School bullying and some associated factors among students aged 13-17 in Nghe An province in 2017

JOURNAL OF MEDICAL RESEARCH<br /> <br /> SCHOOL BULLYING AND SOME ASSOCIATED FACTORS<br /> AMONG STUDENTS AGED 13-17<br /> IN NGHEAN PROVINCE IN 2017<br /> Quynh Anh Tran1, Huong Le Vu Thuy1, Trang Pham Thi Thu1, Bac Truong Dinh2,<br /> Diem Nguyen Thi Hong2<br /> 1<br /> Institute for Preventive Medicine and Public Health, Hanoi Medical University<br /> 2<br /> Department of Preventive Medicine, Ministry of Health<br /> Our study described the prevalence of being bullied among students aged 13-17 and associated factors<br /> in this group in two districts in Nghe An Province in Vietnam in 2017. A cross-sectional study was<br /> performed with 1074 students. The study ananlyzed data from a survey about health risk behaviors<br /> and associated factors among school students. Its questionnaire was based on GSHS survey and<br /> Center for Epidemiological Studies-Depression scale. Students aged 13-17 in two schools, in urban<br /> and rural districts in Nghe An province, were selected for the research. There were two schools in<br /> Vinh city and two in Do Luong district. This study has identified that 16% of students reported that<br /> they were bullied during the last month. The majority of victims were bullied on 1 to 5 days over 30<br /> days. Among bullied students, verbal bullying behaviors were more prevalent than physical behaviors<br /> (38% compared 9%). Being bullied was significant more prevalent among younger students and<br /> independent form gender. Students who reported ever having health risk behaviors including tobacco<br /> and alcohol consumption; and mental health problems were significant more likely to be bullied than<br /> those who never reported such problems. In conclusion, violence in school is becoming a persistent<br /> issue not only in Vietnam but also all over the world. Findings support that the development of<br /> prevention strategies for victims is crucial to reducing the effect of school bullying on children’s future.<br /> <br /> Key words: School bullying, school-aged students, students, violence, cyber bullying<br /> <br /> I. INTRODUCTION<br /> In recent years, the number of children<br /> experiencing violence in school setting is<br /> increasing all over the world. Accroding to<br /> WHO, it is estimated from children’s world<br /> data that over half of children on average<br /> report bullying.<br /> Corresponding author: Huong Le Vu Thuy, Institute for<br /> Preventive Medicine and Public Health, Hanoi Medical<br /> University<br /> Email: lethuyhuong@hmu.edu.vn<br /> Received: 06 June 2017<br /> Accepted: 16 November 2017<br /> <br /> JMR 111 E2 (2) - 2018<br /> <br /> Bullying is intentional and repeated<br /> aggression from which children lack the<br /> ability to protect themselves [1]. Bullying<br /> at school has been associated with poor<br /> academic performance, and mental health<br /> problems including depression, anxiety, and<br /> suicidal thought [2 - 5].<br /> There have been number of studies on<br /> school bullying worldwide. Per one review<br /> of low and middle –income countries, the<br /> prevalence of bullying within individual<br /> countries ranges from 20 to 61% in 18<br /> 107<br /> <br /> JOURNAL OF MEDICAL RESEARCH<br /> countries, and Tajikistan was the country<br /> only with a prevalence of bullying of less<br /> than 20% [6]. In the United State, data from<br /> a recent Youth Risk Behavior Surveillance<br /> showed that more than one- fifth of students<br /> are bullied on school property during 12<br /> months<br /> [7]. The Global School-based<br /> Student Health Survey (GHSH) in China<br /> found that around 32% of students were<br /> bullied over the past 30 days. In South East<br /> Asia, the figures in Singapore revealed<br /> that about a quarter of secondary school<br /> students and one- fifth of primary school<br /> students were victims of bullying [8].