Cyber Bullying among Hospital Staff and its Influence on Mental Health and Professionalism

This study aimed to investigate cyberbullying among hospital staff and its influence on mental health and professionalism. This study is a cross-sectional study using quantitative methods through the distribution of questionnaire forms. A total of 180 respondents were selected from among the staff from Pharmacy Department and Finance Department of the National University of Malaysia Hospital. This study utilized the Cyberbullying Behavior Questionnaire (CBQ) and Depression, Anxiety and Stress scale (DASS). The mental health level of hospital staff is divided into three types of mental health namely stress, anxiety and depression. The study found that the correlation of cyberbullying and mental health levels was acceptable except for the stress levels of hospital staff. This indicates that there is a weak positive relationship between cyberbullying and depression (r = 0.258, k <0.01) and anarchy (r = 0.276, k <0.01). While simple linear regression has a significant influence on cyberbullying on the level of anecdote and depression of SME hospital staff is accepted. This can be demonstrated by looking at the R2 values for cyber bullying for depression (0.067) and anzieties (0.076), where for F depression (1, 12,720), k <0.05 and for F (1, 14.638), k <0.05. This study assists management and hospital staff in identifying cyberbullying and mental health levels of hospital staff and prevents hospital staff from engaging in cyberbullying symptoms.


Introduction
In the era of globalization, every living organism on this earth has been expanded from a technological aspect. The advancement of technology has resulted in benefits that measure and address various challenges. In addition, to fill the void and benefit the community, there are also side effects to the disadvantages of the internet and social media, or known as technology. Over the years, technology has become a problem due to differences in the staff environment today. The rise of technology has shifted to a huge global impact on the mental and physical health of society. Based on technological developments, some types of diseases will not appear.
Based on technological developments, several types of non-communicable diseases will appear; particularly triggered by the use of technology or radiation factors associated with the device. Cyber bullying is a growing phenomenon and is a common feature in the medical The effects of cyber bullying have affected all walks of life, from pre-school to work. The probability of cyberbullying in the workplace is also significant, influencing the behavioral attitudes of employees in their respective workplaces. This has raised the psychosocial risk and need for employee appraisal to ensure employee mental health well-being according to a study by (Kuczynski et al., 2020).
The problem that has been identified as the effect of cyber bullying is related to the mental health of employees. It also affects workplace-related professionalism and behavior such as emotional intelligence, self-esteem, self-motivation and employee self-development skills. The effects of cyberbullying have been negatively demonstrated through work-related stressful situations and should adhere to its influence in the psychosocial and psychological effects, In fact, the deterioration of social abilities of employees by hindering their communication and social skills. This leads to a decrease in the ability of employees in a professionalism.
According to the news posted by Ilah Hafiz Aziz and Feride Hikmet Atak, in Berita Harian in 2018, cyber bullying in the country is at a serious level at the moment and the community needs to be prepared to face the threat, said CyberSecurity Malaysia (CSM) Chief Executive Officer, Datuk Dr Amirudin Abdul Wahab. He said, if not curbed, it will be a threat to self and society because cyber bullying is detected as more dangerous than physical bullying as it can be done by anyone without control in the internet.
Based on the statistics of the Cyber999 Help Center, the Chief Executive Officer of CyberSecurity Malaysia (CSM), Datuk Dr Amirudin Abdul Wahab said, 51 cases involved teenagers up to 18 years, 19 years to 25 years (246), 26 years to 40 years (314), 41 years to 55 years (69) and 56 years and above (69 cases). He said there was an increase in the number of cases reported to the Cyber999 Assistance Center run by CSM and law enforcement. Cyber bullying statistics that have been reported to the Cyber999 Help Center based on the year from 2012 of 62 cases, in 2013 increased to 410 cases, in 2015 slightly decreased 319 cases and in 2016 cases reported as many as 344 cases. Meanwhile, In the third quarter of 2017 alone, a total of 228 cases were reported to the Cyber999 Help Center. The total in six years was 1,737 cases. In fact, through Bernama news on 19 Nov 2019 Cyber Bullying Needs to Be Addressed Immediately, a total of 266 cases were reported in 2018. For the first eight months of 2019, a total of 117 cases were reported.
However, according to Comparitech in 2018 from the International Study Alleys Malaysia's "Top 10" Countries of Most Horror Cases in the World 2018, published by Amira and Fazidi in October 2019, it has been stated that Malaysia has been reported to be the top 10 countries with the highest record cyber bullying. This study has proven that the effects of cyber bullying in terms of emotional abuse have the same effects as physical abuse. This is due to its influence on the mental health of the victim which causes depression and posttraumatic stress disorder (PTSD).
In addition, a study from the Institute for Safe Medication Practices (ISMP) found that many reports of bullying and intimidation (intimidation, bullying) among hospital nurses. But based on feedback from various types of health care, the problem is becoming more widespread, with doctors becoming the most common cause.

