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Factors Affecting Jordanian School Adolescents' Experience of Being Bullied
YJPDN-01657; No of Pages 6 Journal of Pediatric Nursing xxx (2017) xxx–xxx
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Journal of Pediatric Nursing
Factors Affecting Jordanian School Adolescents' Experience of Being Bullied Abeer M. Shaheen a,⁎, Sawsan Hammad a, Eman M. Haourani a, Omayyah S. Nassar b a b
Dept. of Community Health Nursing, University of Jordan, Amman, Jordan Dept. of Maternal & Child Health Nursing, University of Jordan, Amman, Jordan
a r t i c l e
i n f o
Article history: Received 13 July 2017 Revised 9 September 2017 Accepted 9 September 2017 Available online xxxx Keywords: Adolescents Culture-based bullying Cyber bullying Jordan Physical bullying Relational-verbal bullying Socio-demographic factors
a b s t r a c t Purpose: The purpose of this study was to identify the Jordanian school adolescents' experience of being bullied, and to examine its association with selected socio-demographic variables. Design and Methods: This cross sectional descriptive study used multi-stages cluster sampling technique to recruit a sample of in-school adolescents in Jordan (N = 436). The Personal Experiences Checklist was used to measure the experience of bullying. Descriptive statistics and parametric tests were used in the analysis. Results: Relational-verbal bullying was the most common form of bullying while cyber bullying was the least common type. Male adolescents experienced bullying more than females. In addition, adolescents belonging to low-income families experienced bullying more than those from moderate-income families. Finally, being bullied was negatively correlated with academic performance of students. Conclusions: This study indicated that risk factors for bullying are multifaceted which necessitate the development of prevention and intervention strategies to combat bullying taking into consideration these factors. Practice Implications: Schools should introduce environmental changes to discourage bullying and establish a policy with specific guidelines of what constitutes bullying behavior and expected disciplinary procedures. Staff training on information about the definition of bullying, current trends, and the effects of bullying is also recommended. © 2017 Elsevier Inc. All rights reserved.
Introduction Bullying at schools is a serious problem that violates the fundamental rights of children. The prevalence of bullying among school students is wide and well documented across different countries (Laeheem & Sungkharat, 2012; Srabstein & Leventhal, 2010). The prevalence of bullying victimization (parent-reported bullying victimization among children) was 19.2% in the total Nordic countries (i.e. Denmark, Finland, Iceland, Norway, and Sweden) in 2011 (Bjereld, Daneback, & Petzold, 2015). In another study conducted in Sweden, the frequency of bullying victimization (self-report of bullying involvement in the last two months) once or more was 10.6% (Carlerby, Viitasara, Knutsson, & Gådin, 2013). In China, about 25.7% of school students reported being bullied once or more in the past 30 days (Cheng et al., 2010). An Australian study revealed that 8–12% of school students reported being bullied frequently (every few weeks or more) (Lester, Cross, Dooley, & Shaw, 2013). The prevalence of bullying among the Jordanian school students was the highest 44.3% compared to other Arab countries including; Lebanon 33.6%, Oman 38.9%, Morocco 31.9%
⁎ Corresponding author at: Faculty of Nursing, University of Jordan, Amman 11942, Jordan. E-mail address: [email protected] (A.M. Shaheen).
and United Arab Emirates 20.9% (Fleming & Jacobsen, 2010; Kazarian & Ammar, 2013). School bullying is a hostile behavior that occurs repeatedly and in a systematic manner by an individual or a group to gain power, prestige, or goods. It involves an imbalance abusive use of physical or psychological power from the bullies (perpetrators) which make it difficult for the target group to defend themselves (Casebeer, 2012). Bullying is associated with negative long and short physical, psychological, and social outcomes. Bullying increases the risk of emotional impairment, psychosomatic symptoms, lack of self-confidence, running away from home, alcohol intake and drug abuse, absenteeism and accidental or perpetrated injuries (Cheng et al., 2010; Gini & Pozzoli, 2013; Jernbro, Svensson, Tindberg, & Janson, 2012; Lepore & Kliewer, 2013; Srabstein & Leventhal, 2010). The effect of bullying extends into adulthood; for instance, those who were bullied during their childhood are at an increased risk of psychiatric morbidity and poor health in their adulthood (Sourander et al., 2011; Wolke, Copeland, Angold, & Costello, 2013). There are many types of bullying including; physical, verbal, relational, cyber, and cultural-based bullying. Physical bullying involves physical violence such as shoving, kicking, or locking indoors. Verbal bullying includes name-calling or hurtful teasing. Physical and verbal forms of bullying are considered the direct types and can be easily identified and addressed by school authorities. Relational bullying involves
https://doi.org/10.1016/j.pedn.2017.09.003 0882-5963/© 2017 Elsevier Inc. All rights reserved.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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social manipulation of relationships and is considered the indirect form of bullying since the person or the group of persons doing bullying is not necessary identified. Relational bullying usually includes damaging the self-esteem, harming the social status, or excluding the target from a desired group (Casebeer, 2012; Hunt, Peters, & Rapee, 2012). A more recent form of bullying is referred to as cyber bullying which is defined as an intentional and aggressive act conducted repeatedly by an individual or a group using electronic means of communication over a period of time toward a victim who cannot easily defend himself or herself (Fanti, Demetriou, & Hawa, 2012). Having a social media profile may be a strong predictor of cyber bullying regardless of the time spent on these sites (O'Dea & Campbell, 2012). Cultural-based bullying is another type of harmful behavior that occurs due to differences based on culture, religion, language, national origin or national status (Scherr & Larson, 2010). Immigrant students, for instance, who have recently moved from one country to another, are at increased risk of being frequently bullied by their peers (Strohmeier, Kärnä, & Salmivalli, 2011). Bullying victimization is more prevalent in ethnically heterogeneous classes than other homogeneous classes (Vervoort, Scholte, & Overbeek, 2010). In Jordan, one national study (N = 1166) that examined bullying among adolescent school students revealed that bullying was significantly correlated with students' emotional wellbeing and psychosomatic symptoms. Bullied students reported more psychosomatic complaints and frequent tiredness, nervousness and dizziness than non-bullied students. The study has recommended further investigations to examine bullying and its associated factors within the Jordanian culture (Shaheen, Nassar, Saleh, & Arabia, 2014). Another study which investigated the experience of bullying in a sample of Jordanian school children from Amman revealed that the prevalence of bullying was 47% (N = 433). Bullied students reported being truant from school and disliking school than those who were not bullied (AlBitar, Al-Omari, Sonbol, Al-Ahmad, & Cunningham, 2013). Published studies revealed that bullying is a complex multidimensional problem associated with different factors (Fanti et al., 2012; Huang, Hong, & Espelage, 2013; Murray-Harvey, 2010; Shaheen et al., 2014). Socio-demographic factors including; gender, age, and socioeconomic status are individual factors that affect bullying. The results of the World Health Organization's global survey entitled “Health Behaviour in School-aged Children HBSC” showed that boys exposed to bullying as victims and perpetrators were more than girls in all of the forty countries included in the survey (Molcho et al., 2010). Other studies conducted in Turkey, Sweden, and China revealed similar findings (Atik & Güneri, 2013; Carlerby et al., 2013; Huang et al., 2013). However, a Chinese study conducted by Cheng et al. (2010) found that rates of bullying were similar for boys and girls but the forms of being bullied differed according to gender. Trends in victimization of bullying by age suggested that rates of victimization are higher among younger children compared to older children and adolescents (Huang et al., 2013). Studies that investigated the effect of socioeconomic status on bullying indicated that students from lower-socioeconomic status families have a high risk of being victims of bullying (Fu, Land, & Lamb, 2013; Jansen et al., 2012). Parents' educational level, employment status and income were used as indicators for family socioeconomic status. Low educational level of parents, parental unemployment, and low family income increased the risk of bullying among students (Fu et al., 2013; Jansen et al., 2012). One study conducted in Netherlands used parents' educational level and employment status as indicators of family socioeconomic status. This study found that parental educational level was the only indicator of socioeconomic status related to bullying victimization (Tippett & Wolke, 2014). Another study was conducted in Greece used parental education, parental employment, and family economic status found that none of the socioeconomic indicators was associated with peer victimization (Magklara et al., 2012). Academic achievement is an important school level factor that is related to bullying. Low academic achievement scores increased the risk