<br /> Another study in Turkey showed that 22%<br /> were victims, 9.4% were bully/victims and<br /> 9.2% were bullies [9]. In German, Richter<br /> showed that 17% of boys and 10% of girls<br /> from 11 to 15 years old were classified as<br /> repeated bullying perpetrators [10].<br /> Although studies on school bullying have<br /> been conducted in several sites in Vietnam,<br /> there is a lack of data on school students<br /> who are bullied in Nghe An province.<br /> The aims of this study are to describe the<br /> prevalence of being bullied among students<br /> aged 13 - 17 and associated factors in two<br /> districts in Nghe An Province in Vietnam in<br /> 2017<br /> <br /> II. SUBJECTS AND METHODS<br /> 1. Subjects and recruitment<br /> This study used a cross-sectional<br /> study design. By using a formula, the<br /> minimum sample size was estimated to<br /> be 412 students. To be more precise,<br /> once multiplied with design effect and a<br /> sample size of at least 824 students was<br /> determined necessary. In fact, a total of<br /> 108<br /> <br /> 1074 participants involved. The following<br /> formula was used to estimate the sample<br /> size for a proportion of the population.<br /> <br /> n = Z21-α/2 x<br /> <br /> p(1- p)<br /> d2<br /> <br /> p= 0.22 (Le Thi Hai Ha 's study) [9];<br /> = 1.96 (95%CI) and d = 0.04.<br /> In Nghe An Province, located in the centre<br /> of Vietnam, some cases of school bullying<br /> were reported among students in grade 6<br /> to 12 via the internet. Therefore,Vinh city, in<br /> a rural district, and Do Luong district, in a<br /> urban one, were selected. In each location,<br /> a secondary school and high school were<br /> chosen, namely Hong Son secondary<br /> school (282 participants) and Le Viet Thuan<br /> high school (274 participants), located in<br /> Vinh city, and Nguyen Thai Nhu secondary<br /> school (270 participants) and Do Luong III<br /> high school (248 participants) in Do Luong<br /> district.<br /> In secondary schools, students from<br /> grades 7, 8 and 9 were collected. In high<br /> schools students form grades, that is 10<br /> and 11 were collected. Eventually, in each<br /> grade, three or four classes were randomly<br /> selected based on the sizes of classes and<br /> all students in chosen classes were eligible<br /> to participate. Data was collected in the<br /> class setting . First, researchers explained<br /> to students the aim of the survey and how to<br /> complete the questionnaire. The researchers<br /> also expressed that participation was<br /> voluntary. After that, it took 15 to 30 minutes<br /> for students to fill out questionnaire, which<br /> researchers collected directly. There were<br /> around 20 to 40 students in a class.<br /> <br /> JMR 111 E2 (2) - 2018<br /> <br /> JOURNAL OF MEDICAL RESEARCH<br /> 2. Methods<br /> Instrument and data collection<br /> We had applied GSHS questionnaire<br /> that was made by WHO to help countries<br /> measure the behavioural risk factors and<br /> protective factors among young people<br /> aged 13 to 17 years. It focused bullying and<br /> determined current both bullying prevalence<br /> (during past 30 days) and types of bullying<br /> behaviors. Mental health problems (feelings<br /> of loneliness, being worried, hard focus,<br /> and suicide attempt) and health risk<br /> behaviors (alcohol consumption, drug use,<br /> and tobacco use) were also collected.<br /> Data analysis<br /> The data was entered into EPI and<br /> analyzed using STATA 12.0. Descriptive<br /> statistics, odds ratios with 95% CI<br /> (Confidence Interval), and Pearson Chi square tests were used to describe all the<br /> variables. All missing or illogical data were<br /> excluded from the analysis<br /> 3. Ethics<br /> In the study, all students were given the<br /> choice to participate and were assured that<br /> their answers would remain anonymously.