INTRODUCTION
Background
Youth, full of colorful world. Maybe that's the right word to describe that so many colors that will adorn fese adolescents. Elah we understand together bahwasannya fese adolescents is the phase where we find an identity that will mencadi days of adult characters, or commonly known as adolescence is the formation of character (character building). Then surely we must know and be familiar with this phase, a phase which is very influential on subsequent days of our lives, namely the phase and older adults.
In addition to the phase formation of character, the adolescent phase is also referred to as phase transitions, where the phase change between the children grow up through the transition phase that adolescent phase. In the adolescent phase of this many changes, both physically and psychologically. One very prominent in these changes are physical changes.
Most change was first felt by adolescents is a physical change. Puberty occurs is a gradual process of change in the internal and external body of the children become adults. Sex hormones including hormone changes make teenagers become comfortable with themselves and also once so often too focused on his physical condition. For example: teenagers so often look in the mirror only to see pimples or bangs, so too upset with her body shape, and so forth.
In adolescence is characterized by rapid physical growth. Physical conditions in adolescence is seen as an important thing, but when the physical state does not correspond to expectations (the discrepancy between body image with self picture) can cause a sense of dissatisfaction and lack of confidence. Likewise, a disproportionate physical development. Reproductive maturity in adolescence requires effort gratification and if not guided by the norms of behavior can lead to sexual deviation. Maturity of the reproductive organs is also sometimes not immediately accepted by adolescents. Sometimes they are afraid when they first experienced the changes that occur in fisiknnya. For example, many teens are afraid when they first menstruation.
Reproductive health system change must be understood by each of the teens. This is done to understand the ramaja bahwasannya such changes must be balanced with reproductive health itself. This is done so that every teenager to avoid venereal disease, and not stuck to the free sex.
Then as a student who may have passed or are still in the adolescent phase we must know and understand the changes that occur in the adolescent phase, especially in the phase that we can hang the youth about reproductive health and physical changes that young people are not afraid of change in fisiknnya and young people understand the importance of maintaining the reproductive organs and the dangers that occur in reproductive akaibat sexual perversions.
CHAPTER II
DISCUSSION
A. Physical Development in Adolescents
1.1 Definition of
Most change was first felt by adolescents is a physical change. Puberty occurs is a gradual process of change in the internal and external body of the children become adults. Sex hormones including hormone changes make teenagers become comfortable with themselves and also once so often too focused on his physical condition. For example: teenagers so often look in the mirror only to see pimples or bangs, so too upset with her body shape, and so forth.
In adolescence is characterized by rapid physical growth. Physical conditions in adolescence is seen as an important thing, but when the physical state does not correspond to expectations (the discrepancy between body image with self picture) can cause a sense of dissatisfaction and lack of confidence. Likewise, a disproportionate physical development. Reproductive maturity in adolescence requires effort gratification and if not guided by the norms of behavior can lead to sexual deviation.
Development or growth of juvenile limbs, as stated by Monks et al. (1994), sometimes faster than the development of the body. Therefore, for a time, a teenager has a disproportionate body proportions. This will lead to a deep inner rage because at this stage, adolescents are very big concern for her appearance. So the teenager himself is one of the appraisers that are important to the body itself as a social stimulus. When the teens understand the body has met the requirements, as expected by their social environment, then this will be a boost to the self-assessment.
In general, physical changes in adolescence as follows:
1.2 Women
• Breast Growth (3-8 years)
• Growth of pubic hair / genitalia (8 -14 years)
• Growth in weight (9.5 to 14.5 years)
• menarche / menstruation (10-16 years old, sometimes 7 yrs)
• The growth of underarm hair (2 years after pubic hair)
• produce oil and sweat glands (together with the growth of underarm hair)
1.3 Men
• The growth of the testes (10 - 13.5 years)
• Growth of pubic hair / genitalia (10-15 years)
• Enlargement of the body (10.5 - 16 years)
• penis enlargement (11 - 14.5 years)
• Changes in voice due to vocal cord growth (Same with penis enlargement)
• The growth of facial hair and armpit (2 years after pubic hair)
• produce oil and sweat glands (Same with the growth of underarm hair)
Most teens are not able to receive physical condition. This is evident from the appearance of youth who tend to imitate the appearance of another person or a particular character. For example, the Ani-white skin does not feel like a movie star, then Ani will exert every effort to whiten the skin. Ani such behavior would cause problems for themselves and others. Maybe Annie will always refuse when invited to a party by a friend so that over time Ani has no friends, and so forth.