Literature Review
Through a study written by Shafie et al (2017) who conducted a study to see the concept of bullying, the effects of bullying on victims of bullying in the long and short term. Bullying is a dominant behavior that is done repeatedly psychologically or physically from a person or group that is more powerful to someone who has less power. Victims of bullying often have certain characteristics that make them easy for bullies to detect and act on their bullying.
Bullying behavior has an impact on the victim of bullying physically, emotionally and mentally or psychologically. Understanding the long-term and short-term effects of bullying symptoms is very important for counselors to help provide appropriate interventions to victims of bullying in helping the recovery process from this bullying incident. Counselors should strive to find the best and most effective methods in dealing with this phenomenon.
The study written by Isa et al (2019) aims to find out the views of teachers on the problem of bullying among students in schools. Responses are obtained through the distribution of a set of general and open-ended questions sent using electronic mail. Data analysis was done inductively to identify the categories and themes contained in the study material. The findings of the study show that there are ten themes including the definition, location, students involved, causes, and seriousness of the problem of bullying. In fact, it was found that the majority of teachers are less clear about the definition of bullying. However, the problem of bullying among students is serious and needs to be eradicated immediately. It is therefore recommended that further studies, especially grounded theory studies be conducted. This is because preventive measures become less effective if there is no information from the point of view of the teachers who are responsible for dealing with it. In this regard, it is hoped that more research is done on educators so that the problem of bullying among students can be reduced as best as possible.
Next, a study written by Privitera and Campbell (2009) discusses Cyberbullying in the workplace is not focused, and there is an increased risk of bullying in the workplace, but the prevalence of cyber bullying sector is unknown. This exploratory study investigates the prevalence and methods of face-to-face bullying and male cyber bullying in the workplace. 103 Questionnaire surveys [NAQ-R]) were returned from randomly selected Australian respondents from the Workers Union (AMWU). The results showed that 34 percent of respondents were bullied face to face, and 10.7 percent were cyber bullies. This study contributes to the literature of workplace bullying through the exploration of face-to-face prevalence rates and cyber bullying in the workplace, particularly in the manufacturing sector in Queensland, Australia. The results show that the ICT revolution has negative behavior through modern communication technologies such as email and telephone. Cyberbullying is important to understand the extent to which phenomena and effects affect employees, organizations, and society, as well as preventive measures for the eradication of cyberbullying in the workplace.
A study written by Zainudin et al (2016) was conducted to review in terms of digital forensic perspective on cyber bullying on issues especially in Malaysia which includes studies with the definition of bullying cyber, types, roles of people, statistics of who is being targeted, and the types of data commonly used in cyber bullying. Types of Data In digital forensic investigations used by cyber bullies is important for digital forensic investigations, as it is a source of search to detect cyber bullying as in the internet involving several types of data such as images, text, video, voice notes and even in video games. Most people use online social networks as their primary communication medium and in addition a lot of displayed data that can be a source for cyber bullying. Many people fall victim to cyberbullying, some incidents are realized by victims and some are not. Cyber bullying statistics increase year by year, therefore, prevention should be taken and awareness of cyber bullying to help others prevent it from happening in the future.
The next study was written by Dr. Wan Hassan Bin Wan Embong, Zulaili Binti Yaakob, Zetty Heriza Binti Rohani, Mardhiyana Binti Abidin and Farisah Binti Ibrahim (2015). This study aims to examine the activities of cyber bullying among fourth year students by identifying the medium used, the relationship between the experience of cyber bullying and student emotions, as well as obtain a comparison of gender with the involvement of cyber bullying among students. The survey research method is through a quantitative approach has been used in this study. A total of 106 final year student respondents of the Faculty of Education Universiti Teknologi Malaysia were involved in this study. Study data were obtained using a questionnaire instrument containing 30 items. The findings of the study found that the most popular medium is "Facebook" and there is no significant value for gender comparison between male and female study respondents. The selected questions were studied from the point of view of experience and involvement and the questions were divided into several sections namely demographic information, respondents 'involvement in cyber bullying, respondents' experiences and emotional effects after bullying. This study is considered important because it can provide information to students and the university in an effort to control and provide awareness on the symptoms of cyber bullying. This cyberbullying is no longer considered an isolated case and the parties concerned must accept the fact that this cyber bullying is a side effect of the technological boom that needs to be taken seriously.
Studies by Farley et al (2015) have examined the effects of cyberbullying among trainee physicians, and how cyberbullying affects individuals and jobs. Trainee doctors over 6 months working are asked to complete an online survey that includes cyber bullying measures, blaming attribution, negative emotions, job satisfaction, fairness of interaction and mental tension. A total of 158 trainee doctors (104 women, 54 men) were involved as study participants. The findings as a whole, found that a total of 73 people (46.2%) respondents have experienced at least one act of cyber bullying that adversely affects job satisfaction and mental tension. Studies show that cyberbullying related to work, dissatisfaction and mental tension has a negative impact on trainee doctors. This activity shows that more research is needed to explain the nature of cyber bullying and its effects.
A study conducted by Tanrikulu (2015) to better understand the theoretical framework of choice predicting the behavior of cyber bullying. A total of 685 students were taken from four public secondary schools in Istanbul, of which 341 were female (50.2%) and 344 were male (49.8). Their average age is between 15 and 19. Regression analysis was conducted in Malaysia to explore the level of prediction of cyber bullying basic needs. For regression analysis, the appropriateness of the data was checked and it revealed that cyber bullying behavior was understood to be predicted by ownership and power requirements. Given that the two variables account for 12.8 percent of cyber bullying, and there is a negative relationship between the variables. Abnormal behavior is caused by the inability to resolve these differences realistically. In this case, cyber bullying behavior can be considered abnormal behavior.
The study written by Forssell (2016) on cyberbullying in working life is increasing after the advent of modern technology. This study investigates the prevalence of cyberbullying and genocide in Sweden of working life and its relationship to gender and organizational position. Using the Cyberbullying Behavioral Questionnaire (CBQ) questionnaire, the results showed that 9.7 percent of respondents could be labeled as cyberbullied in line with Leymann's cutting criteria. Approximately respondents, 0.7 percent, were labeled as cyberbullied and 3.5 percent were labeled as bullied faces. Although no significant relationship with gender or position in the organization was found for individuals exposed to face-to-face bullying, this study showed that men to a higher degree than women were exposed to cyberbullying. In addition, individuals with supervisory positions are more vulnerable to cyberbullying than individuals without responsibility management.
Further study by Jonsson et al (2017) aimed at analyzing the reliability and validity of the Cyberbullying Behavioral Questionnaire (CBQ) in working life and to analyze the reliability and validity of the short version of Cyberbullying Behavioral Questionnaire -s ( CBQ-S) in working life. A total of 3371 adults worked in Sweden, and 238 in the United States participated in this study. The results of the Exploration Structure Equation Modeling (ESEM) show that the one-factor model has excellent features for the data, and the Cronbach's alpha shows that both scales are reliable. In addition, the validity of the criteria from the scale is indicated by a significant correlation with the following theoretical concepts: well-being, work involvement and intention to quit. The results of the study support the use of CBQ and CBQ-S as reliable and legitimate measures of cyber bullying behavior in working life.