<br /> All personal identities of the respondents<br /> were protected. The survey was performed<br /> with agreement of school leaders and the<br /> Nghe An Department of Education and<br /> Training<br /> <br /> III. RESULTS<br /> 1. General description of the<br /> participants<br /> The proportion of boys was lower than<br /> that of girls: 45.8% versus 54.2%. In term<br /> of a total of 1074 participants (with the<br /> respondent rate is 100%), the percentage<br /> JMR 111 E2 (2) - 2018<br /> <br /> of respondents aged from 13 to 15 years<br /> old was 49.8% compared to 50.2% of those<br /> aged 16 and 17 years old. The percentages<br /> of urban and rural areas were 51.8 and<br /> 48.2 respectively. There were about 14.1%<br /> of total students who reported that they do<br /> not have any close friends to confide in.<br /> Regarding BMI, the proportions of normal<br /> and underweight students were at with<br /> 46.4% and 49.6% respectively, while 4%<br /> of students were classified as overweight/<br /> obese<br /> The proportion of alcohol consumption<br /> was the highest (one of three) health<br /> risk behaviors with about 20.5% of total<br /> students reporting alcohol use, followed by<br /> 8% of participants reporting tobacco use.<br /> Approximately 80% of total respondents<br /> reported that they had diffculty concentrating<br /> during the last 12 months; followed by<br /> 70% of students reporting they felt lonely<br /> during the past 12 months. In addition,<br /> more than half of students reported being<br /> worried during that period. Finally, the rate<br /> of participants who had attempt suicide was<br /> around 10%.<br /> 2. Prevalence of being bullied among<br /> students aged 13-17 in Nghe An<br /> province in Vietnam<br /> The overall past 30 days prevalence<br /> of school bullying was 16%. The majority<br /> of students were bullied on 1 to 2 days,<br /> constituting for 9.8%, followed by 2.7%<br /> of participants who suffered from school<br /> bullying on 3 to 5 days. 1% of students<br /> reported bullying for at least 6 days, and<br /> 1.4% of respondents reported being bullied<br /> all 30 days.<br /> 109<br /> <br /> JOURNAL OF MEDICAL RESEARCH<br /> Table 1. Types of bullying behavior by personal characteristics of bullied students<br /> Physical<br /> bullying<br /> <br /> Characteristics<br /> Gender<br /> Age group<br /> Region<br /> Friendship<br /> <br /> BMI<br /> <br /> Verbal<br /> <br /> Others<br /> <br /> Total<br /> <br /> bullying (%)<br /> <br /> (%)<br /> <br /> 30 (35.7)<br /> <br /> 51 (60.7)<br /> <br /> 84<br /> <br /> Girl<br /> <br /> (%)<br /> 3 (3.6)<br /> <br /> Boy<br /> <br /> 12 (13.6)<br /> <br /> 35 (39.8)<br /> <br /> 41 (46.6)<br /> <br /> 88<br /> <br /> 13 -15<br /> <br /> 9 (9)<br /> <br /> 40 (40)<br /> <br /> 51 (51)<br /> <br /> 100<br /> <br /> 16 – 17<br /> <br /> 6 (8.3)<br /> <br /> 25 (34.7)<br /> <br /> 41 (57.0)<br /> <br /> 72<br /> <br /> Urban<br /> <br /> 7 (8.8)<br /> <br /> 36 (45.6)<br /> <br /> 36 (45.6)<br /> <br /> 79<br /> <br /> Rural<br /> <br /> 8 (8.6)<br /> <br /> 29 (31.2)<br /> <br /> 56 (60.2)<br /> <br /> 93<br /> <br /> Yes<br /> <br /> 13 (9.0)<br /> <br /> 52 (36.1)<br /> <br /> 79 (54.9)<br /> <br /> 144<br /> <br /> No<br /> <br /> 2 (7.4)<br /> <br /> 12 (44.4)<br /> <br /> 13 (48.2)<br /> <br /> 27<br /> <br /> 18.5 to 24.99<br /> <br /> 10 (12.8)<br /> <br /> 32 (41.0)<br /> <br /> 36 (46.2)<br /> <br /> 78<br /> <br /> Under 18.5<br /> <br /> 5 (5.6)<br /> <br /> 31 (34.8)<br /> <br /> 53 (59.6)<br /> <br /> 89<br /> <br /> Over 25<br /> <br /> 0<br /> <br /> 2 (40)<br /> <br /> 3 (60)<br /> <br /> 5<br /> <br /> 3. Associated factors to being bullied among school students<br /> Table 2. Association between personal characteristics and being bullied among<br /> school