2.1. Adolescent Reproductive Health
2.1.1. Understanding Adolescent Reproductive Health
According to the WHO's reproductive health is a state of physical, mental and social guidance, not just freedom from disease or disability in all aspects related to the reproductive system, its functions and processes. Or a situation where people can enjoy their sex life and be able to perform the function and reproductive processes in a healthy and safe. Another understanding of reproductive health in the International Conference on Population and Development, the reproductive health is a state of physical well-being, mental and social guidance in all matters relating to the functions, roles and reproductive systems. Adolescent reproductive health is a health condition related to the system, reproductive functions and processes owned by a teenager. Healthy sense here is not merely mean disease-free or free from disability but also mentally as well as socio-cultural (Fauzi., 2008).
2.1.2. Adolescent
2.1.2.1. Understanding Adolescents
Adolescents are generally defined as those who experienced the transition from childhood to adulthood. According to the World Health Organization (WHO), adolescence (Adolescence) are those aged 10-19 years. While in other terms the UN says young people (youth) for those aged 15-24 years. These are then incorporated into a term of youth (young people), which covers 10-24 years. Meanwhile, the BKKBN program mentioned that the youth are those aged between 10-24 years. According to Hurlock (1993), adolescence is a time filled with shock, the level of search for identity and is the most severe period. According Bisri (1995), adolescents are those who have left the childhood full of dependency and towards the establishment of responsibility.
2.1.2.2. Changes that occur in adolescence
The changes that occur when a child enters adolescence, among others, can be viewed from three dimensions a biological dimension, the dimension of cognitive and social dimensions.
a. Biological dimensions
By the time a child enters puberty is marked by the first menstruation in girls or boys wet dream, he was biologically a very big change. Puberty makes a child has the ability to air-reproduction.
At the time of puberty, girls will have a period, as a sign that the reproductive system is active. In addition there are also physical changes such as the breasts start to develop, hips started to grow, acne and grow hair on the pubic area. The boy began to show changes in the voice, growth of whiskers, Adam's apple, the genitals become larger, bigger muscles, acne and other physical changes. Their physical form is changed rapidly since the beginning of puberty and will bring them to the world of teenagers.
b. Cognitive Dimensions
Cognitive development, adolescents in the view of Jean Piaget (2007) (an expert on cognitive development) is the highest in the last period and the growth stage of formal operations (period of formal operations). In this period, ideally the teens already have the mindset of their own in an attempt to solve complex problems and abstract. Adolescents develop thinking skills so that they can easily imagine many alternative solutions to problems and their possible consequences or results. Capacity to think logically and abstract them so that they are able to develop multi-dimensional thinking like a scientist. The youth no longer receive information as it is, but they will process information and adapt it to their own thinking. They are also able to integrate past and present experience to be transformed into conclusions, predictions, and plans for the future.
c. Moral Dimensions
Adolescence is a period when one starts to wonder about the various phenomena that occur in the surrounding environment as the basis for the formation of their self-worth. The teens began to make its own judgment in the face of popular issues relating to their environment, such as: political, humanitarian, war, social circumstances, and so forth. Teens no longer accept the idea of a rigid, simple, and absolutely given to them during this without rebuttal. Adolescents begin to question the validity of the idea that there are more alternatives and other considerations. Critically, many teens will be out observing and comparing it with the things that had been taught and instilled him.