In addition, the study produced by Mohamad et al (2018) which is related to hoarding behavior is a type of mental illness under obsessive-compulsive disorder according to the Diagnostic Statistical Manual of Mental Disorders ( DSM-5). Individuals with this hoarding behavior are unable to live normal daily life and have mental problems. A total of 150 respondents were selected by simple sampling to answer a set of questionnaires containing three types of instruments namely General Health Questionnaire (GHQ12), Hoarding Rating Scale (HRS), and Mental Health Inventory (MHI). The results of this study found that the majority of working women around Bangi, Selangor have a low hoarding level of 83.3 percent. While 16 percent have a moderate level of hoarding and only one respondent has a high level of hoarding. The majority of respondents have a moderate level of mental health and only 12 percent of respondents have a high level of mental health. It was found that there is a significant relationship between hoarding behavior and mental health level. Hoarding behavior has a negative impact as it has a huge impact on a person's ability to function productively.
In addition, a study by San and Alavi (2017) has examined the extent of work stress among Health Care Assistants at Rumah Ehsan and solutions. This study uses quantitative methods using survey method. The analysis of this study is descriptive. Researchers have used the Occupational Stress Indicator (OSI) study tool. The results of the evaluation as a whole indicate the main factors that cause stress are the structure and climate of the organization. The results also show that there are several ways of managing stress in the workplace. One of the suggestions for improvement in work stress management is that management should plan and organize programs in dealing with work stress.
Next, Abd Razak et al (2018) conducted a study aimed at measuring the level of job sustainability among former clients from the National Anti-Drug Agency (AADK). This study uses a quantitative approach. A total of 130 former AADK customers whose Occupation is the most important element in changing the continuity of quality of life and rehabilitation of drug addicts. The majority of former AADK clients can survive well for between 1 to 2 years depending on wage factors, work environment, interests and skills. studies show that former clients tend to remain only 1 to 2 years in employment if their salary and employment are not in line with their requirements. The findings also found that there was a significant relationship between job satisfaction and job satisfaction with motivation.
Nur Aidaa Mohd Ali, Faudziah Yusof and Syazwana Aziz (2019) have conducted a study to explore the factors that cause Schizophrenia in the Ipoh Perak Protection Center and also explore in more detail the steps taken by patients in controlling patients' emotions Schizophrenia at the Ipoh Perak Shelter. This study uses objective and qualitative sampling methods. A total of four Schizophrenia patients were involved in this study. The results of the study show that there are four factors that cause schizophrenia among the factors are genetic factors, drug abuse factors, work stress factors and poverty factors. The results of the study also show the steps taken by patients in controlling emotions such as reading the Quran, dhikr, ablution ", night prayers and talking with friends. The researcher suggested that the study on the factors of Schizophrenia be further expanded in Malaysia. This is because, researchers found that studies related to this topic are less available in Malaysia. The role of people around such as family members and close friends is very important in ensuring that those with mental illness undergo rehabilitation treatment to recover or be in a controlled condition.
In addition, a study by Baker et al (2019) has studied emotional intelligence and work balance as well as life are two aspects studied in work. The demands between balancing needs and wants as well as improving living standards have caused individuals to often face emotional conflicts between career and family. The effects of individual failure in controlling emotions have led to an increase in issues related to suicide, divorce, depression and so on as a result of stress in the workplace. This article discusses a conceptual survey of the effects of emotional intelligence on work and life balance in the context of a career as a member of the military. Empirical evidence from previous studies serves as a basis in discussing issues related to emotional intelligence and work balance. Based on previous studies that have been conducted has proven that there is a significant positive relationship between emotional intelligence with work and life balance. Researchers have found that individuals with high levels of emotional intelligence are able to balance their careers and personal lives. Therefore, one of the factors that need to be considered by the organization in improving the quality of work and life of employees is to emphasize the element of emotional intelligence. Balance of work and life is an important element in a military career as military personnel are often faced with heavy and challenging demands.
Through a study conducted by , cyber bullying is a communication practice through technology that aims to identify, harass, embarrass or threaten victims through negative words, spreading false information or sharing pictures or videos that can dropping the image of the victim. This study aims to discuss how elements of indecency in language as well as non-compliance of social media ethics can lead to the crime of cyber bullying among adolescents. To achieve the objectives of the study, a series of interviews and observations were conducted for 12 months on 120 adolescents in Malaysia where 324, 362 words were successfully collected. Based on the data obtained, the researchers then conducted a language analysis based on the theory of rudeness (Culpeper 1996). The results show that the phenomenon of clear language disrespect among adolescents in Malaysia is able to give a clearer picture of the crime of cyber bullying. Simon (2017) in her study found that cyberbullying uses modern digital technology deliberately to hurt and demean someone in the cyber world. Cyber bullying is a problem that involves online communication and interaction where the virtual world is borderless. Studies using a qualitative approach have seen from 8 victims of cyber bullying how it feels to be harassed in the cyber world. The results show that these victims are being bullied differently in the cyber world. This study not only focuses on the problem of cyber bullying among school students and adolescents; it also addresses the motives and causes of cyber bullying. Finally, this article will serve as a guide for school teachers, parents and adolescents to prepare to deal with the problem of cyber bullying together.
Subsequently, a study conducted by Hidzir et al (2017) found that bullying is increasingly known as a serious problem in the work environment (Francioli et al., 2016). Bullying is reported to occur in many work organizations. Kassem (2015) claims that bullying is a universal problem in most organizations with a prevalence rate of 3 percent to 4 percent. This issue has been widely discussed by researchers who prove that bullying in the workplace severely affects the organization and has caused serious health damage to its victims. This study aims to examine the relationship between personal factors and the absence of job security of the perpetrator with bullying in the workplace. This study uses quantitative data collection method and uses SmartPLS M2 version 2.0 to analyze the data. Regression analysis showed that personal factors had a positive effect on bullying in the workplace. In contrast, no significant results were found between the absence of job security and bullying in the workplace.
Further studies conducted by Hua et al (2019) show that cyber bullying is the result of electronic or social media. This form of bullying is often overlooked but it can be destructive with face-to-face bullying. Problems reporting a provocative insult study used online bullying among Malaysian youths. The study was conducted in two phases, where the first phase involved surveys using the BuLI questionnaire (Bashing using the Language of the Internet), and the second involved analyzing data channeled from Twitter through Twitter API software and R statistics using key terms derived from the first phase . Preliminary results indicate an insult related to intelligence, physical appearance and qualifications. Realization of linguistics used to convey insults are the category codes mixture of Malay and English.
Studies by Yee et al (2018) are related to cyber bullying has been identified as an important problem among adolescents in Malaysia. However, only a few cyber bullying prevention programs exist in Malaysia to overcome the problem of cyber bullying. Therefore, this study developed a cyber bullying prevention program based on Theory of Reasoned Action (TRA) to examine whether video-based cyber bullying prevention programs can change adolescent behavior toward cyber bullying. In this study, a paired t-test of a total of 384 secondary students with the age group of 15-17 years was randomly assigned to the control group and the experimental group. The results showed that this study significantly increased adolescent knowledge and level of empathy for cyber bullying after program intervention. Although the results do not show a significant decrease in subjective norms. In conclusion, video-based cyber bullying prevention programs are important in changing adolescent behavior toward cyber bullying.
