Abstract
Background: Nursing students face significant academic demands and interpersonal challenges, including bullying within hierarchical educational environments. These stressors may negatively impact psychological well-being, academic performance, and professional development. However, limited empirical evidence exists on these issues among student nurses in Orlu, Imo State, Nigeria. Objective: This cross-sectional study examined bullying experiences, perceived stress, and coping strategies among 313 student nurses selected from three nursing training institutions in Orlu, Imo State, Nigeria. Methods: A structured questionnaire comprising the Negative Acts Questionnaire-Revised (NAQ-R), Perceived Stress Scale (PSS-10), and Brief COPE Inventory was administered. Data were analyzed using descriptive statistics, Pearson correlation, and Chi-square tests. Results: Bullying was moderately experienced (mean=2.67±0.62), with fear of expressing opinion in class (2.92) and verbal insults (2.87) being most common. Perceived stress was high (mean=3.00±0.58), with 53.4% reporting high stress, primarily from academic workload (3.21) and clinical anxiety (3.18). Students predominantly used adaptive coping strategies (mean=3.11), with prayer (3.41) and social support (3.24) most frequent. Pearson correlation revealed a significant moderate positive relationship between bullying and perceived stress (r=0.524, p<0.001). The majority (86.6%) reported being bullied, with no significant association between year of study and bullying experiences (χ²=6.342, df=8, p=0.609). Conclusion: Bullying contributes significantly to perceived stress among student nurses. Nursing institutions should implement anti-bullying policies, stress management programmes, and culturally appropriate coping interventions.References
Abdulaziz Mofdy Almarwani, Atallah Alenezi, Almutairi, M., Fahad Alhowaymel, Alzahrani, N. S., Alharbi, H. F., & Abdulaziz Fahad Abaoud. (2024). Bullying Behaviors and Stress (Acute and Perceived) Among Undergraduate Nursing and Midwifery Students: A Cross-Sectional Correlation Study. Research Square (Research Square). https://doi.org/10.21203/rs.3.rs-4155906/v1
AbuAlula, N. A., Almarwani, A. M., Mamanao, D. M., Altarawneh, N. S., Alharbi, M. R., & Ebeid, I. A. (2023). The Relationship between Bullying and Emotional State among Undergraduate Nursing Students: A Cross-Sectional Correlation Study. Nursing Research and Practice, 2023, e2397229. https://doi.org/10.1155/2023/2397229
Adzakpah, G., Laar, A. S., & Fiadjoe, H. S. (2016). Occupational stress among nurses in a hospital setting in Ghana. Ir.ucc.edu.gh. https://ir.ucc.edu.gh/xmlui/handle/123456789/9070
Afonne, A. J., Agbakoba, N. R., & Nwankwo, C. U. (2023). Stress, stressors, stress responses and coping strategies among student nurses in Anambra State, South-East Nigeria. Advances in Health and Behavior, 6, 263–274. https://doi.org/10.25082/ahb.2023.01.003
Alajaimi, F., Al-Badi, M., Alhabsi, H., AL Azri, M., Al-Ghawi, S., Alwahaibi, M., Jaju, S., & Alwahaibi, N. (2026). Bullying among nursing university students: Prevalence, characteristics, and public health implications. PLOS Global Public Health, 6(1), e0005814. https://doi.org/10.1371/journal.pgph.0005814
Baluwa, M. A., Lazaro, M., Mhango, L., & Msiska, G. (2021). Stress and Coping Strategies Among Malawian Undergraduate Nursing Students. Advances in Medical Education and Practice, Volume 12, 547–556. https://doi.org/10.2147/amep.s300457
Birks, M., Budden, L. M., Biedermann, N., Park, T., & Chapman, Y. (2018). A “rite of passage?”: Bullying experiences of student nurses in Australia. Collegian, 25(1), 45–50. https://doi.org/10.1016/j.colegn.2017.03.005
Budden, L. M., Birks, M., Cant, R., Bagley, T., & Park, T. (2017). Australian student nurses’ experience of bullying and/or harassment during clinical placement. Collegian, 24(2), 125–133. https://doi.org/10.1016/j.colegn.2015.11.004
Cao, J., Fu, M., Liu, J., Liu, J., Sun, H., & Zhuang, H. (2024). Student nurses’ bullying experiences from instructors and nurses in the clinical practice: A qualitative systematic review and meta-synthesis. Nurse Education Today, 146, 106511. https://doi.org/10.1016/j.nedt.2024.106511
Chaabane, S., Chaabna, K., Bhagat, S., Abraham, A., Doraiswamy, S., Mamtani, R., & Cheema, S. (2021). Perceived stress, stressors, and coping strategies among student nurses in the Middle East and North Africa: an overview of systematic reviews. Systematic Reviews, 10(1), 136. https://doi.org/10.1186/s13643-021-01691-9