2.1.3. Anatomy and Function of Reproductive Organs
2.1.3.1. Woman
Divided into the female reproductive organs outside the reproductive organs and reproductive organs inside.
The outside of the reproductive organs:
A. Vulva, the area outside of the female genital organs including the labia majora, labia minora, mons pubis, bulbus vestibuli, vestibule vaginae, major and minor vestibular glands, and orificium vaginae.
2. Labia majora, which form two rounded folds of fatty tissue covered with skin and extends downward and backward from the mons pubis.
3. Mons pubis, which contains the fat pads are located on the anterior surface of the symphysis pubis. After puberty, the skin will be covered by the mons pubis curly hair that forms a particular pattern.
4. Breast / mammary gland organ that is useful for feeding.
Reproductive organs inside:
A. Labia minora, which is the inner labia of the labia majora, and ending with the clitoris, is identical to the penis during the period of fetal development which then undergoes atrophy. In the center there is a hole clitoris urethra to discharge urine only.
2. Hymen, which is a thin membrane elasticity varies regularly perforated in the middle, the outside world as a separator with internal organs. Hymen will disappear after a woman was torn and intercourse (coitus) or after delivery.
3. Vagina, which formed as a circular elongated tube composed of circular muscles in there kanankirinya gland (Bartolini) produces a lubricating fluid when sexual activity.
4. The uterus (womb), which is an organ shaped like fruit peer, the lower shrink and end up as the neck of the womb / cervix uteri. The uterus consists of a thick muscle layer as a place of conception, fetal development. On the inner wall of the uterus is always peel after menstruation.
5. Tuba uterine (fallopian), the channel on the left and right of the uterus, as the passage of the egg / ovum.
6. Ovary, which is the egg-producing organs and produce the hormones estrogen and progesterone. Organ consists of 2 pieces.
Organ function:
The reproductive organs begin to function as first menstruation at the age of 10-14 years and very varied. At that time, began to affect the pituitary gland and the ovaries start to work producing hormones estrogen and progesterone. This hormone will affect the inner wall of the uterus and menstruation occurs. Every month during the fertile period, ovulation occurs with resultant egg / ovum to be released into the uterus through the uterine tubes. The production of this hormone only lasts until menopause, then do not produce themselves. Mammary glands are also affected by this hormone so that the breast will be enlarged.
2.1.3.2. Man
Male genitalia are also divided into male genitals outside and inside of the male genitalia.
The outside of the reproductive organs:
A. Penis, which is elliptical reproductive organs changed in size during sexual activity. The inside of the penis contains blood vessels, muscle and nerve fibers. At its center there is a channel for urine and semen are also called the urethra.
2. Scrotum, which is an organ that looks from the outside is round, there are 2 pieces left and right, a shriveled skin and covered with pubic hair.
Reproductive organs inside:
A. Testis, which is the contents of the scrotum, totaling 2 pieces, consisting of small channels form a braid, as the formation of sperm cells.
2. Vas deferens, which is a channel that carries sperm cells, amounted to 2 pieces.
3. Prostate gland, which is a gland that produces a thick fluid that nourish sperm cells and produce enzymes.
4. Seminal vesicle gland, which is the gland that produces fluid for the life of sperm cells, together with spermatozoa liquid is fused into a product called cement, which is issued every time a man ejaculates.
Organ function:
These organs begin to function as a reproductive system during puberty begins around age 11 -14 years. Activities are regulated by the organs are:
A. Discharge of semen or seminal fluid was first. This went on for life. 2. Testis organ that produces sperm cells will work after obtaining the effect of testosterone produced by Leydig cells in the interstitial.
2.1.4. Factors affecting the reproductive health of adolescents
Adolescent reproductive health is influenced by several things: the tools genital hygiene, access to health education, premarital sexual relations, sexually transmitted diseases (STDs), the influence of mass media, access to affordable reproductive health services, and a harmonious relationship between adolescents with family.