In addition, a study conducted by Muhonen et al (2017) discusses ways to measure and define bullying. Because there is a lack of research investigating cyberbullying in working life, this study focuses on cyberbullying among adolescents, as well as studies on bullying in work life. When confronted with face-to-face bullying, most researchers agree that negative actions are repeated and systematic over time. Questionnaires were distributed to a sample of respondents aged between 25 and 65 living in Southern Sweden. In total, 3,885 individuals answered the questionnaire, but as the purpose of this study was to study cyber bullying in work life, individuals who did not work for the last six months were excluded from the study. Conclusion The results of this study indicate that social organizations act as intermediaries in the relationship between cyber bullying behavior and health, well-being, work involvement and intention to quit. In contrast to previous face-to-face bullying studies, current studies show that cyber bullying behavior has a stronger indirect relationship than direct relationship with health, well-being, work involvement and intention to quit. Kowalski et al (2017) in their study found that there are two studies in cyber bullying namely bullying and infertility of traditional bullying in adults, especially in the workplace. In Study 1, 20 percent of the 3,699 participants were the majority of victims of cyber bullying and 7.5 percent were the majority of traditional bullying victims in adulthood, with 30 percent saying they were bullied at work. Due to the clear evidence of bullying and cyberbullying in the workplace in Study 1, Study 2 discusses the relationship of this construct with disability in the workplace. Infertility and bullying in the workplace are related to 321 participants, as well as cyber bullying and civincivility in the workplace. These results emphasize the importance of studying bullying among adults, and highlight the concepts of bullying freedom and impolite. Correlation of intrusion in the workplace is discussed using job-resource claim theory. A study conducted by Shaari and Kamaluddin (2019) discusses that cyber bullying is a communication practice through technology that aims to identify, harass, embarrass or threaten victims through negative words. This study aims to discuss how elements of indecency in language as well as non-compliance of social media ethics can lead to the crime of cyber bullying among adolescents. Using storytelling methods in parsing previous cases, this paper will discuss some of the incidents of international cyber bullying that are gaining wide coverage around the world. To achieve the objectives of the study, a series of interviews and observations were conducted for 12 months on 120 adolescents in Malaysia where 324, 362 words were successfully collected. Based on the data obtained, the researchers then conducted a language analysis based on the theory of rudeness (Culpeper, 1996). The results show a clear phenomenon of language disrespect among adolescents in Malaysia. Examination of the case along with a discussion of the results of the study conducted together with the relevant theories are expected to provide a clearer picture of the crime of cyber bullying in terms of ethics and socio-culture as well as language practices among adolescents. A study produced by Ramli (2016) aims to look at the factors that drive work stress among support workers at Universiti Kebangsaan Malaysia Medical Center. The study was conducted to evaluate the relationship between work stress factors and positions, marital status, length of service and the highest work stress factors for each position. The research tool used is a personal stress inventory (O'Donnel & Ainsworth, 1984) which has been modified according to the suitability of the study and contains evaluation questionnaire form 2 and evaluation questionnaire form 3. A total of 67 employees were selected as respondents consisting of trained nurses, medical laboratory technologists and assistant administrative officers as well as administrative assistants. Significant relationships were seen through the severity of workload with marital status, in which employees with marital status recorded the highest percentage compared to single status employees. Apart from that, the findings of the study also show that there is a significant relationship to the factor of the severity of the overall stress with the period of service of hospital's support workers. In addition, a study by Asikin et al (2019) to see the extent of the relationship between work stress and burnout problems among employees as well as differences in work stress and burnout based on gender factors throughout their service. To meet the requirements of this study, a survey using a set of questionnaires was conducted on 76 staff serving in the department. Among the research instruments used were demographic-related information, the Maslach Burnout Inventory and the Work Stress Scale. Data were analyzed using correlation method and t-test. The findings of the study found that work stress has a positive relationship with burnout problems among staff. However, the other two hypotheses put forward by the researchers show that there is no difference between work stress and burnout problems in terms of gender. A study by Sukor et al (2018) discusses work stress has a negative impact on employee behavior in the workplace. As a result, organizational management nowadays is increasingly inclined to find effective methods to mitigate the effects of work stress. Therefore, this study was conducted to identify the role of self-enhancing humor as a moderator on the relationship between work stress and organizational loyalty among employees. This study uses a quantitative approach and a total of 340 health workers in the State of Sabah are involved in this study. The results obtained from regression analysis show that job demands are negatively related, while job control is positively related to organizational loyalty among health workers.
In addition, it was found that self-enhancing humor serves as a significant moderator on the relationship between work control and organizational loyalty. These findings provide specific information on the important relationship between work stress, organizational loyalty and self-enhancing humor. It can help organizational management to build effective work stress management interventions to retain employees in the organization. Next, the study produced by Sulaiman et al (2018) discusses the use of cognitive therapy group counseling methods in stress management among police officers in Malaysia. It also discusses what are the scenarios of police pressure, the causes of stress, the effects of stress experienced by police officers in their work and lifestyle and how existing programs have been implemented to reduce police pressure.
The results of this study can provide ideas and suggestions to the Royal Malaysian Police (PDRM) to conduct cognitive therapy group counseling intervention as a method that can be applied to police officers who suffer from high stress in particular and those who suffer from moderate stress in general. Stress among the police is increasing and has a huge impact on police officers who often do work all the time. The top management of the Royal Malaysian Police (PDRM) must take this matter seriously and try to find various alternatives in the form of suitable and effective programs to help police officers be able to use certain approaches to deal with stressful situations.
Next, Ariffin and Idris (2018) have conducted a study related to the existence of various social sites such as Facebook, Twitter, Instagram and WhatsApp as a medium to communicate is widely used because the internet can be accessed by anyone regardless of place and time. Excessive use of WhatsApp can be addictive and have different effects in terms of advantages and disadvantages to users. This study was conducted to evaluate the influence of excessive use of WhatsApp on the attitude of PSMZA students. A total of 250 students were randomly selected consisting of male and female students. The methodology used is a descriptive method and a quantitative approach that uses a questionnaire instrument consisting of three parts, namely part A of demographic information of respondents, part B of the level of information addiction for the use of WhatsApp and information part C related to student attitudes either positive or negative against their environment. However, female students are more addicted to WhatsApp than male students. A study by Moussa et al (2016) aimed at developing a measure of negative emotions in Arabic and to study its psychometric properties. Negative emotions are detected from well-documented observations that scores from a variety of instruments designed to measure the state of depression and anxiety tend to be highly correlated (Clark and Watson, 1991). Lovibond and Lovibond (1995) also present that DASS measures can be distinguished from depression and anxiety and also from negative effects. Stress scales have been shown to measure different negative emotions. Participants aged 18 and over were randomly selected from community groups, through local newspapers, Church groups, and community and school organizations. Arabic-speaking customers aged 18 and above following the Southeast Region Health Service (Sydney) were also included in the sample. There were 125 women and 82 men from the sample selected. Confirmation factor analysis showed that DASS Arabic distinguished between depression, anxiety, and stress but at a lower level than DASS. The factor for all 42 items is comparable to DASS which indicates that the item has been translated and accurately. The last article reviewed is by Aren et al (2017) related to counseling services in healthcare institutions is aimed at helping clients understand and be able to deal with feelings and emotions related to health problems while helping clients to grow and give ongoing support throughout the treatment process. The study was conducted in a qualitative way, to identify issues and challenges faced by counselors in implementing counseling services in healthcare institutions. The findings of the study found that the six main themes of issues and challenges faced by counselors are the role of counselors, service limitations, counselor qualifications, health counseling services applications, improvement suggestions and guidelines. Next, this study also discusses the implications of the study on the role, training and application of health counseling in healthcare institutions.

