Determinant analysis of bullying among school-age children in Yogyakarta, Indonesia

Article history Received, 13 June 2020 Revised, 13 June 2020 Accepted, 13 June 2020 Bullying is a very common, complex, and potentially damaging among school-age children. This incidence has increased from year to year, especially in Yogyakarta. This study aims to determine the factors that influence the occurrence of bullying among school-age children in Yogyakarta. The research method used was quantitative with a cross-sectional design in 114 school-age children in the elementary schools in Yogyakarta. The samples were taken by simple random sampling technique. The research instrument uses a questionnaire. Data were analyzed using the Chi-Square Test. The results showed that the bullying incidence was 51.8% dominated by the type of physical bullying which amounted to 62.7%. There were no significant relationship between sex (p-value = 0, 490), parenting style (p-value = 0778) with the incidence of bullying in school-age children. There were significant relationships between school factors (p-value = 0.001), peers (p-value = 0.024), intensity of watching television shows (p-value = 0.026) with the incidence of bullying in school-age children. It is expected that schools and community health nurses have a role in controlling bullying that occurs in schools


Introduction
Bullying case is currently a serious problem, especially in the group of school-age children. School Bullying Statistics found that 85% of cases of bullying in schools, which is not stopped by the teacher (Menesini & Salmivalli, 2017). In 2014, Wolke et al shows that bullying to children aged 8 years and 10 years in America. At the age of 8 years, 1805 (32.2%) of children are victims of bullying, 58 (1.0%) as a bully, and 376 (6.7%) as perpetrators/victims. At the age of 10 years, 1133 (18.5%) of children are victims of bullying, 50 (0.8%) as a bully, and 336 (5.5%) as perpetrators/victims. Indonesian Child Protection Commission (KPAI) explains that bullying cases in Indonesia are increasing, this is evidenced by the 369 cases of which 25% occurred in schools (KPAI, 2015).
Bullying is one form of aggressive behavior by continually to hurt others who are weaker from it so that the victim feels oppressed under treatment (Rigby, 2013). Bullying occurs when a person or group of persons to threaten the safety of others both physically and psychologically. Cultural oppression or bullying can occur anywhere during the interaction in the social environment (Raven, & Jurkiewicz, 2014). The high incidence of bullying is caused by various factors, among others are factors of personality, communication between individuals who built school-age children with parents and the environment, the role of peer groups, and school conditions (Plexousakis, Kourkoutas, Giovazolias, Chatira, & Nikolopoulos, 2019).
Bullying which occurs continuously will have an impact that can last continuously until adulthood. Victims of bullying behavior will feel disturbed psyche and can commit suicide (Eriksen, Nielsen & Simonsen, 2012). In school-age children, bullying will make lower confidence, lower self-esteem, and decrease student attendance at school. In Psychological impact, bullying lead to stress, if it is not handled can cause mental disturbance (Bowes, Maughan, Caspi, Moffitt, & Arseneault, 2010). Bullying behavior also has a serious physical impact that resulted in injuries such as bruises, cuts, burns, injury to internal organs such as brain hemorrhage, rupture of the stomach, intestines, liver, coma. It requires an effort or policy by the parties concerned (AlBuhairan et al., 2017;Biswas et al., 2020).
Prevention and control of bullying at school-age children have been undertaken by various parties, but its implementation is not optimal (Biswas et al., 2020). All this has no law governing the prohibition of bullying and violence in children, but the implementation has not been implemented optimally (Hong & Espelage, 2012). Management is only done on a case that has been reported. Preventive measures are not optimal. Including the role of health workers, especially nurses have not seen optimal in dealing with bullying in school-age children. Management of bullying will be more effective and efficient when it based on factors that influence the incidence of bullying so that control measures can be traced to the risk factors behind it (Hong, Espelage, & Rose, 2019).
Based on this phenomenon can be seen that the incidence of bullying in school-age children is increasing, which could lead to serious consequences for the child, while the handling is not optimal. Handling is not done effectively because it is based on case-based treatment. It takes search were factors that can lead to bullying that can be used as the basis for prevention and treatment more effectively.

