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Ríos-Becerril J, Cruz-Bello P, Becerril-Amero P, Maldonado-González V. Intervención educativa de enfermería sobre salud sexual y reproductiva en adolescentes. Rev Enferm Inst Mex Seguro Soc. 2016; 24(1):51-4

Educational nursing intervention on sexual and reproductive health in adolescents

Jenyfer Rios-Becerril,¹ Patricia Cruz-Bello,¹ Patricia Becerril-Amero,¹ Victoria Maldonado-Gonzalez¹

¹Facultad de Enfermería y Obstetricia, Universidad Autónoma del Estado de México. Estado de México, México

Correspondence: Patricia Becerril Amero

Email: mspbecerril@gmail.com

Date received: July 22^nd, 2015

Date judged: September 30^th, 2015

Date accepted: November 25^th, 2015

Abstract

Introduction: In the world about 16 million adolescents between 15 and 19 give birth each year. In Mexico, it is reported that although adolescents are aware of their sexuality, they do not make an adequate use of it.

Objective: To design and implement a nursing program on sexual and reproductive health education for adolescents and family in a community at the Estado de México, México.

Methodology: Intervention study in 40 families and 38 teenagers between 12 and 19 years, before the intervention a questionnaire, according to results and implemented designed a program of educational sessions nursing sexual and reproductive health at the end of it applied held another evaluation.

Results: The mean age was 14.7 ± 4.2, the condom was the most effective birth control 81.1 %, 52.6 % reported AIDS/HIV infection as the most popular sexual transmission, the 5.3 % reported having initiated sexual activity.

Conclusions: Most adolescents require further information on contraception, pregnancy prevention and their parents to discuss with them about sexuality issues.

Keywords: Adolescent; Sexual health; Reproductive health; Sexual and reproductive health.

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Introduction

Adolescence is the period of life encompassing mental and social biological maturation- including sexual maturity-and the time of assuming adult roles and responsibilities. The World Health Organization (WHO)¹ defines it as the period of life in which the individual acquires reproductive capacity, transitions their psychological patterns from childhood to adulthood, and consolidates socioeconomic independence, ranging from 10 and 19 years old. This period is included in the stage of youth, from 10 to 24 years. Hiriart² defines adolescence as a period of many changes and new experiences that are tested and that reinforce personal and social skills.

Sexuality is a manifestation of personality that is expressed in all stages of the life of human beings, and communication is the basis for the development of a healthy and responsible sexuality at any level.³ At this stage of life, effective communication between parents and their teenage children plays an important role for sexual and reproductive education, about sexuality itself and physical, physiological, and hormonal changes; it is also necessary to recognize the importance of incorporating personal hygiene habits as the most effective measure to counter the effects of such changes.⁴

In a study of boys aged 12 to 17 years, basic knowledge about sexuality was identified, they reported that the information provided by their parents had "not very clear language" and the topic that they paid the most attention to was " sexually transmitted infections and the consequences of pregnancy".⁵

A study in Venezuela on the sexual behavior of adolescents aged 14 to 18 years found that 84% initiated sexual intercourse before age 15, 64.1% of which had an unstable relationship with their sexual partner and low condom use, so they conclude that it is necessary to design and implement educational programs that address these issues.⁶

Premature sex can lead to unwanted pregnancies and increase the risk of acquiring a sexually transmitted infection (STI) and HIV. In Latin America and the Caribbean the onset of sexual activity in adolescents is before age 15 in 17% of girls; US teenagers experience their first sexual intercourse at 15 years of age.⁷ STIs spread from person to person through sexual contact, but microorganisms have also been identified that can be transmitted from mother to child during pregnancy and childbirth.⁸

Effective communication and a stable family relationship are decisive psychosocial factors for adolescents to avoid risky sexual behaviors that lead to pregnancy in girls or acquiring STIs in both sexes.⁹

Each year worldwide about 16 million girls between 15 and 19 years give birth, representing about 11% of total births. Latin America and the Caribbean and Sub-Saharan Africa log the highest proportion of births in adolescents, because in these regions almost one of every five babies is born to a teen mother.¹⁰

There are several factors contributing to teenage girls being in various complex situations, such as the pressure to marry and have children at an early age, or very limited educational or job prospects. Some do not know how to prevent pregnancy or obtain contraceptives; others may not be able to refuse unwanted sex. Teenagers who become pregnant are less likely than adult women to access safe and legal abortions, or to have access to qualified prenatal, birth, and postpartum care. In low- and middle-income countries, complications of pregnancy and childbirth are the leading causes of death among women aged 15 to 19, and perinatal death is 50% higher among babies born to mothers under 20 years than among those born to mothers between 20 and 29 years. Babies born to teen mothers are more likely to have low birthweight with long-term risks.