2.1.4.1. Cleanliness of the genital organs
Adolescent reproductive health is determined by how the teenager was in caring for and maintaining genital hygiene tools. When reproductive organs moist and wet, then the acidity increases and it facilitates the growth of fungi. Adolescent girls are more susceptible to genital infection if not maintain genital hygiene tools for vaginal organ that is located close to the anus.
2.1.4.2. Access to health education
Teens need to get the correct information about reproductive health to adolescents know the things that should be done and the things that should be avoided. Adolescents have the right to obtain correct information about reproductive health and the information must come from a trusted source. In order for teens to get the right information, adolescent reproductive health should be taught in schools and within the family. The things taught in the curriculum include adolescent reproductive health education about adolescent growth and development, reproductive organs, risk behaviors, sexually transmitted diseases (STDs), and abstinesia as pregnancy prevention, Knowing about adolescent reproductive health is true, we can avoid the negative things done by teenagers. Education on adolescent reproductive health is useful for adolescent health, particularly for preventing premarital sexual behavior, transmission of sexually transmitted diseases, abortion, cervical cancer, pregnancy outside marriage, the moral gradation, and the bleak future of the youth.
2.1.4.3. Premarital sexual relations
Pregnancy and childbirth carry risks of morbidity and mortality is greater in adolescents than in women aged over 20 years. Young women who are younger than 18 years have 2 to 5 times the risk of death compared with women aged 18-25 years old and due to stalled labor, bleeding, and other factors. Emergencies associated with pregnancy are also common in teenagers who are pregnant, for example, hypertension and anemia that adversely affect the body in general.
Unwanted pregnancy in teenagers often end in abortion. Many surveys have been conducted in developing countries showed that nearly 60% of pregnancies in women under 20 years is an unwanted pregnancy or any time (mistimed). Induced abortion are often at greater risk in young women than in those who are older. Many studies have been conducted also showed that the mortality and morbidity often occur due to complications of unsafe abortion. Complications of unsafe abortion, among others, as described in the book Facts of Life are:
A. Sudden death due to severe bleeding
2. Sudden death due to anesthesia failed
3. A slow death due to serious infection around the womb
4. A torn uterus (Uterine Perforation)
5. Damage to the cervix (Cervical Lacerations) which will cause defects in subsequent children
6. Breast cancer (due to an imbalance of estrogen in women)
7. Ovarian cancer (Ovarian Cancer)
8. Cervical cancer (Cervical Cancer)
9. Liver cancer (Liver Cancer)
10. Abnormalities in placental / umbilical cord (Placenta Previa) which will lead to subsequent defects in children and severe bleeding during pregnancy
11. Become infertile / unable to have children again (ectopic pregnancy)
12. Pelvic infection (Pelvic Inflammatory Disease)
13. Infection of the lining of the uterus (endometriosis)
Besides abortion can also cause mental disorders in adolescents is a sense of guilt, feeling lost self-esteem, personality disorders such as screaming, bad dream many times, can even lead to suicidal behavior trials.
2.1.4.4. Drug abuse
Stands for the narcotic drug, alcohol, psychotropic and other addictive substances. Examples of these drugs are addictive drugs: opioids, alcohol, ecstasy, marijuana, morphine, heroin, codeine, and others. If these substances enter the body will affect the central nervous system. The influence of these substances is a decrease or change of consciousness, loss of pain, addiction, pleasure and comfort is exceptional and other influences. The use of this drug on reproductive health at risk because of drug use will affect the increase in free sex. Injecting drug users also increases the risk of HIV / AIDS because the HIV virus can be transmitted by needles used interchangeably.
2.1.4.5. Influence of mass media
The mass media, both print and electronic have a significant role to provide information about the health of adolescent reproductive health in particular. Given the articles made in the mass media, young people will find things to do and avoid in order to maintain their reproductive health.
2.1.4.6. Access to reproductive health services
Health services also play a role in providing preventive and curative measures. Health services can be carried out in health centers, hospitals, clinics, posyandu, and other places are possible. With easy access to health services, youth can conduct consultations on health, especially reproductive health and knowing the correct information about reproductive health. Teens also can take action if the juvenile treatment was already getting the problems associated with their reproductive organs such as sexually transmitted diseases.