of being bullied (Fu et al., 2013). Research studies in eight Asia–Pacific countries indicated that students with low academic achievement scores reported more incidences of being bullied compared to those with high academic achievement scores (Huang et al., 2013). Some studies that linked between bullying and academic achievement found that students who are being bullied are at higher risk of demonstrating poor academic achievement (Swearer, Espelage, Vaillancourt, & Hymel, 2010). The Global School-based Student Health Survey (GSHS) revealed that bullied students reported higher rates of tobacco use (Fleming & Jacobsen, 2010). In addition to that, the HBSC survey found that bullying was a strong predictor of smoking and drinking (Vieno, Gini, & Santinello, 2011). Another study revealed that the risk of smoking initiation was significantly higher among students who were victims of bullying (Weiss, Mouttapa, Cen, Johnson, & Unger, 2011). A longitudinal Finnish study revealed that being frequently victimized at age eight predicted daily heavy smoking even after adjusting for childhood family background (Niemelä et al., 2011). There are few studies which examined bullying and its associated factors within the Jordanian culture. Thus, the aim of the current study was to assess the Jordanian school adolescents' experience of being bullied in relation to four forms of bullying (i.e. relational-verbal, cyber, physical, and cultural-based bullying), and to examine differences and associations in their experiences of being bullied in relation to selected factors (i.e. age, gender, socioeconomic status, smoking behavior, and academic achievement). The specific objectives of the study were to: • Describe the Jordanian school adolescents' experience of being bullied in relation to four forms of bullying including; relational-verbal, cyber, physical, and cultural-based bullying. • Examine differences in the Jordanian school adolescents' experiences of being bullied in relation to selected factors including; age, gender, socioeconomic status, smoking behavior, and academic achievement. Methods Sample Size The study sample was calculated by using G power soft program. Utilizing Z test indicating descriptive study using α = 0.05 two tail level of significance, effect size = 0.2 (low medium), power = 0.8 at least 369 students was needed for this study. Participants In Jordan, there are different sectors that contribute to education, the public education sector represents 57%, the private education sector represents 36.7%, and the United Nations Relief and Work Agency sector (UNRWA) represents 2.9%. Other sectors that contribute to education are the Ministry of Awqaf, Ministry of Higher Education, Ministry of Social Development, and Ministry of Defense. These sectors were excluded from the study because they contribute to education in small percentages. Primary education in Jordan is mandatory by law from the age of six until the age of sixteen (Ministry of Education, 2010b). A three-stage cluster sample technique was used to draw the study sample. The basic sampling unit was the classroom. Therefore, classes were selected with proportion to schools within the educational sectors. At the first level, the researcher randomly selected school directorates that represent the public, private, and UNRWA sectors of education. Then schools were randomly selected within each directorate from a list that is available online by the Ministry of Education (2010a). Five public schools, four private schools, and two UNRWA schools were randomly selected to represent the proportion of education presented by each educational sector. At each selected school, the researcher chose one class of each of the grades from 6th to 10th. Classes were chosen by writing class numbers
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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in separate pieces of paper. These pieces of papers were folded and mixed into a box. Lastly, samples were taken randomly from the box by choosing folded pieces of papers. The researchers contacted the parents of the students in the selected classes and explained the purpose of the study to obtain their consent. All students whom their parents signed the consent form were invited to participate in the study after full explanation was provided by the researchers. Ethical Considerations Ethical approval was obtained from the Research Committee at the school wherein the researcher is a faculty member, the Research Ethical Committee at the Deanship of Academic Research at the university where the researchers work, and Ministry of Education Ethical Committees. Procedure Data were collected from January 2014 to May 2014 using selfadministered questionnaires. The informed consent of parents or legal guardians was obtained prior to data collection. This form stated the purpose of the study, clearly identified that participation in the study is voluntary and that students have the right to withdraw from the study at any time. A written assent was obtained from the students as well. The questionnaire was administered in the classroom and was completed within the class period for all selected classes in the same day. Measures Demographic Information Information on the gender, age, grade, and monthly family income of the students was collected using a Demographic Data Sheet developed by the researchers. Bullying Victimization The Personal Experiences Checklist (PECK) was used to measure the experience of bullying among the students. The PECK is a self-report measurement which assesses the individual's personal experience of being bullied (as victim of bullying). It is suitable for both girls and boys aged 8 to 16 years. This tool uses a five point Likert scale (0 = never, 1 = rarely, 2 = sometimes, 3 = most days, 4 = every day) ranging from zero to 128. It includes 32 items and 4 subscales, relationalverbal bullying subscale composed of 11 items (e.g. turning friends against their peers, or saying mean things behind their back), cyber bullying subscale composed of 8 items (e.g. send nasty things through SMS, e-mail, websites or chat rooms), physical bullying subscale composed of 9 items (e.g. hitting, or kicking), and cultural-based bullying subscale composed of 4 items (e.g. making fun of their language or culture). For each subscale, a separate score can be obtained (Hunt et al., 2012). To allow for a comparison between the four subscales that have a different number of items, the scores were transformed into a 100.0 scale. The PECK is a valid and reliable tool, the internal consistency of this tool (Cronbach's alpha) ranged from 0.78 to 0.91 and test-retest reliability (r) ranged from 0.61 to 0.86 (Hunt et al., 2012). The PECK scale was translated to Arabic language by a bilingual researcher and then validated using the standard back translation technique by a native Arabic researcher who was also fluent in English. The questionnaire was backward translated into English by a native English speaker. Four bilingual researchers in the field of nursing were asked to evaluate the instrument for appropriateness and relevance of the items to the Jordanian culture. The questionnaire was then pilot tested on 40 students who were not included in the final sample. In the current study, the Cronbach's alpha coefficient was 0.95 for PECK scale, 0.86 for relational-verbal bullying subscale, 0.85 for cyber bullying subscale, 0.85 for physical bullying subscale, and 0.75 for
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cultural-based bullying subscale. Students took 20–30 min to complete the questionnaire of the study. Academic Achievement Students' academic achievement was assessed using grade point averages (GPA). Family Socioeconomic Status (SES) The educational level of parents, parents' employment status, and monthly family income were considered indicators of family SES. The attained educational level of mothers and fathers were divided into “less than high school”, and “more than high school”. Parents' employment status was measured using the questions: “is your father employed?”, “is your mother employed?”, and responses were (1 = yes, 2 = no). Students were asked to report their monthly family income in JD as a continuous variable. Smoking Behavior The use of cigarette was measured by the item: “do you smoke?” and responses were 1 = yes, 2 = no. Data Analysis Data were analyzed using the Statistical Package for Social Science (SPSS) version 17. Descriptive statistics (i.e. percentage, mean, standard deviation, minimum, and maximum) were used to describe the demographic characteristics of the study sample. Findings were considered statistically significant if the P value was ≤0.05. The PECK scale and its sub-scales were calculated as sums of item scores and then transformed to a scale ranging from 0 to 100. After the transformation, the mean and standard deviation were calculated for each subscale. The Pearson correlation test was used to examine the association between bullying experience and selected demographic variables. The normality of the bullying total score was checked out and after calculating the Pearson measure of skewness, the result showed a positive skewed scale. To assure normality, the scores were transformed using the square root transformation formula with the Pearson measure of skewness being recalculated and revealed normal distributed scale. Independent sample t-test and analysis of variance ANOVA were used to examine differences in the Jordanian school adolescents' experiences of being bullied in relation to the selected socio-demographic variables. Results Sample Characteristics The selected sample included 474 students. A total of 436 (92%) students completed the questionnaires. The study population was composed of 52.5% (N = 229) females and 47.5% (N = 207) males. The average age of students was 15 (SD = 1.62). The majority of the students were recruited from the governmental schools (70.9%, N = 309) and (11%, N = 48) of them worked after school. Their academic achievement was M = 80.1, SD = 10.4 and their families income in Jordanian Dinar was M = 605, SD = 481.3 (see Table 1). Description of Study Variables Table 2 showed that the mean total score of bullying out of 100 was 8.7 (SD = 12.1) and relational-verbal bullying was the most common form of bullying (M = 11.2, SD = 13.5) while cyber bullying was the least common (M = 8.3, SD = 13.9). In addition, male adolescents scored higher than female adolescents in all types of bullying. Among male adolescents, relational-verbal bullying (M = 6.1, SD = 7.1) followed by physical bullying (M = 4.2, SD = 5.9) were the highest (Table 3).