In Mexico, the adolescent population is 22.2 million, which means for the country and for health services, a population in need of information and care for physical, physiological, psychological and emotional needs, among others. In adolescents 12 to 19 years, it is estimated that 23% of them have already started sexual life, with a greater proportion of men with 25.5%, than women, with 20.5%; the above is an alarming situation, if compared with the data reported in 2006, where the proportion of adolescents aged 12 to 19 who had already initiated sexual life was 15%, of which 17% were men and 14% women.^7,11 Under these conditions, if teens do not receive accurate and timely information about their sexuality and risk-free sexual practice, it can end in an unwanted pregnancy or acquiring a sexually transmitted infection.

One of the government initiatives is in charge of the Centro Nacional de Equidad de Género y Salud Reproductiva, which through the design and structuring of an interactive portal for teenagers, is responsible for providing information, and in case of needing more specialized care, the teen is referred to one of the 776 Servicios Amigables en Salud Sexual y Reproductiva para Adolescentes (Friendly Services in Sexual and Reproductive Health for Teens) operated by the Secretaría de Salud. Through this service, they seek to ensure that this population uses their right to information and counseling on sexuality, in a reliable and free space.¹²

Sex education is often considered a taboo subject, so parents avoid this responsibility, leaving it to teachers. In this regard, adolescents mention that their parents do not provide useful information, sometimes there are feelings of shame for adolescents and a lack of openness on the part of parents, which complicates the communication of simple and complex issues of particular interest to teenagers.

The purpose of the study was to design and implement a program of sexual and reproductive health education for adolescents in the familial environment of a Mexican community, in order to promote sexual and reproductive health in adolescents 12 to 19 years in their own environment, by disseminating methods of personal hygiene, contraceptive methods, sexually transmitted infections, and teenage pregnancy.

Methodology

Through an intervention study, 40 families were included from a community in Toluca, Estado de Mexico, in which 38 adolescents 12 to 19 years of age were identified. All family members who participated in the study received information on the study, and the teens were shown how to fill out the structured questionnaire with 30 multiple-choice items measuring sociodemographics, knowledge of sexual and reproductive health, communication with parents, and sources of information on sexuality. Statistical analysis was performed using SPSS program version 18. The data were analyzed using measures of central tendency, and relative and absolute frequencies. Ethical considerations were based on informed consent, as dictated by the Ley General de Salud for health research.

The design and implementation of the sexual and reproductive health education program included five sessions: a) personal hygiene in adolescence, b) contraception, c) sexually transmitted infections, d) risky sexual behavior e) teen pregnancy.

Each session included educational and fun activities to facilitate learning, and at the end of the educational sessions the program was evaluated by applying the same questionnaire.

Results

The average age of adolescents was 14.7 ± 4.2 years, in the age range of 12-19 years. In hygiene habits 76.4% were found to bathe daily, and 23.7% every third day because the family did not have resources or due to low temperatures, however all adolescents changed underwear daily.

The proportion of teens who said that the condom is the most effective method of prevention increased after the intervention, from 73.7% to 81.1%, this occurred to a lesser extent with birth control pills from 15.8% to 18.9%, and the methods of withdrawal and abstinence remained at 2.6% and 7.9% respectively. They felt that both condoms and pills provide them with protection to prevent sexually transmitted infections and unwanted pregnancies.

Before the intervention, 52.6% of adolescents identified only HIV / AIDS as the best-known STI; after the intervention, 94.8% included among the most common sexually transmitted infections AIDS / HIV, herpes, gonorrhea, syphilis, and human papillomavirus (HPV), which can help them have better sexual practices and lower risk.

97.4% of adolescents communicate with family members about events and concerns that come up during the day; issues of sexuality were addressed in the family in 52.6%; if a question arises in these issues, teenagers ask their mother in 60.5% and health personnel in 18.4%.

With regard to information on sexual and reproductive health provided by teachers, 81.6% consider it useful and 18.4% unhelpful or lacking knowledge, which is contradicted when evaluating knowledge or asking the teen if they have questions, whereupon they mention that they need further information on issues of sexuality.

The adolescents mentioned that they would like their parents talk to them about contraceptive methods in 31.6%, pregnancy prevention in 26.3%, and sexually transmitted infections in 21.1%, a situation that reflects the adolescents’ preference to address these issues at the family level. 65.8% of adolescents report having a dating relationship and consider the relationship they have to be good because there is communication and respect. As for the initiation of active sexual life, 92.1% of adolescents said they had had sexual intercourse, of those who claimed this 5.3% were women with only one sexual partner and out of affection and / or love, and 2.6% were men with two sexual partners and out of curiosity; in both cases the initiation of sexual intercourse was after age 15.