2.1.4.7. Harmonious relationships with family
Closeness with both parents is an influential with adolescent behavior. Teens can share with parents about problems they experienced rejuvenation. The family is the most early education place for a child before she get an education elsewhere. Teens also can get correct information from their parents about proper behavior and good morals in life. In the family as well, teenagers can learn the things that need to be done and to be avoided. Parents also can provide early information about reproductive health care for a teenager.
2.1.4.8. Sexually Transmitted Diseases
Sexually transmitted disease is a disease that is transmitted primarily through sexual contact. Mode of transmission is not just limited to the genital-genital, but can also be oro-genital, or ano-genital. So the disorder arising from venereal disease is not confined to the genital area, but also in extra genital areas. Sexually transmitted diseases can also occur in other ways that direct contact with tools such as towels, clothing, thermometers and others. Besides sexually transmitted diseases can also be transmitted by mothers to their babies while in the womb.
Sexually transmitted diseases are common in Indonesia include: gonorrhea, bacterial vaginosis, herpes simplex, trichomoniasis, syphilis, lymphogranuloma venerium, mole ulcer, granuloma inguinale, and Acquired immune deficiency syndrome (AIDS).
2.2 Knowledge
Before someone new act, he must know in advance what the meaning or behavior benefits for himself or his family. Knowledge is the result of the idea, and this occurred after the conduct of a particular object sensing. Knowledge or cognitive domain is very important in shaping a person's actions (overt behavior). According to Rogers (1974) in Notoatmodjo (2003), before the new one's behavior (adopting the behavior), in the person's place within a sequential process, among others:
A. Consciousness (Awareness), the person is aware in the sense of knowing the stimulus (object) in advance
2. Interest, which the person became interested in the stimulus
3. Evaluation, namely whether or not the person is considering a stimulus for him
4. Trial, people began to try new behaviors
5. Adoption, the subject has to behave in accordance with the knowledge, awareness, and his attitude toward the stimulus.
Measurement of knowledge can be measured by interview or by using a questionnaire measuring instruments or questionnaires that ask about the content of the material to be measured from the research subjects or respondents (Notoadmojo, 2007).
Conclusion
Physical growth at adolescence on the mark with some of the indicators. Breast growth in young women (3-8 years), growth of pubic hair / genitalia (8 -14 years), body growth (9.5 to 14.5 years) menarche / menstruation (10-16 years old, sometimes 7 yrs), the growth of underarm hair (2 years after pubic hair), and sweat glands produce oil (equal to the growth of underarm hair). Whereas in men the mark with the growth of the testes (10 - 13.5 years), growth of pubic hair / genitalia (10-15 years), body enlargement (10.5 - 16 years), penis enlargement (11 to 14.5 years), voice changes due to the growth of the vocal cords (Same with penis enlargement).
Teens need to get the correct information about reproductive health to adolescents know the things that should be done and the things that should be avoided. Adolescents have the right to obtain correct information about reproductive health and the information must come from a trusted source. In order for teens to get the right information, adolescent reproductive health should be taught in schools and within the family. The things taught in the curriculum include adolescent reproductive health education about adolescent growth and development, reproductive organs, risk behaviors, sexually transmitted diseases (STDs), and abstinesia as pregnancy prevention, Knowing about adolescent reproductive health is true, we can avoid the negative things done by teenagers. Education on adolescent reproductive health is useful for adolescent health, particularly for preventing premarital sexual behavior, transmission of sexually transmitted diseases, abortion, cervical cancer, pregnancy outside marriage, the moral gradation, and the bleak future of the youth.
Bibliography
Sarwono, S.W. Of 2000. Adolescent psychology. London: King Grafindo Persada.
Sulaeman, D. Of 1995. Adolescent psychology: Dimensions Perkembangan.Bandung: Mandar CV Maju.