Method
In general, this study is a descriptive quantitative study to study cyber bullying among hospital staff and its influence on mental health and professionalism. This study uses a survey study design with quantitative data obtained through questionnaires. According to Chua (2012) one of the research methods that are usually used to collect information in relation to the current state of the phenomenon is to use the questionnaire method by selecting specific respondents to complete this study. The use of questionnaires in this study is seen as more practical for researchers to obtain information from respondents in large numbers. One of the advantages of using a questionnaire is that it is more extensive, comprehensive and covers many respondents (Jacobs & Ary, 1990). According to Campion (1991), the survey survey method is a specific way to gather information about a large group of population based on the study conducted and want to find the actual study output. Chua (2012) explained that the purpose or goal of the questionnaire survey is to obtain information to explain their perceptions, attitudes, behaviors or values according to their respective views. Among them is that it is very useful to measure opinions, attitudes and behaviors (Chua, 2013). After the researcher decides to conduct the study by survey using the questionnaire method, the research tool is sought from previous researchers. The data obtained from these random samples were then analyzed and presented with significant tests. The results of the next statistical tests will draw conclusions on the characteristics of the population studied.

Population and Sample Study
Population is related to the whole group to be studied (Chua, 2011). The population for this study consists of staff of Universiti Kebangsaan Malaysia Hospital. With such a large population it is impossible for researchers to collect data in a short period of time in conducting this study. Therefore, a sample of the study selected from the population will be used in this study. According to Abdul Ghafar (1999), the study population is composed of all members in the study group. In this study, Sample study focused on medical staff to study about cyber bullying among hospital staff and its influence on mental health and professionalism. The total number of subjects is 180 people and the subjects consist of staff of the Pharmacy department and Finance department from the background of age, race, religion, level of education, position and work experience. The number of subjects is referenced through morgan and krejcie tables. With a total staff of two departments of 331 employees, the table shows a subject ratio of 180.

