Cyberbullying: A 21st Century Health Care Phenomenon
The transition from childhood to adolescence is an important developmental phase in which the child experiences biological, cognitive, and social changes. At the same time, adolescent use of the Internet to acquire and maintain social relationships has become an accepted behavior that may have negative outcomes. As adolescents become increasingly adept with technology tools, they may be at greater risk for experiencing cyberbullying and associated psychosocial issues during childhood and later in adulthood.
Nurses need to be aware of the impact of cyberbullying on adolescents' physical and mental health, including emotional distress and psychosomatic symptoms that bullied adolescents, especially those who experience cyberbullying, may exhibit. These symptoms may include somatic (stomachaches, headaches, nausea, sleeping problems) (Soulander et al., 2010) and/or psychological (depression, isolation, anxiety) (Wang et al., 2011; Wang & Iannotti, 2012) complaints. If cyberbullying victimization is suspected, a detailed assessment is needed that reflects students' use of technology and their experiences with cyberbullying. However, research has shown that adolescents may be reluctant to discuss cyberbullying with adults, including with their parents (Juvonen & Gross, 2008; Mishna et al., 2010). Nurses should find ways to gain the adolescent patient's trust to learn the source of their complaints. In the school setting, bullying prevention programs, such as confidential reporting and peer mentoring, may allow students to feel more comfortable reporting their cyberbullying victim experience to the school nurse or to a trusted teacher or administrator (Swartz, 2009).
If psychosomatic or psychological complaints can be traced to traditional bullying or cyberbullying, the nurse should be aware of the reporting requirements for any type of bullying. According to Scott (2012), both health professionals and educators are mandated to report any suspected case of bullying, even if it is unsubstantiated. For example, in a school setting, the staff nurse must inform the building and/or district administrator of the suspected bullying. It is then the responsibility of the admin istrator to report the abuse to the Family Service Agency in their area. School health professionals, as well as educators, who fail to report suspected bullying or abuse may be criminally or monetarily liable if the child becomes hurt or injured after school administrators become aware of the situation (Scott, 2012).
Addressing youth violence and prevention by engaging in public health strategies that include early detection of cyberbullying as well as promotion of community awareness and education is an obligation of nurses. Given the covert nature of this 21st century phenomenon, along with subsequent difficulties that victims encounter, a team effort is needed to develop preventive programs, including interventions for adolescents at risk. Ideally, a multidisciplinary team would include parents, school administrators and teachers, and healthcare providers. Table 7 outlines means by which nurses and collaborators can address the problem of cyberbullying and implement cyberbullying prevention (Hinduja & Patchin, 2009b).
Implications for Nurses
The transition from childhood to adolescence is an important developmental phase in which the child experiences biological, cognitive, and social changes. At the same time, adolescent use of the Internet to acquire and maintain social relationships has become an accepted behavior that may have negative outcomes. As adolescents become increasingly adept with technology tools, they may be at greater risk for experiencing cyberbullying and associated psychosocial issues during childhood and later in adulthood.
Nurses need to be aware of the impact of cyberbullying on adolescents' physical and mental health, including emotional distress and psychosomatic symptoms that bullied adolescents, especially those who experience cyberbullying, may exhibit. These symptoms may include somatic (stomachaches, headaches, nausea, sleeping problems) (Soulander et al., 2010) and/or psychological (depression, isolation, anxiety) (Wang et al., 2011; Wang & Iannotti, 2012) complaints. If cyberbullying victimization is suspected, a detailed assessment is needed that reflects students' use of technology and their experiences with cyberbullying. However, research has shown that adolescents may be reluctant to discuss cyberbullying with adults, including with their parents (Juvonen & Gross, 2008; Mishna et al., 2010). Nurses should find ways to gain the adolescent patient's trust to learn the source of their complaints. In the school setting, bullying prevention programs, such as confidential reporting and peer mentoring, may allow students to feel more comfortable reporting their cyberbullying victim experience to the school nurse or to a trusted teacher or administrator (Swartz, 2009).
If psychosomatic or psychological complaints can be traced to traditional bullying or cyberbullying, the nurse should be aware of the reporting requirements for any type of bullying. According to Scott (2012), both health professionals and educators are mandated to report any suspected case of bullying, even if it is unsubstantiated. For example, in a school setting, the staff nurse must inform the building and/or district administrator of the suspected bullying. It is then the responsibility of the admin istrator to report the abuse to the Family Service Agency in their area. School health professionals, as well as educators, who fail to report suspected bullying or abuse may be criminally or monetarily liable if the child becomes hurt or injured after school administrators become aware of the situation (Scott, 2012).
Addressing youth violence and prevention by engaging in public health strategies that include early detection of cyberbullying as well as promotion of community awareness and education is an obligation of nurses. Given the covert nature of this 21st century phenomenon, along with subsequent difficulties that victims encounter, a team effort is needed to develop preventive programs, including interventions for adolescents at risk. Ideally, a multidisciplinary team would include parents, school administrators and teachers, and healthcare providers. Table 7 outlines means by which nurses and collaborators can address the problem of cyberbullying and implement cyberbullying prevention (Hinduja & Patchin, 2009b).
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