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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Table 1 Socio-demographic characteristic N = 436. Variable
Table 3 Description of the bullying total score and its subscale in regard to adolescents gender. N (%)
Gender Male Female School classification Governmental Private UNRWA Father levels of education High school and less More than High school Mother levels of education High school and less More than High school Father's job Employed Unemployed Mother's job
Mean (SD)
207 (47.5) 229 (52.5)
M (SD)
Male Female Male Female Male Female Male Female Male Female
14.6 (19.5) 8.2 (9.8) 6.1 (7.1) 3.9 (4.5) 3.9 (5.5) 1.6 (2.9) 4.2 (5.9) 2.3 (3.5) 1.9 (2.9) 1.1 (1.9)
Relational-verbal bullying
309 (70.9) 52 (11.9) 75 (17.2)
Cyberbullying
259 (59.2) 177 (40.8)
Bullying based on culture
Physical bullying
373 (85.6) 63 (14.4)
Academic achievement (out of 100) Age Monthly family income in Jordanian dinar
89 (20.4) 347 (79.6) 47 (10.8) 48 (11) Range 47–98 11–18 years 50–5000
M (SD) 80.1 (10.4) 15 (1.619) 605 (481.316)
Differences in Bullying Experience in Relation to Socio-demographic Variables The results of student's t-test revealed a statistically significant difference in bullying experience among males and females (t (434) = 4.02, P b 0.001). Male adolescents experienced bullying more than females (M = 3.1, SD = 2.2). In addition, adolescents who smoke statistically differed than nonsmokers (t (434) = 3.8, P b 0.001) and scored significantly higher (M = 3.2, SD = 2.3). The adolescents who were working after school (t (434) = 3.32, P = 0.002) scored statistically significantly higher than those who did not work (M = 3.8, SD = 2.5). Also, being bullied was significantly negatively correlated with the graduate average point (r = −0.126, P = 0.009). In regard to parents' educational level and job, neither their educational level nor their employment status had an impact on adolescents' bullying experience. Adolescents' age was a continuous variable and based on the developmental stages of adolescents, it was categorized into early, middle, and late stage adolescent (Hockenberry, Wilson, & Wong, 2012). Analysis of variance was carried out and revealed a statistically significant difference among these three stages (F (2, 433) = 5.34, P = 0.005). Schefee post hoc criterion for multiple groups comparison was carried out and revealed a statistically significant difference among the early stage group and the middle stage group (P = 0.013), the early stage adolescents experienced bullying more than the middle stage adolescents (M = 3.13, SD = 1.9). The middle stage and the late stage did not differ from each other (P = 0.09) as well as the early stage and the late stage (P = 0.82). Family income was re-coded into three groups (i.e. low, middle, and high) based on the cutoff point
Table 2 Description of the bullying scale total score and its subscale.
Bullying total score Relational-verbal bullying Cyberbullying Physical bullying Bullying based on culture
Variable
Bullying total score
275 (63.1) 161 (36.9)
Unemployed Smoker adolescents Adolescents who work after school
Variable
Bullying sub-scale
Raw score
Transformed score out of 100
M (SD)
M (SD)
11.2 (15.5) 4.9 (5.9) 2.7 (4.5) 3.2 (4.9) 1.5 (2.5)
8.7 (12.1) 11.2 (13.5) 8.3 (13.9) 8.8 (13.5) 9.1 (15.5)
created by SPSS program. The results showed a statistically significant difference among families with low and moderate income (F (2, 433) = 4.75, P = 0.009); adolescents belonging to low income families group experienced more bullying than the moderate group (M = 2.98, SD = 2.03). The moderate income group and the high income group did not differ from each other (P = 0.11) as well as the high income group and the low income group (P = 0.76) (Table 4). Discussion The present study assessed the Jordanian school adolescents' experience of being bullied in relation to four forms (i.e. relational-verbal, cyber, physical, and cultural-based bullying), and selected sociodemographic factors were examined for statistical differences and associations. The relational-verbal bullying was the most prevalent type of bullying. This finding is consistent with previous studies conducted in Turkey, China, and in the United States which reported relational bullying as the most prevalent type among adolescents (Huang et al., 2013; Piskin, 2010). The higher prevalence of the relational-verbal form of
Table 4 Differences in total bullying experience among groups in relation to different socio-demographic variables N = 436. Variable Gender Male Female Smoking status Smoker Non-smoker Working after school Yes group No group Fathers' educational level High school and less Higher than high school Mothers' educational level High school and less Higher than high school Fathers' job Employed Unemployed Mothers' job Employed Unemployed Stages of adolescents Early stage (10−13) Middle stage (14–16) Late stage (17–19) Monthly income Low Moderate High
Mean (SD)
P-value
Test value
df
3.1 (2.2) 2.4 (1.6)
b 0.001⁎⁎⁎
4.02
434
3.9 (2.3) 2.6 (1.9)
b0.001⁎⁎⁎
3.8
434
3.8 (2.5) 2.6 (1.8)
0.002⁎⁎
3. 32
434
2.81 (2.07) 2.58 (1.78)
0.22
1.217
434
2.72 (1.98) 2.71 (1.93)
0.97
0.037
434
2.76 (1.91) 2.47 (2.21)
0.27
1.1
434
3.06 (10.96) 2.63 (1.96)
0.06
1.88
434
3.13 (1.9) 2.44 (1.8) 2.95 (2.2)
0.005⁎⁎
5.34
2433
2.98 (2.03) 2.29 (1.78) 2.79 (1.96)
0.009⁎⁎
4.75
2433
⁎⁎ P b 0.01, two tailed. ⁎⁎⁎ P b 0.001, two tailed.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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bullying could be explained by difficulty to identify this form by the school officials (Casebeer, 2012). In the current study, the boys were more likely to report the experience of being bullied than the girls, which was similar to previous research studies (Atik & Güneri, 2013; Carlerby et al., 2013; Fleming & Jacobsen, 2010; Huang et al., 2013). This could be due to the differences in the male gender construction from the female gender construction since boys have a higher acceptance and expectancy of power practices such as bullying others (Connell, 2012). On the other hand, the adolescents who bullied others could use bullying as a mean to cover their low self-esteem (Patchin & Hinduja, 2010). Other researchers have claimed that boys use bullying as a coping strategy to counteract their mental health problems more than girls (Gustafsson et al., 2010). This also could result from the boys' willingness to report their bullying experience more than girls. However, Cheng et al. (2010) found little gender difference in the prevalence of being bullied. The forms of bullying did differ by gender. The males were more likely to be victims of physical, relational-verbal, cyber, and culturalbased bullying more than females. Similar patterns of bullying were found in the study conducted by Craig et al. (2009). These gender patterns were different from the stereotyped patterns reported by Huang et al. (2013) and Cheng et al. (2010) who found that boys were more involved in physical bullying, whereas girls were more involved in relational bullying. The prevalence of bullying was lower among the older adolescents compared to the younger adolescents. This was consistent with other studies (Huang et al., 2013). There are several explanations why younger adolescents are more prone to bullying than older adolescents. The reduction of bullying by age could be due to physical, psychological, and social developmental changes as adolescents grow up, which serve as protective factors from bullying at schools. Moreover, this may reflect the differences between elementary, middle, and high school conditions in relation to academic demands and social climate. Some studies claimed that young adolescents report bullying more than older ones which justifies the high prevalence of bullying among the early stage of adolescence (Hong & Espelage, 2012). Cheng et al. (2010) found no significant differences among age and grades while a Turkish study by Atik and Güneri (2013) found that bullying is more prevalent among the older students compared to younger students. Further longitudinal investigations are needed for better understanding of the age influence on bullying experience. In the current study, bullied students were more likely to use tobacco than