Method
This research has passed the ethics committee review of ethics in the Faculty of medicine and health sciences, Universitas Muhammadiyah Yogyakarta. This study aims to determine the factors that influence the incidence of bullying in school-age children in Yogyakarta. This research method is quantitative correlational research with a cross-sectional design. Samples are fifth and sixth-grade students and their parents at the elementary school in Yogyakarta were taken by random sampling technique. The number of samples included in this study is as much as 114. The independent variable in this study is the grade class level, age, gender, employment status of parents, parental education, family economic status, school characteristics, the characteristics of peers, the intensity of watching TV in one day, and the parents' parenting in childhood schools in Yogyakarta. The dependent variable in this study was the incidence of bullying in school-age children in Yogyakarta.
The instrument used in this study is a questionnaire which refers to a modified literature review and research from several sources. Questionnaires have been tested by the validity and reliability beforehand and declared valid and reliable. The univariate analysis in this study is used to determine the distribution and frequency each variable covering grade level, age, gender, employment status of parents, parental education, family economic status, school characteristics, the characteristics of peers, the duration of watching TV in one day, and the parents' parenting school-age children and bullying in children school age in Yogyakarta. The bivariate analysis in this research using the Chi-Square Test.
Journal of Health Technology Assessment in Midwifery ISSN 2620-5653 Vol. 3, No. 1, May 2020   Based on Table 1, the majority of respondents in this study were at the age of 11 years (57.0%). Based on gender characteristics, most of the respondents were female (59.6%). Based on the education level of parents, most of them had a high education level (68%). The results obtained that most of the parent of respondents as a worker.

The Incidence of Bullying among School-Age Children
This section explains the result of the incidence of bullying among school age children in this research. Table 2 describes the frequency and distribution of bullying among school age children in Yogyakarta. Statistical analysis showed that the incidence of bullying in as many as 51.8% of respondents claimed to have suffered or the student doing the bullying. In line with another study conducted by Latifah (2012) shows that 65% of students doing the bullying in the school environment. Table 3 shows distribution of bullying types among school age children in Yogyakarta, which categorized into physical bullying, verbal bullying and relational bullying. Based on Table 3 shows that the type of bullying that occurs is physical bullying (62.7%), verbal (45.8%), and relational (40.7%). Results showed that the percentage of physical bullying is higher than other types of bullying. One student could experience more than one type of bullying. Table 4 reveals the frequency and distribution of bullying status at school age children in this research. Based on Table 4, show that students can act as an actor or a victim. The results of this study describe the number of students as a victim is higher than an actor.

Type of Parenting Style Adopted in School-Age Children in Yogyakarta
There are four categories for parenting style adopted by parents within this research. Table 5 describes the distribution and frequency of parenting style of school age children. Based on Table 5 shows that the parenting style that the most dominant is authoritarian. Authoritarian parenting style is parenting that applies discipline and tends to organize a child's lives and without involving them in decision making. This is indicated by 33 (28.9%) of parents are applying authoritative parenting.

Intensity or Duration of Watching Television on school-age children in Yogyakarta
In regards to the intensity or duration of watching television, this research found that there are three different groups which are those have high intensity, medium intensity and low intensity. This can be seen in the Table 6. Based on Table 6, it can be explained that the intensity of watching television on school-age children in elementary schools in Yogyakarta is mostly in the medium category, as many as 75 (65.8%) of respondents. Table 7 shows the characteristics of school factors in which categorized into two groups which are positive and negative. Characteristics school factors seen from the school's response in the event of bullying in the school environment. According to table 7, it can be seen that as many as 59 (51.9%) of students answered that the characteristics of school factors are negative that teachers do not punish warn or reprimand the student if the student is involved in bullying.

Characteristics of Peers
There are two groups which describes characteristics of peers in which can be seen in the Table 8. Based on Table 8 it can be seen that most of the students had gangs (66.7%). "Gang" is known as a peer group of children who has the same characteristics and interest. 51 Vol. 3, No. 1, May 2020, pp. 46-56 Nina Dwi Lestari et al. (Determinant analysis of bullying among school-age children…)

The Relationship of Gender with Bullying at School -Age Children
The relationship of gender with bullying is also found from this research. Table 9 describes the result. According to table 9 can be seen that women have dominated bullying than men, those female students involved in bullying by 37 (32.5%) of respondents, while the male students involved in bullying at 22 (19.3%) of respondents. There is no significant relationship between gender with bullying at school age (p-value = 0, 490).

The Relationship between School Factors with Bullying at School-Age Children
Table 10 describes the result of statistics of the relationship between school factors with bullying at school age children. According to the table 10 is known that students who got a strike (school factor positive) when involved in bullying, consequently they are not involved in bullying (32.5%), while students who did not get a punishment when there are involved in bullying (school factor negative), the majority students perform or engage in bullying which amounted to 19,3%. There is a significant relationship between school factors and the incidence of bullying at school-age (p-value = 0.001).