Alatas, Alwi. , 2005. (For) 13 +, Teens Can Also Be Happy, Successful, Independent. New York: Plume.
Background
Youth, full of colorful world. Maybe that's the right word to describe that so many colors that will adorn fese adolescents. Elah we understand together bahwasannya fese adolescents is the phase where we find an identity that will mencadi days of adult characters, or commonly known as adolescence is the formation of character (character building). Then surely we must know and be familiar with this phase, a phase which is very influential on subsequent days of our lives, namely the phase and older adults.
In addition to the phase formation of character, the adolescent phase is also referred to as phase transitions, where the phase change between the children grow up through the transition phase that adolescent phase. In the adolescent phase of this many changes, both physically and psychologically. One very prominent in these changes are physical changes.
Most change was first felt by adolescents is a physical change. Puberty occurs is a gradual process of change in the internal and external body of the children become adults. Sex hormones including hormone changes make teenagers become comfortable with themselves and also once so often too focused on his physical condition. For example: teenagers so often look in the mirror only to see pimples or bangs, so too upset with her body shape, and so forth.
In adolescence is characterized by rapid physical growth. Physical conditions in adolescence is seen as an important thing, but when the physical state does not correspond to expectations (the discrepancy between body image with self picture) can cause a sense of dissatisfaction and lack of confidence. Likewise, a disproportionate physical development. Reproductive maturity in adolescence requires effort gratification and if not guided by the norms of behavior can lead to sexual deviation. Maturity of the reproductive organs is also sometimes not immediately accepted by adolescents. Sometimes they are afraid when they first experienced the changes that occur in fisiknnya. For example, many teens are afraid when they first menstruation.
Reproductive health system change must be understood by each of the teens. This is done to understand the ramaja bahwasannya such changes must be balanced with reproductive health itself. This is done so that every teenager to avoid venereal disease, and not stuck to the free sex.
Then as a student who may have passed or are still in the adolescent phase we must know and understand the changes that occur in the adolescent phase, especially in the phase that we can hang the youth about reproductive health and physical changes that young people are not afraid of change in fisiknnya and young people understand the importance of maintaining the reproductive organs and the dangers that occur in reproductive akaibat sexual perversions.
CHAPTER II
DISCUSSION
A. Physical Development in Adolescents
1.1 Definition of
Most change was first felt by adolescents is a physical change. Puberty occurs is a gradual process of change in the internal and external body of the children become adults. Sex hormones including hormone changes make teenagers become comfortable with themselves and also once so often too focused on his physical condition. For example: teenagers so often look in the mirror only to see pimples or bangs, so too upset with her body shape, and so forth.
In adolescence is characterized by rapid physical growth. Physical conditions in adolescence is seen as an important thing, but when the physical state does not correspond to expectations (the discrepancy between body image with self picture) can cause a sense of dissatisfaction and lack of confidence. Likewise, a disproportionate physical development. Reproductive maturity in adolescence requires effort gratification and if not guided by the norms of behavior can lead to sexual deviation.
Development or growth of juvenile limbs, as stated by Monks et al. (1994), sometimes faster than the development of the body. Therefore, for a time, a teenager has a disproportionate body proportions. This will lead to a deep inner rage because at this stage, adolescents are very big concern for her appearance. So the teenager himself is one of the appraisers that are important to the body itself as a social stimulus. When the teens understand the body has met the requirements, as expected by their social environment, then this will be a boost to the self-assessment.