non-bullied students. This finding is consistent with the study of Fleming and Jacobsen (2010) and Vieno et al. (2011). Victimization causes stress, anxiety, isolation, and fear from school and all of these factors could be a precursor to tobacco use. This study measured three indicators for socioeconomic status including; parents' educational level, parents' employment status, and family income. Neither parents' educational level nor their employment status had an impact on adolescents' bullying experience. However, adolescents belonging to low income families experienced more bullying than those belonging to moderate income families. Family income was the most significant indicator for family socioeconomic status and this can mostly be explained within the context of Jordanian culture as following; parents' access to education mostly can guarantee them a job that constitutes a source of family income. Jordan classified as a third world country in terms of gross national income which results in a limited employee income that usually does not exceed the poverty line. Thus we suggest that employed parents in Jordan may not be able to provide resources required to meet their children's needs. In turn those children may have feelings of inferiority and this increases their vulnerability to bullying. On the other side, most parents who have low educational level may practice liberal professions that are characterized by a high rate of income which enables them to meet their children's demands. Therefore, our study reflected that the education of parents and their job are not strong indicators of family status affecting
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the bullying victimization. Our results are in consistent with other studies that linked low socioeconomic status of adolescents' family to the increased risk to bullying victimization (Fu et al., 2013; Jansen et al., 2012). As a result of this deterioration in the economy in Jordan, some children work after school to be able to provide the basic needs of their families, which put them at a higher risk of being bully victims. In terms of academic achievement, being bullied was significantly negatively correlated with students' academic performance. The link between bullying victimization and academic performance is complicated. Previous research studies found that low academic achievement scores increased the likelihood of being a bully victim (Atik & Güneri, 2013). In addition, at the individual-level being bullied leads to poor academic performance (Swearer et al., 2010). However, another study showed that there was no significant association between the level of academic performance and students' reports of bullying (Green, Dunn, Johnson, & Molnar, 2011). This result highlights the importance of providing a safe learning environment for students at school. Limitations The study used self-reported data which may result in response bias relating to socially desirable responses. Another limitation is the crosssectional nature of the study which limits the ability to infer causal relationships. Finally, our study sample included in-school adolescents thus the sample may not be representative for adolescents not attending schools who could be at risk for bullying involvement. Implications for Practice This study presents valuable information for school counselors, health care professionals, school staff, students and parents regarding bullying and its associated factors. Relational-verbal bullying was the most common type of bullying, thus more emphasis should be given in teaching students problem solving, social and interpersonal skills to enhance their communication with each other. Schools should introduce environmental changes to discourage bullying such as increased supervision in the playground and lunchrooms, divide break times into two or three groups by age to minimize the exposure of younger students to older students. Schools should establish a policy with specific guidelines of what constitutes bullying behavior and expected disciplinary procedures. Staff training by the school nurse which includes information and discussion about the definition of bullying, current trends, and the effects of bullying is recommended. The school nurse should review all interventions being implemented as part of the overall anti-bullying strategy at school. Additionally, the application of risk assessment tools that determine type and frequency of bullying by the school nurse is important. The school nurse should focus on educating both students and parents about bullying with particular emphasis on bystanders (students who observe bullying) who can contribute to helping victims and reducing bullying. In Jordan, we still do not have school health nurses at the majority of our schools. The establishment of school health nursing will help our students to address bullying through health promotion and preventing strategies which will result in making our schools safer for all adolescents. Conclusion This study indicated that risk factors for bullying are multifaceted. Individual level factors including; gender, age, and family socioeconomic status, and school level factors including academic achievement are important factors that affect bullying victimization. These findings necessitate the development of prevention and intervention strategies to combat bullying adaptive to the Jordanian culture.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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Acknowledgments The authors are grateful to the Deanship for Scientific Research—University of Jordan (85/2013-2014) - for funding this study. Our thanks extend to school students who participated in this study. Authorship Statement We confirm that all listed authors meet the authorship criteria and that all authors are in agreement with the content of the manuscript. Disclosure There are no competing interests associated with this study. References Al-Bitar, Z. B., Al-Omari, I. K., Sonbol, H. N., Al-Ahmad, H. T., & Cunningham, S. J. (2013). Bullying among Jordanian schoolchildren, its effects on school performance, and the contribution of general physical and dentofacial features. American Journal of Orthodontics and Dentofacial Orthopedics, 144(6), 872–878. Atik, G., & Güneri, O. Y. (2013). Bullying and victimization: Predictive role of individual, parental, and academic factors. School Psychology International, 34(6), 658–673. https://doi.org/10.1177/0143034313479699. Bjereld, Y., Daneback, K., & Petzold, M. (2015). Differences in prevalence of bullying victimization between native and immigrant children in the Nordic countries: a parent‐reported serial cross‐sectional study. Child: care, health and development, 41(4), 593–599. Carlerby, H., Viitasara, E., Knutsson, A., & Gådin, K. G. (2013). How bullying involvement is associated with the distribution of parental background and with subjective health complaints among Swedish boys and girls. Social Indicators Research, 111(3), 775–783. Casebeer, C. M. (2012). School bullying: Why quick fixes do not prevent school failure. Preventing School Failure: Alternative Education for Children and Youth, 56(3), 165–171. Cheng, Y., Newman, I. M., Qu, M., Mbulo, L., Chai, Y., Chen, Y., & Shell, D. F. (2010). Being bullied and psychosocial adjustment among middle school students in China. Journal of School Health, 80(4), 193–199. Connell, R. (2012). Gender, health and theory: Conceptualizing the issue, in local and world perspective. Social Science & Medicine, 74(11), 1675–1683. Craig, W., Harel-Fisch, Y., Fogel-Grinvald, H., Dostaler, S., Hetland, J., Simons-Morton, B., ... Due, P. (2009). A cross-national profile of bullying and victimization among adolescents in 40 countries. International Journal of Public Health, 54(2), 216–224. Fanti, K. A., Demetriou, A. G., & Hawa, V. V. (2012). A longitudinal study of cyberbullying: Examining risk and protective factors. The European Journal of Developmental Psychology, 9(2), 168–181. Fleming, L. C., & Jacobsen, K. H. (2010). Bullying among middle-school students in low and middle income countries. Health Promotion International, 25(1), 73–84. Fu, Q., Land, K. C., & Lamb, V. L. (2013). Bullying victimization, socioeconomic status and behavioral characteristics