Relationship between Peer and Bullying in School-Age Children in Yogyakarta
The relationship between peer and bullying in school age children was also found from this research and it can be seen in Table 11. According to the table 11, it can be seen that the majority of respondents who have experienced gang and involved the bullying that is equal to 45 (39.5%) of respondents, while respondents who do not have gangs majority are not involved in bullying which amounted to 24 (21.1%) of respondents. There is a significant correlation between the incidence of bullying and peers in school-age children (p-value = 0.024).

Relationship between Parenting Style and Occurrence of Bullying at School-Age Children in Yogyakarta
The result of statistical analysis of relationship parenting style and occurrence of bullying among school age children can be seen from Table 12.  Table 12 shows that there is a relationship between parenting style with bullying at school age (p-value = 0.778> 0.05).

The relationship between the Intensity of Watching Television and Bullying
The result of statistical analyisi of relationship between the intensity of watching television and bullying can be seen in Table 13. According to table 13, indicate that all respondents that have an intensity watching television in a high category are involved in the bullying that is equal to 100%. Respondents who had the intensity of watching television in the moderate category, the majority are involved in bullying which amounted to 42 respondents (56%), while respondents who had low-intensity category of watching TV, the majority do not commit acts of bullying at 22 (62.9%). The statistical test results obtained pvalue = 0.026 (> 0.05), which indicates that there is a significant correlation between the intensity of watching television and bullying.

Discussion
School-age is a period in which children have between 9-12 years of age. Characteristics of children of school age will tend to be more active in the movement, and at this stage, the child will begin to socialize with others, begin to adapt to the environment, begin to develop confidence and begin to cultivate a sense of trying to get to the desired destination. If the child fails in the process of achieving goals, the child will develop emotions that can lead to bullying (Umianita Risca Wulandari, Budihastuti, & Pamungkasari, 2017). Vol. 3, No. 1, May 2020, pp.  Based on gender characteristics, most of the respondents were female (59.6%). This can happen because most of the students where it placed of study are women. Previous study explains that one of the factors that can cause a person to do the bullying is gender (Silva, Pereira, Mendonça, Nunes, & de Oliveira, 2013). Another study explains that girls are more frequent bullying as many as 54.3% compared with boys as 45.7% (Biswas et al., 2020). Females also tend to have a gang that is equal to (62%) compared to male (54%). Girls are much more aggressive compared with boys. Boys are more likely to experience bullying as boys can receive and tend to not reply to bullying behavior that earned by their peers, different from the girls always want to look stronger than with someone else, so that girls have a high risk for bullying behavior (O'Brien, 2011).

