Overall, (50.9 %, 95%CI: 47.2, 54.5) of students who participated in this survey reported being bullied. The prevalence of bullying was higher among male (55.7%, 95% CI: 51.1, 60.2) compared to female [Table 1].
Mental health behaviors
Students facing loneliness (61.5%, 95% CI: 56.7, 66.1), anxiety (65.0%, 95% CI: 60.4, 69.2), considered suicide (60.8%, 95% CI: 54.9, 66.4), attempted suicide (72.9%, 95% CI: 67.2, 77.9), missed school feeling unsafe (61.7%, 95% CI: 57.1,66.0), missed school without permission (60.8%, 95% CI: 56.4, 65.1), and involvement in physical fight (70.1%, 95% CI: 65.8, 74.2) had high prevalence of being bullied.
Health risk behaviors
Bullying prevalence was high among students who were involved in health risk behaviors like smoking (75.2%, 95%CI: 67.8, 81.4), using smokeless tobacco products (76.1%, 95%CI: 66.7, 83.4), drink alcohol (72.5%, 95%CI: 60.7, 81.8), and involved in sexual risk behavior (65.1%, 95%CI: 55.0, 74.1).
Other variables like age, overweight, underweight, physically active were not found to have statistically significant association with bullying.
Table 2: Prevalence of school bully-victims among school going adolescents of Nepal
Variables
|
Total Number
|
Weighted Count
|
Prevalence
|
95%CI
|
Age
|
|
|
|
|
Early adolescent
|
3130
|
1514
|
50.4
|
45.1,55.8
|
Late adolescent
|
3028
|
1453
|
51.5
|
47.5,55.3
|
Sex***
|
|
|
|
|
Male
|
2839
|
1505
|
55.7
|
51.1,60.2
|
Female
|
3265
|
1427
|
46.1
|
42.4,50.0
|
Felt lonely***
|
|
|
|
|
Yes
|
2102
|
1245
|
61.5
|
56.7,66.1
|
No
|
3971
|
1671
|
45.4
|
41.4,49.4
|
Anxiety***
|
|
|
|
|
Yes
|
2209
|
1349
|
65.0
|
60.4,69.2
|
No
|
3955
|
1618
|
43.7
|
39.4,48.0
|
Considered suicide**
|
|
|
|
|
Yes
|
752
|
455
|
60.8
|
54.9,66.4
|
No
|
5329
|
2460
|
49.0
|
44.7,53.3
|
Attempted suicide***
|
|
|
|
|
Yes
|
544
|
391
|
72.9
|
67.2,77.9
|
No
|
5629
|
2587
|
48.5
|
44.6,52.4
|
Involved in physical fight***
|
|
|
|
|
Yes
|
2339
|
1578
|
70.1
|
65.8,74.2
|
No
|
3845
|
1399
|
38.3
|
34.7,42.1
|
Missed school feeling unsafe***
|
|
|
|
|
Yes
|
2345
|
1380
|
61.7
|
57.1,66.0
|
No
|
3784
|
1562
|
43.3
|
38.6,48.0
|
Missed school without permission***
|
|
|
|
|
Yes
|
1644
|
971
|
60.8
|
56.4,65.1
|
No
|
4406
|
1942
|
46.9
|
42.7,51.1
|
Smoking ***
|
|
|
|
|
Yes
|
328
|
240
|
75.2
|
67.8,81.4
|
No
|
5740
|
2671
|
49.2
|
45.4,53.0
|
Smokeless tobacco use ***
|
|
|
|
|
Yes
|
290
|
217
|
76.05
|
66.7,83.4
|
No
|
5884
|
2756
|
49.41
|
45.8,53.0
|
Alcohol use ***
|
|
|
|
|
Yes
|
265
|
193
|
72.5
|
60.7,81.8
|
No
|
5814
|
2712
|
49.4
|
45.7,53.2
|
Overweight
|
|
|
|
|
Yes
|
315
|
162
|
53.2
|
43.4,62.7
|
No
|
5886
|
2826
|
50.7
|
47.2,54.2
|
Underweight
|
|
|
|
|
Yes
|
598
|
312
|
53.6
|
48.6,58.6
|
No
|
4910
|
2324
|
50.08
|
46.6,53.6
|
Sexual risk behavior **
|
|
|
|
|
Yes
|
213
|
129
|
65.1
|
55.0,74.1
|
No
|
5769
|
2737
|
50.3
|
46.4,54.1
|
Physically active
|
|
|
|
|
Yes
|
1068
|
501
|
49.4
|
42.3,56.5
|
No
|
5035
|
2440
|
51.2
|
47.4,55.0
|
Total
|
6201
|
2988
|
50.9
|
47.2,54.5
|
*p < 0.05, **p < 0.01, ***p < 0.001
Multivariable analysis revealed that a significant association was seen between bullied students and tobacco use (aOR 1.99, 95% CI: 1.09, 3.61) and involvement in physical fight (aOR 3.70, 95% CI: 3.00, 4.56). No clear associations were found between bullying and other risk variables like smoking, alcohol use, overweight, underweight, sexual risk behavior and physically active. [Table 3].
