Contents lists available at ScienceDirect International Journal of Nursing Studies journal homepage: www.elsevier.com/locate/ijns Social media use profile, social skills, and nurse-patient interaction among Registered Nurses in tertiary hospitals: A structural equation model analysis Micah Celine O. Mariano a , John Christian M. Maniego a , Hariette Lou Marie D. Manila a , Ram Cedrick C. Mapanoo a , Kerwin Miguel A. Maquiran a , John Rey B. Macindo a, ⁎ , Lourdes Marie S. Tejero b , Gian Carlo S. Torres a a College of Nursing, University of Santo Tomas, España Boulevard, Manila, 1008, Philippines b College of Nursing, University of the Philippines – Manila, Pedro Gil, Manila, 1000, Philippines ARTICLE INFO Keywords: Nurse-patient interaction Social media use Social skills Non-handheld device Handheld device ABSTRACT Background: Social media has become increasingly important over the past decades and has been integrated in various environments, including the healthcare setting. Yet, the influence of social media use on the social skills and nurse-patient interaction of nurses is an area in nursing that requires further studies. This study determined the interrelationships among social media use profile, social skills, and nurse-patient interaction of Registered Nurses in tertiary hospitals. Methods: Employing structural equation modeling, a descriptive-correlational study was conducted among 212 consecutively-selected nurses from two tertiary hospitals. Consenting respondents completed a two-part survey composed of the respondent profile sheet and the Social Skills Inventory. The respondent profile sheet assessed demographic profile and social media use profile in terms of the mode, frequency, and duration of utilization. Three trained team members observed each nurse-patient dyad and completed the Nurse-Patient Bonding Instrument. Results: A good fit model illustrated the negative effects of frequent social media use to patient openness (β = -0.18, p < 0.05) and engagement (β = -0.11, p ≤ 0.05). Longer use of social media on a daily basis, however, positively affected both dimensions of social skills. Accessing social media platforms using non- handheld devices showed the most influential positive effects to social skills and nurse-patient interaction. Additionally, although verbal social skills positively affected most dimensions of nurse-patient interaction, non- verbal social skills negatively influenced patient engagement (β = -0.19, p = 0.019) and nurse openness (β = -0.38, p ≤ 0.05). Conclusion: The structural model illustrates the effects of using social media on the social skills and nurse-patient interaction of nurses and emphasizes the need for implementing institutional policies on the judicious use and application of social media in the workplace. Further, social skills development programs geared toward having a balanced social skill must be implemented. What is already known about the topic? • Social media has several benefits but has corresponding dis- advantages, especially when employed in the healthcare setting. • The social skills of nurses and nurse-patient interaction are im- portant facilitators of positive patient outcomes. • There are limited studies on social media use in the nursing field. The interrelationship among social media use profile, social skills, and nurse-patient interaction of nurses is an area in nursing that requires further studies. What this paper adds • Although longer duration of using social media on a daily basis improves social skills, frequent use of social media negatively affects nurse-patient interaction. Institutions must implement clear policies and guidelines on the judicious use and application of social media in the workplace to maximize the benefits and to limit the potential https://doi.org/10.1016/j.ijnurstu.2017.12.014 Received 2 May 2017; Received in revised form 24 December 2017; Accepted 28 December 2017 ⁎ Corresponding author. E-mail addresses: mceline.mariano@gmail.com (M.C.O. Mariano), jocomaniego@gmail.com (J.C.M. Maniego), hariettemanila@yahoo.com (H.L.M.D. Manila), rmapanoo012@yahoo.com (R.C.C. Mapanoo), kerwinmaquiran@gmail.com (K.M.A. Maquiran), johnreymasindo@yahoo.co.uk, janrei.masindo@gmail.com (J.R.B. Macindo), lstejero@up.edu.ph (L.M.S. Tejero), gstorres@ust.edu.ph (G.C.S. Torres). International Journal of Nursing Studies 80 (2018) 76–82 0020-7489/ © 2018 Elsevier Ltd. All rights reserved. T