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Based on the education level of parents, most of them had a high school education level, a literature mentioned that the level of parental education will influence someone to commit acts of bullying (Shetgiri, Lin, Avila, & Flores, 2012). The educational background of parents will influence their parenting style (Hoskins, 2014). Attitudes are formed by the child will be affected by their parents. Parents who have a high education tend to apply the appropriate parenting style and also prevent child to commit bullying. Parents have a critical role in child development, especially in the bad good learning process, norms, and regulations that must be adhered to in the family and society (Astuti, Kurniawati, & Fitriani, 2020).
The results obtained that most of the parents of respondents are workers. In line with the result of the research which states that working parents will tend to have a child commit bullying behavior because the child will tend to be neglected and did not receive attention from their parents (Menesini & Salmivalli, 2017). Parents who work mostly less attention to the development of children because they tend to ignore and is busy with her work (Anifah, Dasuki, K, & Triratnawati, 2018). Children who have parents who work will feel the lack of affection from parents and they will lose the moment of a child's development. The parents were also less known what children do outside the home (Butler, 2018).
The most dominant type of bullying in this study is physical bullying because, in school-age development, the child will tend to be hyperactive and often uses his body strength. In line with research conducted previously that the type of physical bullying done by younger children as many as 71.9% is greater than the incidence of verbal and relational bullying. Physical bullying is bullying that can be done by physical contact (Kavanagh, Priest, Emerson, Milner, & King, 2018). Another research shows that the type of bullying is often done by school-age children is physical bullying, because the child will tend to be expressed the feeling by acting as his friend to be considered more powerful than the other (Khamis, 2015). School-age children typically have a peer group and tend to perform physical bullying to others who are considered weaker than others and also for a recognition group that is considered strong and powerful (Markkanen, Välimaa, & Kannas, 2019).
The results of this study describe the number of students as a victim is higher than an actor. This can happen because at school-age children have certain characteristics, the results of observations conducted by researchers show that most children who are victims have the characters of shy, timid, has a smaller body size in comparison with another friend, and most of them did not have many friends. Majority of respondents had experienced physical bullying (>50%) in the school. Boys have the strength of its physical development while girls had been developed in emotional (feeling) so that girls are more likely to experience bullying or victims than being bullies (actors) (Menesini & Salmivalli, 2017). However, in this research there is no significant relationship between gender with bullying at school age (p-value = 0, 490). These results can be affected by how the play patterns of students in the school, the boys and girls often play together and they have quite the same in their activities. The results of this study is contrasted with research conducted previously that gender also can be the factor of bullying (Menesini & Salmivalli, 2017). Men are more often exhibit an attitude of acceptance toward bullying behavior. In contrast to the results of previous studies that stated that there is a relationship between gender with bullying in school-age children (Brzezinski, 2016).
Additionally, this research shows that there is a significant relationship between school factors and the incidence of bullying at school-age (p-value = 0.001). The presence of a significant relationship between school factors to the incidence of bullying can occur because, during school, the attitudes of students are still under the supervision of the teacher. This result is in line with the results of research which states that if the school has a lack of supervision for a student, it can lead to the incidence of bullying among school-age children (Umianita Risca Wulandari et al., 2017). This result Journal of Health Technology Assessment in Midwifery ISSN 2620-5653 Vol. 3, No. 1, May 2020  of the research is also consistent with research revealed that bullying is happening at school that has less attention to the student (Plexousakis et al., 2019). That is because if the teachers are in the school considers taunting and disturbing behavior performed by the student/student is a reasonable delinquency behavior owned subsidiary at his age. The other school factor is knowledge of teachers themselves about bullying. Lack of knowledge of the teachers can also be one of the causes of bullying at school-age children while at school. This is supported by the results of research which mentioned that the perception of teachers about bullying either the vulnerability issues of bullying, the benefits of doing prevention of bullying, and how to prevent bullying (Bowes et al., 2010). Teachers tend to assume the bullying that commonly occurs in school-age children, it looks like normally event without regard to the impact that would happen to the students involved in bullying (Khamis, 2015).
Peers have a considerable influence on the behavior of school-age children. They tend to imitate what friends do to be accepted by his friend. School-age children have not been able to determine what should be emulated and what should not be imitated. This is in line with the results of research which states that peer is also can be a factor that influences bullying behavior in children (Umianita Risca Wulandari et al., 2017). This is also consistent with research which shows that children that have peers, involved 59.4% incidence of bullying. Children who commit acts of bullying to others tend to get support from their peers. Children who commit acts of bullying are often labeled by the other children as children who often disrupt or even a child who respected so that the other children are inclined to let the bullying act occurred. In the school environment will also give a bad influence to more friends. Bad behavior that may appear is harsh words to others, either the teacher or a friend. Some children who commit acts of bullying usually just want to get the recognition to be accepted by their friends or even as a means of proving that if he was in power in the group. By the time the children do acts of bullying, anyone feels comfortable with it, and also there was an uncomfortable act against his bullying. Parenting adopted by parents varies from authoritarian, permissive, authoritative, and uninvolved, depending on the parents who assume the appropriate parenting and good to be applied to children. Authoritarian parenting has a high level of control. The permissive parenting style is parenting that spoils the child. Parenting uninvolved is a parenting style that ignores the child's development. Authoritative is parenting that balanced between the dimension control and warmth and has to be very appropriate to be applied to children (Bowes et al., 2010). The results are consistent with other study which showed that there was no relationship between parenting styles against bullying in children (p-Value 0,270). Parenting styles have an important role in children to control the bullying incident. However, parenting styles are not the only factors that can cause a child to behave bullying. Many factors can cause a child to engage in bullying including individual factors, school factors, and the social environment (community).

Conclusion
The conclusion of the research is there is a significant relationship between school factors and the incidence of bullying at school age (p-value = 0.001). There is a significant relationship between the characteristics of peers and bullying at school age (p-value = 0.024). There is a significant correlation between the intensity of watching television and bullying at school-age children with pvalue = 0.026. There is no significant relationship between gender and bullying at school age (p-value = 0.490). There is no relationship between parenting style and bullying (p value= 0.778)

Recommendation
It is expected to the family to control the factors that related to bullying. So that children can be protected from bullying. Schools should apply some regulations to control the bullying incident. Schools can also cooperate with the nurses in terms of education and prevention as well as reduce the incidence of bullying in schools. Community nurses can take precautions by way of promotion and preventive measures against bullying and involve families and teachers in addressing bullying.