of 12th graders in the United States, 1989 to 2009: Repetitive trends and persistent risk differentials. Child Indicators Research, 6(1), 1–21. Gini, G., & Pozzoli, T. (2013). Bullied children and psychosomatic problems: A metaanalysis. Pediatrics, 132(4), 720–729. Green, J. G., Dunn, E. C., Johnson, R. M., & Molnar, B. E. (2011). A multilevel investigation of the association between school context and adolescent nonphysical bullying. Journal of School Violence, 10(2), 133–149. Gustafsson, J. E., Westling Allodi, M., Alin, A., Kerman, B., et al. (2010). School, learning and mental health: A systematic review. Stockholm: The Royal Swedish Academy of Sciences, The Health Committee. Hockenberry, M. J., Wilson, D., & Wong, D. L. (2012). Wong's essentials of pediatric nursing (9th edition ). Elsevier Health Sciences. Hong, J. S., & Espelage, D. L. (2012). A review of research on bullying and peer victimization in school: An ecological system analysis. Aggression and Violent Behavior, 17(4), 311–322. Huang, H., Hong, J., & Espelage, D. (2013). Understanding factors associated with bullying and peer victimization in Chinese schools within ecological contexts. Journal of Child and Family Studies, 22(7), 881–892. https://doi.org/10.1007/s10826-012-9647-4. Hunt, C., Peters, L., & Rapee, R. M. (2012). Development of a measure of the experience of being bullied in youth. Psychological Assessment, 24(1), 156. Jansen, P. W., Verlinden, M., Dommisse-van Berkel, A., Mieloo, C., van der Ende, J., Veenstra, R., ... Tiemeier, H. (2012). Prevalence of bullying and victimization among
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Contents lists available at ScienceDirect
Journal of Pediatric Nursing
Factors Affecting Jordanian School Adolescents' Experience of Being Bullied Abeer M. Shaheen a,⁎, Sawsan Hammad a, Eman M. Haourani a, Omayyah S. Nassar b a b
Dept. of Community Health Nursing, University of Jordan, Amman, Jordan Dept. of Maternal & Child Health Nursing, University of Jordan, Amman, Jordan
a r t i c l e
i n f o
Article history: Received 13 July 2017 Revised 9 September 2017 Accepted 9 September 2017 Available online xxxx Keywords: Adolescents Culture-based bullying Cyber bullying Jordan Physical bullying Relational-verbal bullying Socio-demographic factors
a b s t r a c t Purpose: The purpose of this study was to identify the Jordanian school adolescents' experience of being bullied, and to examine its association with selected socio-demographic variables. Design and Methods: This cross sectional descriptive study used multi-stages cluster sampling technique to recruit a sample of in-school adolescents in Jordan (N = 436). The Personal Experiences Checklist was used to measure the experience of bullying. Descriptive statistics and parametric tests were used in the analysis. Results: Relational-verbal bullying was the most common form of bullying while cyber bullying was the least common type. Male adolescents experienced bullying more than females. In addition, adolescents belonging to low-income families experienced bullying more than those from moderate-income families. Finally, being bullied was negatively correlated with academic performance of students. Conclusions: This study indicated that risk factors for bullying are multifaceted which necessitate the development of prevention and intervention strategies to combat bullying taking into consideration these factors. Practice Implications: Schools should introduce environmental changes to discourage bullying and establish a policy with specific guidelines of what constitutes bullying behavior and expected disciplinary procedures. Staff training on information about the definition of bullying, current trends, and the effects of bullying is also recommended. © 2017 Elsevier Inc. All rights reserved.
Introduction Bullying at schools is a serious problem that violates the fundamental rights of children. The prevalence of bullying among school students is wide and well documented across different countries (Laeheem & Sungkharat, 2012; Srabstein & Leventhal, 2010). The prevalence of bullying victimization (parent-reported bullying victimization among children) was 19.2% in the total Nordic countries (i.e. Denmark, Finland, Iceland, Norway, and Sweden) in 2011 (Bjereld, Daneback, & Petzold, 2015). In another study conducted in Sweden, the frequency of bullying victimization (self-report of bullying involvement in the last two months) once or more was 10.6% (Carlerby, Viitasara, Knutsson, & Gådin, 2013). In China, about 25.7% of school students reported being bullied once or more in the past 30 days (Cheng et al., 2010). An Australian study revealed that 8–12% of school students reported being bullied frequently (every few weeks or more) (Lester, Cross, Dooley, & Shaw, 2013). The prevalence of bullying among the Jordanian school students was the highest 44.3% compared to other Arab countries including; Lebanon 33.6%, Oman 38.9%, Morocco 31.9%
⁎ Corresponding author at: Faculty of Nursing, University of Jordan, Amman 11942, Jordan. E-mail address: [email protected] (A.M. Shaheen).
and United Arab Emirates 20.9% (Fleming & Jacobsen, 2010; Kazarian & Ammar, 2013). School bullying is a hostile behavior that occurs repeatedly and in a systematic manner by an individual or a group to gain power, prestige, or goods. It involves an imbalance abusive use of physical or psychological power from the bullies (perpetrators) which make it difficult for the target group to defend themselves (Casebeer, 2012). Bullying is associated with negative long and short physical, psychological, and social outcomes. Bullying increases the risk of emotional impairment, psychosomatic symptoms, lack of self-confidence, running away from home, alcohol intake and drug abuse, absenteeism and accidental or perpetrated injuries (Cheng et al., 2010; Gini & Pozzoli, 2013; Jernbro, Svensson, Tindberg, & Janson, 2012; Lepore & Kliewer, 2013; Srabstein & Leventhal, 2010). The effect of bullying extends into adulthood; for instance, those who were bullied during their childhood are at an increased risk of psychiatric morbidity and poor health in their adulthood (Sourander et al., 2011; Wolke, Copeland, Angold, & Costello, 2013). There are many types of bullying including; physical, verbal, relational, cyber, and cultural-based bullying. Physical bullying involves physical violence such as shoving, kicking, or locking indoors. Verbal bullying includes name-calling or hurtful teasing. Physical and verbal forms of bullying are considered the direct types and can be easily identified and addressed by school authorities. Relational bullying involves
https://doi.org/10.1016/j.pedn.2017.09.003 0882-5963/© 2017 Elsevier Inc. All rights reserved.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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social manipulation of relationships and is considered the indirect form of bullying since the person or the group of persons doing bullying is not necessary identified. Relational bullying usually includes damaging the self-esteem, harming the social status, or excluding the target from a desired group (Casebeer, 2012; Hunt, Peters, & Rapee, 2012). A more recent form of bullying is referred to as cyber bullying which is defined as an intentional and aggressive act conducted repeatedly by an individual or a group using electronic means of communication over a period of time toward a victim who cannot easily defend himself or herself (Fanti, Demetriou, & Hawa, 2012). Having a social media profile may be a strong predictor of cyber bullying regardless of the time spent on these sites (O'Dea & Campbell, 2012). Cultural-based bullying is another type of harmful behavior that occurs due to differences based on culture, religion, language, national origin or national status (Scherr & Larson, 2010). Immigrant students, for instance, who have recently moved from one country to another, are at increased risk of being frequently bullied by their peers (Strohmeier, Kärnä, & Salmivalli, 2011). Bullying victimization is more prevalent in ethnically heterogeneous classes than other homogeneous classes (Vervoort, Scholte, & Overbeek, 2010). In Jordan, one national study (N = 1166) that examined bullying among adolescent school students revealed that bullying