Bullying in school children: How much do teachers know?

CONTEXT: Bullying is an emerging serious problem in schools worldwide resulting in physical and mental health problems in victimized children. Teachers play a critical role in identifying the acts of bullying, assisting the children who are victimized, linking up with healthcare providers for managing physical and emotional consequences of bullying, as well as managing bullying at school. AIMS: To determine teachers' knowledge regarding bullying among secondary school children. SETTINGS AND
DESIGN: A cross-sectional study conducted in five public and five private schools of Jamshed Town, Karachi, Pakistan. METHODS AND MATERIALS: The study continued from October 2012 to February 2013. Stratified random sampling was used to select teachers. Data were collected through a pre-piloted structured questionnaire. STATISTICAL ANALYSIS USED: Data were analyzed using the SPSS v19.0. Descriptive analysis was done by calculating frequencies and percentages of the categorical variables such as teacher's age, educational level, and presence of adequate knowledge regarding bullying. The outcome variable of interest was knowledge about bullying.
RESULTS: Almost half of the153 teachers (n = 82, 53.6%) lacked adequate knowledge about bullying in school children. A statistically significant association was present between knowledge of bullying with gender (P-value = 0.02), educational level of the teachers (P-value = 0.05), years of teaching experience (P-value = 0.04), and educational training of teachers (P-value = 0.01).
CONCLUSIONS: More than half of the teachers were deficient in their knowledge about bullying in school children.

Introduction

Bullying is generally defined as intentional abuse or intimidation having a component of real or perceived power imbalance and repetition over time.[1] It includes actions such as physical attacks, verbal aggression, social exclusion, sexual harassment, emotional blackmailing, and hurtful messages through social media.[12] Bullying is an implacable problem and its prevalence varies with study place or group. It tends to increase through the primary grades and peaks in middle and early secondary classes.[3] It frequently occurs on way to and from school, lunch breaks, and places such as playgrounds, cafeterias, bathrooms, hallways, and even in the presence of teachers in classrooms.[4]

Bullying is being recognized as an important public health issue internationally. The rising phenomenon of bullying is posing enormous challenges to the school educational system in several countries worldwide causing a negative effect on academic stability, student health, well-being, and safety.[5] On a daily basis, teachers remain at the frontline to deal with complex behavior issues in children. For this, they must have considerable knowledge of dynamics of school bullying for correct identification, intervention, and prevention of such incidents. Research indicates that teachers’ ability to identify bullies and victims is influenced by the age of students, frequency of contact with the students, the nature or type of bullying behavior, knowledge and perception of the degree of bullying, and their responsiveness toward children.[6] Bullying may occur even in close proximity of teachers, but they can underestimate the extent of bullying if they are not primed to identify such acts.[7] The discrepancy between knowledge and actual occurrence of bullying incidents can be attributed to the lack of access of teachers to many contexts of student dealings, resulting in inaccurate estimation of bullying behavior. School bullying is considered a common precursor of youth violence.[8] In Pakistan, however, community violence is permeating into schools, while on other teachers may not be able to address school bullying. This may be owing to not having a good understanding of acts of bullying, huge workload, and less focused attitude of school management and education authorities toward these issues.[89]

It is established that childhood bullying has a propensity to continue into adulthood and, if persistent, can leave lifelong scars. Bullying has a major impact on children's development because of the association with a range of adverse physical and mental health problems such as issues of bed-wetting, stomach-ache, headache, low self-esteem, and depression.[1310] Currently, there are neither robust clinical practice guidelines nor active school policies or social support groups for dealing with reported bullying in Pakistan. Nevertheless, health consequences, both physical and mental, are serious enough to warrant intervention by school and health authorities.

Teachers are considered as critically useful resources in encouraging school and community-based healthcare providers to screen for health-related risk factors in victims of bullying.[4] They are placed in a pivotal position to recognize bullying early on and liaise with the healthcare providers for timely intervention. Healthcare providers help screen for physical and psychiatric illnesses, counsel families, and be convincing advocates for bullying prevention in schools.[11]

Research on school bullying is relatively still an emerging domain in Pakistan, in spite growing interest in studying school bullying and victimization. Studies have been done to determine bullying among medical students[12] and healthcare professionals[13] but research on school children bullying particularly with respect to knowledge of teachers is limited.[714] The current study was planned with the objective to determine knowledge of teachers about the notion of bullying, various acts and behaviors that entail bullying, and potential effects on the physical and mental health of children who are victimized.