Study Instrument
The questionnaire used in testing or conducting this study is the Cyberbullying Behavior Questionnaire (CBQ) developed by (Johnsons et al., 2017). This questionnaire is taken from one of the journals entitled "Exploring cyberbullying and face-to-face bullying in working life -Prevalence, targets and expressions". The constructed question is a set of questionnaires containing 20 items followed by five scales using a 5-point Likert scale. This questionnaire is a set of self-assessment by study respondents. This test tool measures the extent of cyberbullying among working individuals. For the screening of a healthy mind, this study uses a questionnaire from the Mental Health Module Unit, Ministry of Health Malaysia (MOH, 2017). This questionnaire contains 21 items that measure the level of mental health including the dimensions of depression, anxiety and stress.

Result
The normality test is the earliest thing to do before inferential statistical analysis is done. This is to ensure that the data obtained has a normal distribution of data. According to Micceri (1989), the distribution of data in most of these psychological and social science research studies is difficult to obtain a normal distribution of data (Micceri, 1989). The data normality analysis was based on the Kolmogorov-Smirnov test because the number of respondents exceeded 50 people and found that all 180 data obtained were insignificant (p <0.05). Therefore, researchers have implemented several methods to ensure that the data obtained are normally distributed. Some of the outliers found in the data obtained have been removed and this makes the number of data is 170.