was significantly correlated with students' emotional wellbeing and psychosomatic symptoms. Bullied students reported more psychosomatic complaints and frequent tiredness, nervousness and dizziness than non-bullied students. The study has recommended further investigations to examine bullying and its associated factors within the Jordanian culture (Shaheen, Nassar, Saleh, & Arabia, 2014). Another study which investigated the experience of bullying in a sample of Jordanian school children from Amman revealed that the prevalence of bullying was 47% (N = 433). Bullied students reported being truant from school and disliking school than those who were not bullied (AlBitar, Al-Omari, Sonbol, Al-Ahmad, & Cunningham, 2013). Published studies revealed that bullying is a complex multidimensional problem associated with different factors (Fanti et al., 2012; Huang, Hong, & Espelage, 2013; Murray-Harvey, 2010; Shaheen et al., 2014). Socio-demographic factors including; gender, age, and socioeconomic status are individual factors that affect bullying. The results of the World Health Organization's global survey entitled “Health Behaviour in School-aged Children HBSC” showed that boys exposed to bullying as victims and perpetrators were more than girls in all of the forty countries included in the survey (Molcho et al., 2010). Other studies conducted in Turkey, Sweden, and China revealed similar findings (Atik & Güneri, 2013; Carlerby et al., 2013; Huang et al., 2013). However, a Chinese study conducted by Cheng et al. (2010) found that rates of bullying were similar for boys and girls but the forms of being bullied differed according to gender. Trends in victimization of bullying by age suggested that rates of victimization are higher among younger children compared to older children and adolescents (Huang et al., 2013). Studies that investigated the effect of socioeconomic status on bullying indicated that students from lower-socioeconomic status families have a high risk of being victims of bullying (Fu, Land, & Lamb, 2013; Jansen et al., 2012). Parents' educational level, employment status and income were used as indicators for family socioeconomic status. Low educational level of parents, parental unemployment, and low family income increased the risk of bullying among students (Fu et al., 2013; Jansen et al., 2012). One study conducted in Netherlands used parents' educational level and employment status as indicators of family socioeconomic status. This study found that parental educational level was the only indicator of socioeconomic status related to bullying victimization (Tippett & Wolke, 2014). Another study was conducted in Greece used parental education, parental employment, and family economic status found that none of the socioeconomic indicators was associated with peer victimization (Magklara et al., 2012). Academic achievement is an important school level factor that is related to bullying. Low academic achievement scores increased the risk
of being bullied (Fu et al., 2013). Research studies in eight Asia–Pacific countries indicated that students with low academic achievement scores reported more incidences of being bullied compared to those with high academic achievement scores (Huang et al., 2013). Some studies that linked between bullying and academic achievement found that students who are being bullied are at higher risk of demonstrating poor academic achievement (Swearer, Espelage, Vaillancourt, & Hymel, 2010). The Global School-based Student Health Survey (GSHS) revealed that bullied students reported higher rates of tobacco use (Fleming & Jacobsen, 2010). In addition to that, the HBSC survey found that bullying was a strong predictor of smoking and drinking (Vieno, Gini, & Santinello, 2011). Another study revealed that the risk of smoking initiation was significantly higher among students who were victims of bullying (Weiss, Mouttapa, Cen, Johnson, & Unger, 2011). A longitudinal Finnish study revealed that being frequently victimized at age eight predicted daily heavy smoking even after adjusting for childhood family background (Niemelä et al., 2011). There are few studies which examined bullying and its associated factors within the Jordanian culture. Thus, the aim of the current study was to assess the Jordanian school adolescents' experience of being bullied in relation to four forms of bullying (i.e. relational-verbal, cyber, physical, and cultural-based bullying), and to examine differences and associations in their experiences of being bullied in relation to selected factors (i.e. age, gender, socioeconomic status, smoking behavior, and academic achievement). The specific objectives of the study were to: • Describe the Jordanian school adolescents' experience of being bullied in relation to four forms of bullying including; relational-verbal, cyber, physical, and cultural-based bullying. • Examine differences in the Jordanian school adolescents' experiences of being bullied in relation to selected factors including; age, gender, socioeconomic status, smoking behavior, and academic achievement. Methods Sample Size The study sample was calculated by using G power soft program. Utilizing Z test indicating descriptive study using α = 0.05 two tail level of significance, effect size = 0.2 (low medium), power = 0.8 at least 369 students was needed for this study. Participants In Jordan, there are different sectors that contribute to education, the public education sector represents 57%, the private education sector represents 36.7%, and the United Nations Relief and Work Agency sector (UNRWA) represents 2.9%. Other sectors that contribute to education are the Ministry of Awqaf, Ministry of Higher Education, Ministry of Social Development, and Ministry of Defense. These sectors were excluded from the study because they contribute to education in small percentages. Primary education in Jordan is mandatory by law from the age of six until the age of sixteen (Ministry of Education, 2010b). A three-stage cluster sample technique was used to draw the study sample. The basic sampling unit was the classroom. Therefore, classes were selected with proportion to schools within the educational sectors. At the first level, the researcher randomly selected school directorates that represent the public, private, and UNRWA sectors of education. Then schools were randomly selected within each directorate from a list that is available online by the Ministry of Education (2010a). Five public schools, four private schools, and two UNRWA schools were randomly selected to represent the proportion of education presented by each educational sector. At each selected school, the researcher chose one class of each of the grades from 6th to 10th. Classes were chosen by writing class numbers
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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in separate pieces of paper. These pieces of papers were folded and mixed into a box. Lastly, samples were taken randomly from the box by choosing folded pieces of papers. The researchers contacted the parents of the students in the selected classes and explained the purpose of the study to obtain their consent. All students whom their parents signed the consent form were invited to participate in the study after full explanation was provided by the researchers. Ethical Considerations Ethical approval was obtained from the Research Committee at the school wherein the researcher is a faculty member, the Research Ethical Committee at the Deanship of Academic Research at the university where the researchers work, and Ministry of Education Ethical Committees. Procedure Data were collected from January 2014 to May 2014 using selfadministered questionnaires. The informed consent of parents or legal guardians was obtained prior to data collection. This form stated the purpose of the study, clearly identified that participation in the study is voluntary and that students have the right to withdraw from the study at any time. A written assent was obtained from the students as well. The questionnaire was administered in the classroom and was completed within the class period for all selected classes in the same day. Measures Demographic Information Information on the gender, age, grade, and monthly family income