Subjects and Methods

This cross-sectional survey was conducted from October 2012 to February 2013, and the data was collected from ten schools of Jamshed Town, Karachi. Two-staged stratified random sampling was used. In the first stage, a list of schools was used to randomly select five public and five private schools. In the second stage, random selection of teachers (aged 18 years and above) was done from a list of school teachers of secondary classes of selected schools. Teachers with less than 12 months experience and who were absent on the day of data collection were excluded. The sample size was calculated using World Health Organization's sample size calculator[15] with Confidence Interval of 95%, bound on error of 5% and approximated proportion of teachers’ knowledge about bullying in school children of 60%.[16] After addition of 10% for non-responders, the final sample size was 153 participants. Approval was taken from the Ethical Review Committee (ERC) of the Aga Khan University. Written permission was sought first from District Education Officer and then from individual school principals. Confidentiality of the participants was maintained, and informed consent was obtained from the participating teachers.

A pre-tested, coded, self-administered questionnaire in English language was distributed among the teachers that took about 15–20 min to fill. The questionnaire was adapted from Peer Relations Assessment Questionnaires – Revised (PRAQ-R) for Teachers, from Australian Council for Educational Research (ACER).[17] The questionnaire consisted of two parts: the first part contained teacher's demographic data, years of teaching experience, and additional teaching courses taken or not. The second part had questions pertaining to teachers’ knowledge regarding bullying, which included acts constituting physical, verbal, and emotional bullying, common sites of bullying, and adverse physical and mental health problems as a consequence of bullying. Each correct answer was coded as 1.

Data were double entered and analyzed in Statistical Package for Social Sciences version 19.0 (SPSS 19.0). Descriptive analysis was done by calculating frequencies and percentages of the categorical variables such as teacher's age, educational level, and presence of adequate knowledge regarding bullying. Ranges were calculated for continuous variables such as age and years of experience. The outcome variable of interest was knowledge about bullying. Frequencies of questions related to knowledge were calculated. The Pearson Chi-square test with 95% confidence interval was used to compare the data. A 5% level of significance was in the study. Effect modifiers were controlled through stratification of teachers’ educational level and years of teaching experience. All the analysis was two-tailed, and P values of 0.05 or less were considered significant.

Results

A total of 188 teachers (111 private and 77 public schools) were approached. With a decline rate of 18.6%, 153 teachers were recruited. Of the 153 teachers, 86.9% (n = 133) were females and 13.1% (n = 20) were males. The proportion of teachers from public schools was 42.5%, whereas 57.5% belonged to private schools. A majority (43.1%) of the participating teachers were from 18–32 years. Further demographic details are discussed in Table 1.

Table 1

Demographic characteristics of school teachers

Demographic Variables (n=153)	Frequency n (%)
Age
18-32 years	66 (43.1)
33-47 years	53 (34.6)
48 years and above	34 (22.2)
Gender
Female	133 (86.9)
Male	20 (13.1)
Level of Education
Undergraduate	16 (10.5)
Graduate	79 (51.6)
Postgraduate	58 (37.9)
Teaching Experience
1 to 5 years	52 (34)
5 to 10 years	35 (22.9)
More than 10 years	66 (43.1)
Formal Educational Training Course
Yes	91 (59.5)
No	62 (40.5)
School
Public	65 (42.5)
Private	88 (57.5)

Overall knowledge was adequate in about 71 (46.4%) teachers, whereas 82 (53.6%) had inadequate knowledge. Regarding the definition of bullying, 124 (81%) teachers were able to answer correctly, with a higher proportion of teachers belonging to private school as compared to public school (51.6% vs. 38.7%), however, the results were not statistically significant (P = 0.07). On exploring teachers’ knowledge on different types of bullying (physical, verbal, and emotional), a mixed response pattern was observed. Although a large group of teachers responded correctly for physical acts of bullying such as pushing (84.3%) and hitting (84.3%), the act of mimicking (22.2%) and spreading rumors (18.3%) were identified by only one-fifth of the teachers. Moreover, only one-third of the teachers considered teasing (30.1%) and blackmailing (32%) as acts of bullying [Figure 1].