Chidinma Abaribe, Chisom Uduhirinwa, & Amarachi Onuiri. (2025). Perceived stress and coping mechanisms among student nurses during clinical placements in Babcock university, Ilishan-Remo, Ogun state. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03374-5
Courtney-Pratt, H., Pich, J., Levett-Jones, T., & Moxey, A. (2018). “I was yelled at, intimidated and treated unfairly”: Student nurses’ experiences of being bullied in clinical and academic settings. Journal of Clinical Nursing, 27(5-6), e903–e912. https://doi.org/10.1111/jocn.13983
Decoras. (2026). Google Scholar. Google.com. https://scholar.google.com/scholar?q=Cohen+Kamarck+Mermelstein+perceived+stress
Einarsen . (2026). Bullying and Emotional Abuse in the Workplace. Google Books. https://books.google.com.ng/books?hl=en&lr=&id=6L0HYxz1CdUC&oi=fnd&pg=PA103&dq=Einarsen+Hoel+Zapf+Cooper+bullying&ots=9_DUsDAJTV&sig=hkOSrlVeku351VKfNwv1HhzVNHY&redir_esc=y#v=onepage&q=Einarsen%20Hoel%20Zapf%20Cooper%20bullying&f=false
Ezo, E., Asnakech Zekiwos, Taye Mezgebu, Senteyehu Admasu, Bethelhem Birhanu, Getachew Ossabo, Nigusu, E., Girma, A., Selamawit Wondala, Abdella, J., Dinka Lamesa, Meskerem Teketel, Wubishet Gezimu, Sahle, T., & Seife Awgchew. (2024). Prevalence and Associated Factors of Stress and Coping Strategies of Nursing Students During Clinical Practice in School of Nursing, Wachemo University, Ethiopia. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241272528
FRANCIS-EDOZIUNO, C. C., ABIONA, M. O., & ODETOLA, T. D. (2023). Stressors and coping measures among undergraduate student nurses in Western Nigeria. PAN AFRICA SCIENCE JOURNAL, 3(04). https://doi.org/10.47787/pasj.v3i04.55
Galbraith, N. D., & Brown, K. E. (2011). Assessing intervention effectiveness for reducing stress in student nurses: quantitative systematic review. Journal of Advanced Nursing, 67(4), 709–721. https://doi.org/10.1111/j.1365-2648.2010.05549.x
Iyus Yosep, Fitria, N., Mardhiyah, A., Tuti Pahria, Yamin, A., & Rohman Hikmat. (2024). Experiences of bullying among student nurses during clinical practice: a scoping review of qualitative studies. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02439-1
Labrague. (2021). Leodoro J. Google.com. https://scholar.google.com/citations?user=Z5GMjdUAAAAJ&hl=en&oi=sra
Labrague, L. J., McEnroe-Petitte, D. M., Gloe, D., Thomas, L., Papathanasiou, I. V., & Tsaras, K. (2016). A literature review on stress and coping strategies in student nurses. Journal of Mental Health, 26(5), 471–480. https://doi.org/10.1080/09638237.2016.1244721
Lu, S.-F., Chiang, S.-W., & Hsu, Y.-C. (2024). Perceived stress and coping strategies among undergraduate student nurses in the psychiatric practicum during the COVID-19 pandemic: A cross-sectional quantitative study. Tzu Chi Medical Journal. https://doi.org/10.4103/tcmj.tcmj_132_24
Mazalová, L., Gurková, E., & Štureková, L. (2022). Student nurses’ perceived stress and clinical learning experience. Nurse Education in Practice, 64, 103457. https://doi.org/10.1016/j.nepr.2022.103457
Nebhinani, M., Kumar, A., Parihar, A., & Rani, R. (2020). Stress and coping strategies among undergraduate student nurses: A descriptive assessment from Western Rajasthan. Indian Journal of Community Medicine, 45(2), 172. https://doi.org/10.4103/ijcm.ijcm_231_19
Nurunnabi, M., Hossain, S. F. A. H., Chinna, K., Sundarasen, S., Khoshaim, H. B., Kamaludin, K., Baloch, G. M., Sukayt, A., & Shan, X. (2020). Coping strategies of students for anxiety during the COVID-19 pandemic in China: a cross-sectional study. F1000Research, 9, 1115. https://doi.org/10.12688/f1000research.25557.1
Onieva-Zafra, M. D., Fernández-Muñoz, J. J., Fernández-Martínez, E., García-Sánchez, F. J., Abreu-Sánchez, A., & Parra-Fernández, M. L. (2020). Anxiety, perceived stress and coping strategies in student nurses: a cross-sectional, correlational, descriptive study. BMC Medical Education, 20(1). https://doi.org/10.1186/s12909-020-02294-z
Pan, L., Lei, M., Zhang, Z., & Lei, W. (2024). Bullying experience of undergraduate nurse students during clinical placement in Henan Province, China. Teaching and Learning in Nursing, 19(2). https://doi.org/10.1016/j.teln.2024.01.014

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2026 Onia Orinate Peters, Emmanuel Obioma Nkwocha, Ifeanyi Hermanguild Uzomanze (Author)