Discussion

The study coincides with the literature, since teens have at some point heard talk about contraception and sexually transmitted infections, and identify the effectiveness of condoms as a primary contraceptive method and AIDS / HIV as the best-known transmitted infection,11 which shows that they need more and better information and advice in the field of sexuality.¹²

This coincides with Hiriart,² that adolescence is a stage in which there are moments of doubt and confusion from the moment physical, psychological, and emotional changes begin; talking to teens about sexuality involves creating environments of sincerity and trust. On the other hand, one must address issues of sexuality without stigmas and taboos that limit and prevent their understanding,¹² there is a clear need for information about contraception, sexually transmitted infections, and prevention and consequences of unwanted pregnancy. Primarily, the issues that adolescents pay more attention to are sexually transmitted infections and the consequences and prevention of unwanted pregnancies,5 which coincides with what was observed during the sexual and reproductive health program development. It is shown that communication is the basis for the development of a healthy and responsible sexuality.⁴

Conclusions

The need and interest was identified for adolescents to receive information about contraception linked to a good and responsible sexual practice.

As for communication by parents with their children about sexuality during the intervention, they showed interest in getting more involved in the sex education of their children. This reinforces the initiative to have parent workshops to give information on sexuality and provide techniques to address this with their children in a trusting relationship that allows their questions to be answered in the family.

References

1. Organización Mundial de la Salud. La salud de los jóvenes: un desafío para la sociedad. Informe de un Grupo de Estudio de la OMS acerca de los jóvenes y la «Salud para Todos en el Año 2000». (Serie de Informes Técnicos 731) [Internet]. Ginebra: OMS; 1986 [Citado 2015 Ene 12]. 134 p. Disponible en: http://www.rua.unam.mx/repo_rua/temas_transversales_de_interes_general/600_tecnologia__ciencias_aplicadas_/610_ciencias_medicas__medicina/_5536.pdf.Hiriart V. Sexualidad y adolescencia. Una experiencia inédita. México: Terracota, 2010. 95 p.
2. Álvarez de la Cruz C. Comunicación y sexualidad. Enferm Glob. [Internet]. 2010 [Citado 2015 Ene 12].:9(2)]. Disponible en: http://revistas.um.es/eglobal/article/download/107301/103311.
3. Loyola A. La importancia de mantener una buena higiene en la adolescencia. Revistapadres Apod. [Internet]. 2013 [Citado 2015 Ene 12].:9(2)]. Disponible en: http://revistapadres.com/inicio/index.php/es/familia/56-la-importancia-de-mantener-una-buena-higiene-en-la-adolescencia.
4. Parajeles Reyes M, Zamora Arrieta M. Educación sexual en la adolescencia: la vivencia de un trabajo comunal universitario. Med Leg C R. 2012 [Citado 2015 Ene 12];9(2)]. 29(2):1-10. Disponible en: http://www.scielo.sa.cr/pdf/mlcr/v29n2/art8.pdf.
5. Benítez Martínez M, Fariña Reinoso AT, Molina Nápoles IL, Martínez Valdéz E, Suárez Tamayo S,  Cañas Ávila N. Actitudes frente al VIH/SIDA en estudiantes de la escuela Simón Rodríguez, Estado Bolívar, Venezuela. Rev Cubana Hig Epidemiol. 2013; 51(3):242-252.
6. Torriente Barzaga N, Diago Caballero D, Rizo Vázquez AC, Menéndez López LR. Conocimientos elementales sobre educación sexual en alumnos de una escuela secundaria básica urbana. 2010 [Citado 2015 Ene 12];9(4): 576-587]. Disponible en: http://scielo.sld.cu/pdf/rhcm/v9n4/rhcm18410.pdf.
7. Organización Mundial de la Salud. Adolescentes: riesgos para la salud y soluciones
8. (Nota descriptiva N° 345) [Internet]. Ginebra: OMS; 2014 [Citado 2015 Ene 12]. Disponible en: http://www.who.int/mediacentre/factsheets/fs345/es/.
9. Muriel Suárez S, Aguirre López M,  Cruz Ruiz S, Varela Hidalgo C. Comportamientos alarmantes: infantiles y juveniles. México: Ediciones Euroméxico, 2013. 302 p.
10. Fondo de las Naciones Unidas para la Infancia. La adolescencia. Una época de oportunidades. Estado Mundial de la Infancia 2011. [Internet]. Nueva York: UNICEF; 2011, 148 p. [Citado 2015 Ene 12]. Disponible en: http://www.unicef.es/sites/www.unicef.es/files/EMI2011.pdf.
11. Instituto Nacional de Salud Pública (México). Encuesta Nacional de Salud y Nutrición 2012. México: Secretaría de Salud, 2012. [internet]. [Citado 2015 Ene 12]. Disponible en: ensanut.insp.mx.
12. Secretaría de Salud (México). Norma oficial mexicana, NOM 005-SSA2-1993, De los servicios de planificación familiar. [Citado 2015 Ene 12]. Disponible en: http://www.salud.gob.mx/unidades/cdi/nom/005ssa23.html
    

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