of the students was collected using a Demographic Data Sheet developed by the researchers. Bullying Victimization The Personal Experiences Checklist (PECK) was used to measure the experience of bullying among the students. The PECK is a self-report measurement which assesses the individual's personal experience of being bullied (as victim of bullying). It is suitable for both girls and boys aged 8 to 16 years. This tool uses a five point Likert scale (0 = never, 1 = rarely, 2 = sometimes, 3 = most days, 4 = every day) ranging from zero to 128. It includes 32 items and 4 subscales, relationalverbal bullying subscale composed of 11 items (e.g. turning friends against their peers, or saying mean things behind their back), cyber bullying subscale composed of 8 items (e.g. send nasty things through SMS, e-mail, websites or chat rooms), physical bullying subscale composed of 9 items (e.g. hitting, or kicking), and cultural-based bullying subscale composed of 4 items (e.g. making fun of their language or culture). For each subscale, a separate score can be obtained (Hunt et al., 2012). To allow for a comparison between the four subscales that have a different number of items, the scores were transformed into a 100.0 scale. The PECK is a valid and reliable tool, the internal consistency of this tool (Cronbach's alpha) ranged from 0.78 to 0.91 and test-retest reliability (r) ranged from 0.61 to 0.86 (Hunt et al., 2012). The PECK scale was translated to Arabic language by a bilingual researcher and then validated using the standard back translation technique by a native Arabic researcher who was also fluent in English. The questionnaire was backward translated into English by a native English speaker. Four bilingual researchers in the field of nursing were asked to evaluate the instrument for appropriateness and relevance of the items to the Jordanian culture. The questionnaire was then pilot tested on 40 students who were not included in the final sample. In the current study, the Cronbach's alpha coefficient was 0.95 for PECK scale, 0.86 for relational-verbal bullying subscale, 0.85 for cyber bullying subscale, 0.85 for physical bullying subscale, and 0.75 for
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cultural-based bullying subscale. Students took 20–30 min to complete the questionnaire of the study. Academic Achievement Students' academic achievement was assessed using grade point averages (GPA). Family Socioeconomic Status (SES) The educational level of parents, parents' employment status, and monthly family income were considered indicators of family SES. The attained educational level of mothers and fathers were divided into “less than high school”, and “more than high school”. Parents' employment status was measured using the questions: “is your father employed?”, “is your mother employed?”, and responses were (1 = yes, 2 = no). Students were asked to report their monthly family income in JD as a continuous variable. Smoking Behavior The use of cigarette was measured by the item: “do you smoke?” and responses were 1 = yes, 2 = no. Data Analysis Data were analyzed using the Statistical Package for Social Science (SPSS) version 17. Descriptive statistics (i.e. percentage, mean, standard deviation, minimum, and maximum) were used to describe the demographic characteristics of the study sample. Findings were considered statistically significant if the P value was ≤0.05. The PECK scale and its sub-scales were calculated as sums of item scores and then transformed to a scale ranging from 0 to 100. After the transformation, the mean and standard deviation were calculated for each subscale. The Pearson correlation test was used to examine the association between bullying experience and selected demographic variables. The normality of the bullying total score was checked out and after calculating the Pearson measure of skewness, the result showed a positive skewed scale. To assure normality, the scores were transformed using the square root transformation formula with the Pearson measure of skewness being recalculated and revealed normal distributed scale. Independent sample t-test and analysis of variance ANOVA were used to examine differences in the Jordanian school adolescents' experiences of being bullied in relation to the selected socio-demographic variables. Results Sample Characteristics The selected sample included 474 students. A total of 436 (92%) students completed the questionnaires. The study population was composed of 52.5% (N = 229) females and 47.5% (N = 207) males. The average age of students was 15 (SD = 1.62). The majority of the students were recruited from the governmental schools (70.9%, N = 309) and (11%, N = 48) of them worked after school. Their academic achievement was M = 80.1, SD = 10.4 and their families income in Jordanian Dinar was M = 605, SD = 481.3 (see Table 1). Description of Study Variables Table 2 showed that the mean total score of bullying out of 100 was 8.7 (SD = 12.1) and relational-verbal bullying was the most common form of bullying (M = 11.2, SD = 13.5) while cyber bullying was the least common (M = 8.3, SD = 13.9). In addition, male adolescents scored higher than female adolescents in all types of bullying. Among male adolescents, relational-verbal bullying (M = 6.1, SD = 7.1) followed by physical bullying (M = 4.2, SD = 5.9) were the highest (Table 3).
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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Table 1 Socio-demographic characteristic N = 436. Variable
Table 3 Description of the bullying total score and its subscale in regard to adolescents gender. N (%)
Gender Male Female School classification Governmental Private UNRWA Father levels of education High school and less More than High school Mother levels of education High school and less More than High school Father's job Employed Unemployed Mother's job
Mean (SD)
207 (47.5) 229 (52.5)
M (SD)
Male Female Male Female Male Female Male Female Male Female
14.6 (19.5) 8.2 (9.8) 6.1 (7.1) 3.9 (4.5) 3.9 (5.5) 1.6 (2.9) 4.2 (5.9) 2.3 (3.5) 1.9 (2.9) 1.1 (1.9)
Relational-verbal bullying
309 (70.9) 52 (11.9) 75 (17.2)
Cyberbullying
259 (59.2) 177 (40.8)
Bullying based on culture
Physical bullying
373 (85.6) 63 (14.4)
Academic achievement (out of 100) Age Monthly family income in Jordanian dinar
89 (20.4) 347 (79.6) 47 (10.8) 48 (11) Range 47–98 11–18 years 50–5000
M (SD) 80.1 (10.4) 15 (1.619) 605 (481.316)
Differences in Bullying Experience in Relation to Socio-demographic Variables The results of student's t-test revealed a statistically significant difference in bullying experience among males and females (t (434) = 4.02, P b 0.001). Male adolescents experienced bullying more than females (M = 3.1, SD = 2.2). In addition, adolescents who smoke statistically differed than nonsmokers (t (434) = 3.8, P b 0.001) and scored significantly higher (M = 3.2, SD = 2.3). The adolescents who were working after school (t (434) = 3.32, P = 0.002) scored statistically significantly higher than those who did not work (M = 3.8, SD = 2.5). Also, being bullied was significantly negatively correlated with the graduate average point (r = −0.126, P = 0.009). In regard to parents' educational level and job, neither their educational level nor their employment status had an impact on adolescents' bullying experience. Adolescents' age was a continuous variable and based on the developmental stages of adolescents, it was categorized into early, middle, and late stage adolescent (Hockenberry, Wilson, & Wong, 2012). Analysis of variance was carried out and revealed a statistically significant difference among these three stages (F (2, 433) = 5.34, P = 0.005). Schefee post hoc criterion for multiple groups comparison was carried out and revealed a statistically significant difference among the early stage group and the middle stage group (P = 0.013), the early stage adolescents experienced bullying more than the middle stage adolescents (M = 3.13, SD = 1.9). The middle stage and the late stage did not differ from each other (P = 0.09) as well as the early stage and the late stage (P = 0.82). Family income was re-coded into three groups (i.e. low, middle, and high) based on the cutoff point
Table 2 Description of the bullying scale total score and its subscale.
