Bullying-Related Victimization in Clinical Learning Environments: Coping Responses and the Moderating Role of Self-Esteem Among Undergraduate Nursing Students in Sri Lanka

Bullying-related victimization in clinical learning environments is an important psychosocial stressor in nursing education, with potential implications for students’ coping processes and professional development. Although bullying and related interpersonal mistreatment have been widely documented, research has largely focused on prevalence and descriptive experiences, with limited attention to factors influencing students’ coping responses. This study examined associations between bullying-related victimization, self-esteem, and coping strategies among undergraduate nursing students in Sri Lanka and tested whether self-esteem moderated the association between bullying-related victimization and coping responses. An analytical cross-sectional study was conducted among 214 undergraduate nursing students with clinical placement experience. Data were collected using self-report measures of bullying-related victimization and perpetration, self-esteem, and coping strategies. Descriptive statistics, Spearman’s rank-order correlations, and moderation analyses using Hayes’ PROCESS macro were performed. The bullying-related victimization score was positively correlated with problem-focused coping (rs = 0.22, p = 0.001), emotion-focused coping (rs = 0.34, p < 0.001), and avoidant coping (rs = 0.35, p < 0.001). Bullying-related perpetration was positively associated with emotion-focused and avoidant coping. Self-esteem was negatively correlated with problem-focused (rs = −0.32, p < 0.001) and emotion-focused coping (rs = −0.15, p = 0.031). Self-esteem significantly moderated the relationship between victimization severity and problem-focused coping (B = 0.049, SE = 0.020, p = 0.017), but not emotion-focused or avoidant coping. These findings suggest that bullying-related victimization is associated with multiple coping responses, while the moderating role of self-esteem appears limited to problem-focused coping.