Cyber Bullying and Depression Levels of Hospital Staff.
Correlation analysis was conducted using Pearson correlation analysis method. The results of the correlation analysis shown found that there was a weak and significant positive relationship between cyber bullying and depression levels for staff. The correlation value is r = 0.258, k <0.01. The results of the analysis show a hypothesis stating that there is a weak and significant positive relationship between cyber bullying and the level of depression of hospital staff is accepted. Thus, there is a significant relationship between cyber bullying and staff depression levels.Buli Siber Dan Tahap Kerisauan Kakitangan Hospital. Correlation analysis was conducted using Pearson correlation analysis method. The results of the correlation analysis shown found that there was a weak and significant positive relationship between cyber bullying and the level of anzieti for staff. The correlation value is r = 0.276, k <0.01. The results of the analysis show a hypothesis stating that there is a weak and significant positive relationship between cyber bullying and the level of hospitality of hospital staff is accepted. Thus, there is a significant relationship between cyberbullying and staff level of anzieti.

Cyber Bullying And The Stress Level Of Hospital Staff.
For hypothesis 3, correlation analysis was conducted using Pearson correlation analysis method. The results of the correlation analysis conducted found that there was no significant relationship between cyber bullying and stress levels among hospital staff. The correlation value is r = 0.100, k> 0.05. The results of the analysis show a hypothesis stating that there is a significant relationship between cyber bullying and staff stress levels fail to be accepted. Thus, there is no significant relationship between cyber bullying and stress levels of hospital staff.

Jadual 1 Correlation analysis of stress, anxiety, depression and cyberbullying
Pearson Correlation (r)

The Influence of Cyber Bullying on the Depression Level of Hospital Staff
There was a positive linear relationship (R = 0.258) between cyber bullying and the level of depression of hospital staff. Cyber bullying i.e. independent variable shows a R square value of 0.067 or 6.7 percent of the variance that exists in the level of depression of hospital staff i.e. dependent variable. The values in the ANOVA table show this model with a R square value of 6.7 percent is significant where F (1, 12.720), k <0.05. This indicates that there is a significant influence of cyber bullying on the level of depression of hospital staff. Therefore, cyber bullying is a significant factor in the level of depression of hospital staff in. Beta values indicate a contribution of 0.258 equivalent to 25.8 percent for cyber bullying significantly affects the level of depression. Cyber bullying (Beta = 0.258, k <0.05) was a significant predictor with an overall R2 = 0.067. Therefore, the higher the cyberbullying, the higher the depression of hospital staff.

Influence of Cyberbullying on the Level of Anxiety
The results showed a positive linear relationship (R = 0.276) between cyber bullying and the level of anxiety of hospital staff. Cyber bullying i.e. independent variable shows a R square value of 0.076 or 7.6 percent of the variance that exists in the level of anxiety of hospital staff i.e. dependent variable.
The ANOVA value indicates that the R square value of 7.6% is significant where F (1, 14.638), k <0.05. Thus, the hypothesis stating that there is a significant influence of cyber bullying on the level of anxiety of hospital staff is accepted. Therefore, cyber bullying is a significant factor in the level of anxiety of hospital staff. Results of regression test analysis to predict cyberbullying on anxiety levels among hospital staff at. Beta values indicate a contribution of 0.276 equivalent to 27.6% for cyber bullying significantly affects the level of anxiety. Anxiety level can be predicted by 0.102 (cyber bullying) + 2.283. Cyber bullying (Beta = 0.276, k <0.05) was a significant predictor with an overall R2 = 0.076. Therefore, the higher the cyberbullying, the higher the level of anxiety of hospital staff.