Figure 1

Correct Responses (%) of teachers for various behaviors as acts of bullying

A majority of the teachers knew that acts of bullying mostly occurred outside the schools (65.4%), whereas only some responded that they consider canteens (32%), classrooms (25.5%), and bathrooms (11.8%) as potential areas for bullying.

The most commonly recognized physical and mental health symptoms mentioned by teachers were feelings of depression (73.9%), headache (69.6%), and low self-esteem (68%). The ability of the teachers to recognize suicidal thoughts (24.8%) was the least [Figures 2 and 3].

Figure 2

Teachers’ recognition of physical health problems in children as a consequence of bullying

Figure 3

Teachers’ recognition of mental health problems in children as a consequence of bullying

The teachers who correctly defined bullying demonstrated variable pattern of responses when asked about individual health symptoms [Table 2]. More than two-thirds (66.2%) were not able to identify suicidal thoughts as a result of bullying.

Table 2

Relationship of teachers’ correctly defining bullying with recognition of physical and mental health symptoms in children as a consequence of being victimized

Physical and Mental Health Problems in Children	Definition of bullying			P
	Incorrect Response (n=29, 19%)	Correct Response (n=124, 81%)	Total (n=153)
Backache
No	38 (46.3)	29 (40.8)	67 (43.8)	0.494‡
Yes	44 (53.7)	42 (59.2)	86 (56.2)
Headache*
No	30 (36.6)	16 (22.5)	46 (30.1)	0.059‡
Yes	52 (63.4)	55 (77.5)	107 (69.9)
Stomach ache
No	51 (62.2)	37 (52.1)	88 (57.5)	0.208‡
Yes	31 (37.8)	34 (47.9)	65 (42.5)
Vomiting
No	56 (68.3)	44 (62.0)	100 (65.4)	0.413‡
Yes	26 (31.7)	27 (38.0)	53 (34.6)
Breathing difficulty
No	48 (58.5)	38 (53.5)	86 (56.2)	0.533‡
Yes	34 (41.5)	33 (46.5)	67 (43.8)
Feeling of Anxiety**
No	40 (48.8)	14 (19.7)	54 (35.3)	0.000‡
Yes	42 (51.2)	57 (80.3)	99 (64.7)
Feeling of Depression*
No	23 (28.0)	17 (23.9)	40 (26.1)	0.0564‡
Yes	59 (72.0)	54 (76.1)	113 (73.9)
Low self-esteem*
No	32 (39.0)	17 (23.9)	49 (32.0)	0.046‡
Yes	50 (61.0)	54 (76.1)	104 (68.0)
Loneliness*
No	42 (51.2)	23 (32.4)	65 (42.5)	0.019‡
Yes	40 (48.8)	48 (67.6)	88 (57.5)
Suicidal thoughts*
No	68 (82.9)	47 (66.2)	115 (75.2)	0.017‡
Yes	14 (17.1)	24 (33.8)	38 (24.8)

*P-value≤0.05, **P-value≤0.0001, ‡Chi-square test

Of teachers who had received some professional training in education (59.4%), the majority were unable to give correct answers about knowledge of bullying (61.6%). Interestingly, a larger proportion of teachers (58%) without formal training had a better knowledge of bullying, showing a statistically significant association (P-value = 0.017). Another observation of note is that the increasing years of experience was not helpful in making the teachers knowledgeable regarding bullying behaviors (P-value = 0.04); with teachers having 1–5 years’ experience identifying bullying correctly in 36.6% cases, whereas 52.4% did not recognize in spite having experience of more than 10 years.

Discussion

This study demonstrates the extent of teachers’ knowledge regarding bullying among secondary school children of Karachi. In this study, more than half of the teachers had inadequate knowledge about this emerging and serious phenomenon of school bullying. Literature shows that school bullying is being widely recognized as a grave public health issue, and serious attention is required by health and education authorities for prevention.[12] Teachers were at the forefront to deal with these matters, and they should be well-equipped with the knowledge and skills to identify, prevent, and intervene in such complex situations.[14]