Bullying total score Relational-verbal bullying Cyberbullying Physical bullying Bullying based on culture
Variable
Bullying total score
275 (63.1) 161 (36.9)
Unemployed Smoker adolescents Adolescents who work after school
Variable
Bullying sub-scale
Raw score
Transformed score out of 100
M (SD)
M (SD)
11.2 (15.5) 4.9 (5.9) 2.7 (4.5) 3.2 (4.9) 1.5 (2.5)
8.7 (12.1) 11.2 (13.5) 8.3 (13.9) 8.8 (13.5) 9.1 (15.5)
created by SPSS program. The results showed a statistically significant difference among families with low and moderate income (F (2, 433) = 4.75, P = 0.009); adolescents belonging to low income families group experienced more bullying than the moderate group (M = 2.98, SD = 2.03). The moderate income group and the high income group did not differ from each other (P = 0.11) as well as the high income group and the low income group (P = 0.76) (Table 4). Discussion The present study assessed the Jordanian school adolescents' experience of being bullied in relation to four forms (i.e. relational-verbal, cyber, physical, and cultural-based bullying), and selected sociodemographic factors were examined for statistical differences and associations. The relational-verbal bullying was the most prevalent type of bullying. This finding is consistent with previous studies conducted in Turkey, China, and in the United States which reported relational bullying as the most prevalent type among adolescents (Huang et al., 2013; Piskin, 2010). The higher prevalence of the relational-verbal form of
Table 4 Differences in total bullying experience among groups in relation to different socio-demographic variables N = 436. Variable Gender Male Female Smoking status Smoker Non-smoker Working after school Yes group No group Fathers' educational level High school and less Higher than high school Mothers' educational level High school and less Higher than high school Fathers' job Employed Unemployed Mothers' job Employed Unemployed Stages of adolescents Early stage (10−13) Middle stage (14–16) Late stage (17–19) Monthly income Low Moderate High
Mean (SD)
P-value
Test value
df
3.1 (2.2) 2.4 (1.6)
b 0.001⁎⁎⁎
4.02
434
3.9 (2.3) 2.6 (1.9)
b0.001⁎⁎⁎
3.8
434
3.8 (2.5) 2.6 (1.8)
0.002⁎⁎
3. 32
434
2.81 (2.07) 2.58 (1.78)
0.22
1.217
434
2.72 (1.98) 2.71 (1.93)
0.97
0.037
434
2.76 (1.91) 2.47 (2.21)
0.27
1.1
434
3.06 (10.96) 2.63 (1.96)
0.06
1.88
434
3.13 (1.9) 2.44 (1.8) 2.95 (2.2)
0.005⁎⁎
5.34
2433
2.98 (2.03) 2.29 (1.78) 2.79 (1.96)
0.009⁎⁎
4.75
2433
⁎⁎ P b 0.01, two tailed. ⁎⁎⁎ P b 0.001, two tailed.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
A.M. Shaheen et al. / Journal of Pediatric Nursing xxx (2017) xxx–xxx
bullying could be explained by difficulty to identify this form by the school officials (Casebeer, 2012). In the current study, the boys were more likely to report the experience of being bullied than the girls, which was similar to previous research studies (Atik & Güneri, 2013; Carlerby et al., 2013; Fleming & Jacobsen, 2010; Huang et al., 2013). This could be due to the differences in the male gender construction from the female gender construction since boys have a higher acceptance and expectancy of power practices such as bullying others (Connell, 2012). On the other hand, the adolescents who bullied others could use bullying as a mean to cover their low self-esteem (Patchin & Hinduja, 2010). Other researchers have claimed that boys use bullying as a coping strategy to counteract their mental health problems more than girls (Gustafsson et al., 2010). This also could result from the boys' willingness to report their bullying experience more than girls. However, Cheng et al. (2010) found little gender difference in the prevalence of being bullied. The forms of bullying did differ by gender. The males were more likely to be victims of physical, relational-verbal, cyber, and culturalbased bullying more than females. Similar patterns of bullying were found in the study conducted by Craig et al. (2009). These gender patterns were different from the stereotyped patterns reported by Huang et al. (2013) and Cheng et al. (2010) who found that boys were more involved in physical bullying, whereas girls were more involved in relational bullying. The prevalence of bullying was lower among the older adolescents compared to the younger adolescents. This was consistent with other studies (Huang et al., 2013). There are several explanations why younger adolescents are more prone to bullying than older adolescents. The reduction of bullying by age could be due to physical, psychological, and social developmental changes as adolescents grow up, which serve as protective factors from bullying at schools. Moreover, this may reflect the differences between elementary, middle, and high school conditions in relation to academic demands and social climate. Some studies claimed that young adolescents report bullying more than older ones which justifies the high prevalence of bullying among the early stage of adolescence (Hong & Espelage, 2012). Cheng et al. (2010) found no significant differences among age and grades while a Turkish study by Atik and Güneri (2013) found that bullying is more prevalent among the older students compared to younger students. Further longitudinal investigations are needed for better understanding of the age influence on bullying experience. In the current study, bullied students were more likely to use tobacco than non-bullied students. This finding is consistent with the study of Fleming and Jacobsen (2010) and Vieno et al. (2011). Victimization causes stress, anxiety, isolation, and fear from school and all of these factors could be a precursor to tobacco use. This study measured three indicators for socioeconomic status including; parents' educational level, parents' employment status, and family income. Neither parents' educational level nor their employment status had an impact on adolescents' bullying experience. However, adolescents belonging to low income families experienced more bullying than those belonging to moderate income families. Family income was the most significant indicator for family socioeconomic status and this can mostly be explained within the context of Jordanian culture as following; parents' access to education mostly can guarantee them a job that constitutes a source of family income. Jordan classified as a third world country in terms of gross national income which results in a limited employee income that usually does not exceed the poverty line. Thus we suggest that employed parents in Jordan may not be able to provide resources required to meet their children's needs. In turn those children may have feelings of inferiority and this increases their vulnerability to bullying. On the other side, most parents who have low educational level may practice liberal professions that are characterized by a high rate of income which enables them to meet their children's demands. Therefore, our study reflected that the education of parents and their job are not strong indicators of family status affecting
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the bullying victimization. Our results are in consistent with other studies that linked low socioeconomic status of adolescents' family to the increased risk to bullying victimization (Fu et al., 2013; Jansen et al., 2012). As a result of this deterioration in the economy in Jordan, some children work after school to be able to provide the basic needs of their families, which put them at a higher risk of being bully victims. In terms of academic achievement, being bullied was significantly negatively correlated with students' academic performance. The link between bullying victimization and academic performance is complicated. Previous research studies found that low academic achievement scores increased the likelihood of being a bully victim (Atik & Güneri, 2013). In addition, at the individual-level being bullied leads to poor academic performance (Swearer et al., 2010). However, another study showed that there was no significant association between the level of academic performance and students' reports of bullying (Green, Dunn, Johnson, & Molnar, 2011). This result highlights the importance of providing a safe learning environment for students at school. Limitations The study used self-reported data which may result in response bias relating to socially desirable responses. Another limitation is the crosssectional nature of the study which limits the ability to infer causal relationships. Finally, our study sample included in-school adolescents thus the sample may not be representative for adolescents not attending schools who could be at risk for bullying involvement. Implications for Practice This study presents valuable information for school counselors, health care professionals, school staff, students and parents regarding bullying and its associated factors. Relational-verbal bullying was the most common type of bullying, thus more emphasis should be given in teaching students problem solving, social and interpersonal skills to enhance their communication with each other. Schools should introduce environmental changes to discourage bullying such as increased supervision in the playground and lunchrooms, divide break times into two or three groups by age to minimize the exposure of younger students to older students. Schools should establish a policy with specific guidelines of what constitutes bullying behavior and expected disciplinary procedures. Staff training by the school nurse which includes information and discussion about the definition of bullying, current trends, and the effects of bullying is recommended. The school nurse should review all interventions being implemented as part of the overall anti-bullying strategy at school. Additionally, the application of risk assessment tools that determine type and frequency of bullying by the school nurse is important. The school nurse should focus on educating both students and parents about bullying with particular emphasis on bystanders (students who observe bullying) who can contribute to helping victims and reducing bullying. In Jordan, we still do not have school health nurses at the majority of our schools. The establishment of school health nursing will help our students to address bullying through health promotion and preventing strategies which will result in making our schools safer for all adolescents. Conclusion This study indicated that risk factors for bullying are multifaceted. Individual level factors including; gender, age, and family socioeconomic status, and school level factors including academic achievement are important factors that affect bullying victimization. These findings necessitate the development of prevention and intervention strategies to combat bullying adaptive to the Jordanian culture.
Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003
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A.M. Shaheen et al. / Journal of Pediatric Nursing xxx (2017) xxx–xxx
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Please cite this article as: Shaheen, A.M., et al., Factors Affecting Jordanian School Adolescents' Experience of Being Bullied, Journal of Pediatric Nursing (2017), https://doi.org/10.1016/j.pedn.2017.09.003