Table 3: Multivariable analysis of health risk behaviors of school bully-victims among school going adolescents of Nepal
Variables
|
Crude OR
|
95% CI
|
Adjusted OR*
|
95% CI
|
Smoking (Ref:No)
|
|
|
|
|
Yes
|
3.13
|
2.13,4.61
|
1.53
|
0.96,2.43
|
Smokeless tobacco use(Ref:No)
|
|
|
|
|
Yes
|
3.25
|
2.07,5.11
|
1.99
|
1.09,3.61
|
Alcohol use (Ref:No)
|
|
|
|
|
Yes
|
2.70
|
1.55,4.68
|
1.13
|
0.77,1.67
|
Overweight (Ref:No)
|
|
|
|
|
Yes
|
1.10
|
0.79,1.55
|
1.02
|
0.71,1.47
|
Underweight (Ref:No)
|
|
|
|
|
Yes
|
1.15
|
0.91,1.46
|
1.17
|
0.86,1.58
|
Sexual Risk Behavior(Ref:No)
|
|
|
|
|
Yes
|
1.85
|
1.20,2.85
|
0.89
|
0.51,1.55
|
Involved in physical fight (Ref:No)
|
|
|
|
|
Yes
|
3.78
|
3.06,4.66
|
3.70
|
3.00,4.56
|
Physically active (Ref:No)
|
|
|
|
|
Yes
|
0.93
|
0.70,1.24
|
0.98
|
0.71,1.36
|
*Adjusted for smoking, smokeless tobacco use, alcohol use, overweight, underweight, sexual risk behavior, involved in physical fight and physically active
Multivariable analysis showed that there was signification association between bullying and loneliness (aOR 1.39, 95% CI: 1.14, 1.69), anxiety (aOR 1.97, 95% CI: 1.57, 2.47), attempted suicide (aOR 1.99, 95% CI: 1.48, 2.67), missed school feeling unsafe (aOR 1.72, 95% CI: 1.36, 2.19) and missed school without permission (aOR 1.43, 95% CI: 1.14, 1.79) [Table 4].
Table 4: Multivariable analysis of mental health behaviors of school bully -victims among school going adolescents of Nepal
Variables
|
Crude OR
|
95% CI
|
Adjusted OR*
|
95% CI
|
Loneliness (Ref:No)
|
|
|
|
|
Yes
|
1.92
|
1.58,2.34
|
1.39
|
1.14,1.69
|
Anxiety(Ref:No)
|
|
|
|
|
Yes
|
2.39
|
1.93,2.96
|
1.97
|
1.57,2.47
|
Considered suicide(Ref:No)
|
|
|
|
|
Yes
|
1.62
|
1.16,2.26
|
1.10
|
0.81,1.50
|
Attempted suicide(Ref:No)
|
|
|
|
|
Yes
|
2.86
|
2.12,3.86
|
1.99
|
1.48,2.67
|
Missed school feeling unsafe(Ref:No)
|
|
|
|
|
Yes
|
2.11
|
1.67,2.67
|
1.72
|
1.36,2.19
|
Missed school without permission(Ref:No)
|
|
|
|
|
Yes
|
1.76
|
1.43,2.16
|
1.43
|
1.14,1.79
|
*Adjusted for loneliness, anxiety, considered suicide, attempted suicide, missed school feeling unsafe and missed school without permission