Relationship Between Cyberbullying and Mental Health Levels
In the findings of this study, the study found that there is a weak and significant positive relationship between cyber bullying and the level of depression and the level of anzieti of hospital staff at. The correlation analysis that has been conducted found that there is a weak and significant positive relationship between cyber bullying and depression levels for staff. In addition, there is a weak and significant positive relationship between cyber bullying and anxiety levels for staff. Thus, the study found that there was a weak and significant positive relationship between cyber bullying and the level of depression and anxiety of hospital staff at.
The results of this study are in line with previous studies in knowing the relationship between cyber bullying and a person's level of depression and anxiety. According to a study from Hellfeldt et al (2019), the study found that there is an association between victims of cyberbullying with depression and there is also a link between cyberbullying victims with anxiety levels (Hellfeldt et al., 2020).
In fact, the results of this study are also in line with the study from Gonzalez-Cabrera et al (2017) who found that there was an association between cyberbullying victims with mental health levels and there was an association between cyberbullying victims and anxiety levels (Gonzalez-Cabrera et al., 2017). With this, it can be concluded that there is a connection between the victims of cyber bullying and a person's mental health, namely the level of depression and the level of anxiety. In addition, the findings of this study are also in line with the study by Farley et al (2015) has examined the effects of cyberbullying among trainee physicians, and how cyberbullying affects individuals and occupations. This study found that respondents have experienced at least one act of cyber bullying that adversely affects job satisfaction and mental tension. Studies show that cyberbullying related to work, dissatisfaction and mental tension has a negative impact on trainee doctors. This activity shows that more research is needed to explain the nature of cyber bullying and its effects.

The Influence of Cyberbullying on Mental Health Levels
In the findings of this study, the study found that cyber bullying is the effect of increasing or decreasing the level of depression and the level of anxiety in the hospital staff. The results show that there is a positive linear relationship between cyber bullying and the level of depression of hospital staff. Therefore, the hypothesis stating that there is a significant influence of cyber bullying on the level of depression of hospital staff is accepted and this shows that cyber bullying is a significant factor on the level of depression of hospital staff in.
In addition, the findings of this study also show that there is a positive linear relationship between cyber bullying and the level of anxiety of hospital staff. Thus, the hypothesis stating that there is a significant influence of cyber bullying on the level of anxiety of hospital staff is accepted. Therefore, cyber bullying is a significant factor in the level of training of hospital staff. The results of this study are in line with previous studies in knowing the effects of cyber bullying on a person's level of depression and anxiety. According to studies from Na (2013), the results of a study after controlling gender and race, linear regression results related to the effects of cyber bullying on significant depression. The model explains 23 percent of the total variation in depression. Increased perceptions of challenging cognitive assessments and increased perceptions of control cognitive assessments do not predict decreased levels of depression as hypothesized unsupported. Increased perception of threat cognitive assessment predicts increased levels of depression as hypothesized to be supported (Hyunjoo Na, 2013). This indicates that cyber bullying affects the level of depression of individuals.
Whereas in the same study explained that the results of the multiple linear regression model of cyberbullying against anxiety are significant. Increased perceptions of challenging cognitive assessments and increased perceptions of control cognitive assessments do not predict decreased levels of anxiety as hypothesized to be unsupported. Increased perception of cognitive threat assessment does not predict an increase in anxiety levels as hypothesized is supported.
In fact, this study is also in line with a study by Taskin Tanrikulu (2015) who found that the theoretical framework of choice predicts cyber bullying behavior and this study reveals that cyber bullying behavior is understood to be predicted by belonging needs and power. In conclusion, the results of this study are in line with the results of previous tests.

Conclusion of the Study
This study was conducted to examine cyber bullying among hospital staff and its influence on mental health and professionalism. The findings of the study obtained will be formulated based on the objectives of the study. The objective of the first study was to examine the level of cyber bullying among hospital staff. The findings show that the level of cyber bullying for staff is low. Involvement in cyberbullying can affect an individual's level of mental health. This can be proved when the objective of the second study which examines the mental health level of hospital staff is in the normal level for each level of stress, anxiety and depression. The findings of this study show that the level of stress, anxiety and depression for hospital staff in is normal. For the third objective of the study to find out the relationship between cyber bullying and the level of mental health of hospital staff found that there is a significant positive and weak relationship between cyber bullying with depression and anxiety levels of hospital staff. It can be concluded that there is a relationship between cyber bullying and the level of depression as well as the level of anxiety of hospital staff at the Universiti Kebangsaan Malaysia Hospital. The objective of the next study to find out the effect of cyber bullying on the mental health level of hospital staff shows the Beta value of cyber bullying on depression and anzieti is significant where cyber bullying is a factor for the level of increase or decrease for depression and anzieti level of hospital staff.