISCUSSION
The objectives of the study were to determine the types
of, the frequency of, and reasons for social media usage in
healthcare. In addition, we aimed to explore the advantages
and main challenges associated with using social media in
healthcare from patients’ perspectives. The study results
showed that most participants used social media. The highest
proportion of patients using social media in healthcare was
younger than 30 years. This result is consistent with the
findings reported by Özgüven and Mucan,[23] who indicated
that adult patients aged 18 to 31 were the most frequent
users of social media for health‑related issues.

100 70
60.5
90 60
80
50 44.6
70
Percentage
Percentage

60 40
50 46.2
35.3 30 24.1
40 31 33.4 30.8 21.8
30 20.7 20
20 9
10
10
0 0
YouTube Twitter Snapchat Instagram Facebook WhatsApp Education Communication Research Awareness Marketing
Applications Purpose for using social media

Figure 1: Social media applications used more frequently Figure 2: Reasons for using social media in healthcare

Table 2: Advantages and challenges associated with using social media in healthcare
Statement Strongly Disagree, Neutral, Agree, Strongly
disagree, n (%) n (%) n (%) n (%) agree, n (%)
Using social media is useful for achieving better health 11 (2.9) 22 (5.8) 71 (18.8) 207 (54.9) 66 (17.5)
Using social media is useful only for obtaining knowledge 37 (9.8) 98 (26.0) 59 (15.6) 142 (37.7) 41 (10.9)
about healthcare
Using social media can enhance my understanding of my own 14 (3.7) 32 (8.5) 62 (16.4) 199 (52.8) 70 (18.6)
health condition and help me learn about symptoms and
treatment
Using social media is useful for sharing experiences with other 15 (4.0) 59 (15.6) 75 (19.9) 176 (46.7) 52 (13.8)
patients living with the same health condition
Using social media in the healthcare setting has the potential 9 (2.4) 27 (7.2) 64 (17.0) 201 (53.3) 76 (20.2)
to improve doctor‑patient communication
When communicating with my healthcare provider, he/she 16 (4.2) 52 (13.8) 144 (38.2) 137 (36.3) 28 (7.4)
usually responds to me
The main challenge in using social media in healthcare is the 61 (16.2) 148 (39.3) 98 (26.0) 56 (14.9) 14 (3.7)
probability of a breach in confidentiality and the security of
patient information

118 Saudi Journal for Health Sciences - Volume 7, Issue 2, May-August 2018
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Al‑Qahtani, et al.: Social Media in healthcare
The present study found that Snapchat and Instagram were
more frequently used than other applications. This result is
consistent with the findings reported by the Pew Research
Center,[24] who indicated that Snapchat and Instagram are
especially popular among those ages 18 to 24.
The literature has shown that Facebook is an essential
application for patients to obtain information about health
conditions.[11,25] In Saudi Arabia, recent statistics indicate
that during the 3rd quarter of 2017, the most popular social
media application was WhatsApp, with a 71% penetration
rate in Saudi Arabia.[26] Our result showed that WhatsApp
and Facebook were used more frequently by only 30.8% and
20.7% of the patients, respectively. Our results contradict the
Statista[26] finding and the findings of the previous studies
mentioned above.
Regarding the main reasons for using social media, the results
of this study indicate that most patients use social media
to increase their awareness of health‑related issues and for
self‑education. Our finding is consistent with the finding
reported by Antheunis et al.,[8] who found that increasing
knowledge was the main purpose for patients who use certain
social media applications.
The result of this study indicated that using social media
has the potential to improve doctor‑patient communication,
improve the understanding of health‑related issues, and
enable the sharing of experiences with other patients,
which were the main advantages of using social media in
healthcare according to the patients’ perceptions. These
results were compatible with previous studies conducted
by Jackson et al.,[11] and Cooper,[25] who reported that using
social media allows patients to connect with each other,
share their experience about a specific disease, and obtain
feedback about that disease.
Previous studies suggest that using social media in healthcare
builds transparent doctor‑patient relationships and enhances
communication between the doctor and patient.[9] Notably,
although most patients in the current study believed that
social media has the potential to improve doctor‑patient
communication, only 40% of the participants agreed that
when communicating with their healthcare provider, their
healthcare provider responded to them.
The results of this study indicated that a small percentage
of patients believed that using social media in healthcare
might breach confidentiality and the security of their
information, which was the main challenge in using social
media in healthcare. This result is consistent with the
findings of a previous study that indicated that the most
significant challenge in patients’ social media use might be
the reluctance of patients to discuss their experiences via
social media sites due to security and privacy issues, which
may form a barrier to using social media.[9,27] Therefore,
Saudi Journal for Health Sciences - Volume 7, Issue 2, May-August 2018 119
social media sites are recommended to ensure the privacy
and security of their users.
CONCLUSION
Patients use more than one type of social media application.
However, Snapchat showed the highest usage frequency
among patients. The main advantages of using social media
in healthcare, as perceived by patients, were the potential to
improve doctor–patient communication, the understanding
of health‑related issues, and the ability to share experiences
with other patients with a similar health condition.
The main limitation of this study is that it was conducted in
only one major hospital in Eastern Province, Saudi Arabia,
which may limit the generalizability of the results.
For future research directions, the following are recommended:
• Conducting similar studies in different hospitals among
different groups, such as physicians, nurses and other
healthcare providers
• Building virtual communities in social media applications
that enable patients to share their experiences with other
patients with the same disease
• Raising awareness about social media usage in healthcare
• Encouraging patients to communicate with physicians
using social media by ensuring that their health
information remains confidential.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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