Findings suggest that a large proportion of teachers (81%) were able to correctly define bullying as a form of repeated aggression involving the imbalance of power to cause distress or control another. This finding is consistent with other studies where teachers have defined bullying as a pervasive problem within the school environment and have highlighted the existence of intentional acts with an imbalance of power.[1618] While elaborating on various acts of bullying, this study demonstrated that the teachers considered the direct acts of bullying, such as physical (75.8%) and verbal (85.6%) to be more common than indirect forms like emotional, which was comparable to results seen in a Malaysian study.[16] In addition, the study findings reflected variability of knowledge among participants while responding about various acts. Although most teachers were aware of the definition of bullying, their in-depth insight of what acts constitute bullying may be somewhat fragmented; having responded correctly for physical acts such as pushing (84.3%) and hitting (84.3%) and certain other subtle acts such as that of mimicking (22.2%) and spreading rumors (18.3%) were identified by only one-fifth of the teachers. Moreover, only one-third of the teachers identified teasing (30.1%) and blackmailing (32%) as prevalent acts of bullying. Literature also revealed teachers’ perspectives to be more in line with overt acts of bullying, and at times, they tend to report the low prevalence of bullying compared to students.[19] As teachers hold a great responsibility, there is a need to develop their concepts comprehensively about overt and covert acts and behaviors that come within the broad spectrum of bullying.[18]

In line with past research, this study found that the majority of teachers considered bullying to be more common outside schools (65.4%). However, there are certain places inside the school with limited direct adult supervision, like bathrooms (11.8%), where these acts tend to occur more.[46] Nevertheless, bullying is also common in classrooms where there is supervision but that also varies according to the student characteristics, age, and extent of these acts.[4]

Literature shows that health problems associated with bullying include physical illnesses such as headaches, sleep disturbances, bed-wetting, and psychosocial issues such as depression, anxiety, substance abuse, and suicidal thoughts and attempts.[21011] Among the health problems, this study reported that headache (69.9%) and backache (56.2%) were the common physical health problems; while feeling depressed (73.9%) and anxious (64.7%), and having low self-esteem (68%) were the most common mental health problems to occur in victimized children (P < 0.001).

Alarmingly, only a small proportion of teachers (24.8%) reported bullying to be linked with suicidal thoughts, and only 47.9% of those with good knowledge responded correctly to this question. In Pakistan, like other countries of the world, frequency of bullying and subsequently rate of attempted or committed homicides and suicides are increasing over the past few years.[20] Hence, school bullying is a major health challenge requiring combined efforts by educators and healthcare providers in concrete ways.[1] The time of the teacher spent with the students is an essential component in their understanding of bullying and its health consequences. Thus, the more knowledge teachers have regarding the health consequences of student bullying, the better it helps in minimizing this risk.[1421]

Several demographic characteristics were related significantly to teachers’ likelihood of understanding bullying. The participants were majority females (86.9%) and had a better knowledge of bullying (80.3%, P value = 0.024) as compared to male participants. Typically, females tend to choose this profession more than males and this is in congruence to multiple international studies.[1622] It is generally expected that increasing experience of teaching can be predictor of early identification and intervention for bullying. However, interestingly, a greater proportion of teachers in this study with an adequate amount of knowledge had experience only between 1–5 years (P-value = 0.041). It can be explained by the fact that fresh teachers are more vigilant with less chances of burnout even if they may not have witnessed more bullying episodes as compared to those with greater experience of teaching.[1418]

Although not a primary study outcome, an interesting finding was that about 88 teachers belonged to private sector schools, and among them, 51.1% were found to have adequate knowledge. From the public sector schools, 65 teachers participated with 40.0% being knowledgeable. Although the teachers in public sector schools are commissioned on the basis of a professional degree in education, their curriculum does include some chapters on the concept of bullying, this is not the case with private sector schools, where having a formal degree in education may or may not be a mandate.

The potential limitation of this study is a small sample size, which limits its generalizability, hence, the findings cannot be considered representative of what all teachers recognize bullying to be. Gender bias may exist in the sample because most of the study participants were females who may consider bullying behaviors differently from the male teachers.[22]

Conclusion

This study highlights novel information regarding teachers’ knowledge about the pervasive problem of bullying. It is essential to educate teachers about concepts, acts, and dynamics of bullying and prime them to be responsible to intervene in such sensitive situations. They have a vital role in timely involving healthcare providers, who can help screen at-risk children for physical and mental health issues, counsel families, and help establish bullying prevention programs with schools. Global events, such as Anti-Bullying Day, can be used as an opportunity to draw attention to and raise awareness of these issues among the general population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.