students<br /> Bullied<br /> students<br /> <br /> Characteristics<br /> <br /> Gender<br /> Age Group<br /> Region<br /> <br /> Friendship<br /> <br /> BMI<br /> <br /> 110<br /> <br /> OR (95%CI)<br /> <br /> n<br /> <br /> %<br /> <br /> Girl<br /> <br /> 84<br /> <br /> 14.5<br /> <br /> 1.0<br /> <br /> Boy<br /> <br /> 88<br /> <br /> 17.9<br /> <br /> 1.3 (0.9 - 1.8)<br /> <br /> 13 -15<br /> <br /> 100<br /> <br /> 18.7<br /> <br /> 1.5 (1.1 - 2.1)<br /> <br /> 16 – 17<br /> <br /> 72<br /> <br /> 13.4<br /> <br /> 1.0<br /> <br /> Urban<br /> <br /> 79<br /> <br /> 14.2<br /> <br /> 1.0<br /> <br /> Rural<br /> <br /> 93<br /> <br /> 18.0<br /> <br /> 1.3 (1 - 1.8)<br /> <br /> Have close friends<br /> <br /> 144<br /> <br /> 15.8<br /> <br /> 1.0<br /> <br /> Have no close<br /> friend<br /> <br /> 27<br /> <br /> 18.0<br /> <br /> 1.2 (0.7-1.8)<br /> <br /> 18.5 to 24.99<br /> <br /> 78<br /> <br /> 15.7<br /> <br /> 1<br /> <br /> Under 18.5<br /> <br /> 89<br /> <br /> 16.7<br /> <br /> 1.1 (0.8-1.5)<br /> <br /> Over 25<br /> <br /> 5<br /> <br /> 11.6<br /> <br /> 0.7 (0.3-1.9)<br /> <br /> p - value<br /> <br /> > 0.05<br /> 0.017 < 0.05<br /> > 0.05<br /> <br /> > 0.05<br /> <br /> > 0.05<br /> <br /> JMR 111 E2 (2) - 2018<br /> <br /> JOURNAL OF MEDICAL RESEARCH<br /> Table 2 presents, according to age group, the propotion among 13-15 year-old students<br /> roughtly one in five, whist it was 13,4% among those of 16-17.<br /> Table 3. Association between mental health problem and being bullied<br /> among school students<br /> Bullied students<br /> <br /> Mental health<br /> problems<br /> Loneliness<br /> Being worried<br /> Hard focus<br /> Suicide attempt<br /> <br /> N<br /> <br /> %<br /> <br /> Ever<br /> <br /> 137<br /> <br /> 18.4<br /> <br /> Never<br /> <br /> 34<br /> <br /> 10.4<br /> <br /> Ever<br /> <br /> 121<br /> <br /> 20.2<br /> <br /> Never<br /> <br /> 50<br /> <br /> 10.6<br /> <br /> Ever<br /> <br /> 151<br /> <br /> 17.7<br /> <br /> Never<br /> <br /> 19<br /> <br /> 8.8<br /> <br /> Ever<br /> <br /> 35<br /> <br /> 31.8<br /> <br /> Never<br /> <br /> 137<br /> <br /> 14.2<br /> <br /> OR<br /> 1.9 (1.3-2.9)<br /> <br /> p- value<br /> <br /> 0.001 < 0.05<br /> <br /> 2.1 (1.5-3.1)<br /> < 0.05<br /> 2.2(1.3-3.7)<br /> <br /> 0.001 < 0.05<br /> <br /> 2.8 (1.8-4.4)<br /> < 0.05<br /> <br /> Table 3 indicates that mental health problems were associated with being victim of<br /> perpetration among school students. There is also evidence that students with mental health<br /> problems were significant likely to be perpetrated than those who had no any psychiatric<br /> problems.<br /> 29.1% of respondents who had ever smoked reported that they were bullied during the<br /> past 30 days. In participants using alcohol at least one drink during their lives, 25.5% of them<br /> reported being bullied. Statistically, students who had ever used tobacco and alcohol were<br /> associated with being bullied. The prevalence of being bullied among students who had ever<br /> consumed drug in their lifetime was nearly 30%. Although the odd ratio was reasonably high,<br /> there was no significant association between drug use and being a victim<br /> <br /> IV. DISCUSSION<br /> Findings of current study indicated that nearly 16% of total students reported being bullied<br /> over the past 30 days. This prevalence was lower than figures reported in previous studies<br /> conducted in Vietnam .and other countries, which reported a range from 20-50% bullying<br /> victims among school students [7, 8].<br /> These distinctions can be explained by the discrepancies between sample sizes,<br /> instruments used or the time period when studies were carried out or even geographic<br /> features.<br /> This current research investigated the percentages of each type of bullying behaviors<br /> JMR 111 E2 (2) - 2018<br /> <br /> 111<br /> <br />