In general, physical changes in adolescence as follows:
1.2 Women
• Breast Growth (3-8 years)
• Growth of pubic hair / genitalia (8 -14 years)
• Growth in weight (9.5 to 14.5 years)
• menarche / menstruation (10-16 years old, sometimes 7 yrs)
• The growth of underarm hair (2 years after pubic hair)
• produce oil and sweat glands (together with the growth of underarm hair)
1.3 Men
• The growth of the testes (10 - 13.5 years)
• Growth of pubic hair / genitalia (10-15 years)
• Enlargement of the body (10.5 - 16 years)
• penis enlargement (11 - 14.5 years)
• Changes in voice due to vocal cord growth (Same with penis enlargement)
• The growth of facial hair and armpit (2 years after pubic hair)
• produce oil and sweat glands (Same with the growth of underarm hair)
Most teens are not able to receive physical condition. This is evident from the appearance of youth who tend to imitate the appearance of another person or a particular character. For example, the Ani-white skin does not feel like a movie star, then Ani will exert every effort to whiten the skin. Ani such behavior would cause problems for themselves and others. Maybe Annie will always refuse when invited to a party by a friend so that over time Ani has no friends, and so forth.
2.1. Adolescent Reproductive Health
2.1.1. Understanding Adolescent Reproductive Health
According to the WHO's reproductive health is a state of physical, mental and social guidance, not just freedom from disease or disability in all aspects related to the reproductive system, its functions and processes. Or a situation where people can enjoy their sex life and be able to perform the function and reproductive processes in a healthy and safe. Another understanding of reproductive health in the International Conference on Population and Development, the reproductive health is a state of physical well-being, mental and social guidance in all matters relating to the functions, roles and reproductive systems. Adolescent reproductive health is a health condition related to the system, reproductive functions and processes owned by a teenager. Healthy sense here is not merely mean disease-free or free from disability but also mentally as well as socio-cultural (Fauzi., 2008).
2.1.2. Adolescent
2.1.2.1. Understanding Adolescents
Adolescents are generally defined as those who experienced the transition from childhood to adulthood. According to the World Health Organization (WHO), adolescence (Adolescence) are those aged 10-19 years. While in other terms the UN says young people (youth) for those aged 15-24 years. These are then incorporated into a term of youth (young people), which covers 10-24 years. Meanwhile, the BKKBN program mentioned that the youth are those aged between 10-24 years. According to Hurlock (1993), adolescence is a time filled with shock, the level of search for identity and is the most severe period. According Bisri (1995), adolescents are those who have left the childhood full of dependency and towards the establishment of responsibility.
2.1.2.2. Changes that occur in adolescence
The changes that occur when a child enters adolescence, among others, can be viewed from three dimensions a biological dimension, the dimension of cognitive and social dimensions.
a. Biological dimensions
By the time a child enters puberty is marked by the first menstruation in girls or boys wet dream, he was biologically a very big change. Puberty makes a child has the ability to air-reproduction.
At the time of puberty, girls will have a period, as a sign that the reproductive system is active. In addition there are also physical changes such as the breasts start to develop, hips started to grow, acne and grow hair on the pubic area. The boy began to show changes in the voice, growth of whiskers, Adam's apple, the genitals become larger, bigger muscles, acne and other physical changes. Their physical form is changed rapidly since the beginning of puberty and will bring them to the world of teenagers.
b. Cognitive Dimensions
Cognitive development, adolescents in the view of Jean Piaget (2007) (an expert on cognitive development) is the highest in the last period and the growth stage of formal operations (period of formal operations). In this period, ideally the teens already have the mindset of their own in an attempt to solve complex problems and abstract. Adolescents develop thinking skills so that they can easily imagine many alternative solutions to problems and their possible consequences or results. Capacity to think logically and abstract them so that they are able to develop multi-dimensional thinking like a scientist. The youth no longer receive information as it is, but they will process information and adapt it to their own thinking. They are also able to integrate past and present experience to be transformed into conclusions, predictions, and plans for the future.
c. Moral Dimensions
Adolescence is a period when one starts to wonder about the various phenomena that occur in the surrounding environment as the basis for the formation of their self-worth. The teens began to make its own judgment in the face of popular issues relating to their environment, such as: political, humanitarian, war, social circumstances, and so forth. Teens no longer accept the idea of a rigid, simple, and absolutely given to them during this without rebuttal. Adolescents begin to question the validity of the idea that there are more alternatives and other considerations. Critically, many teens will be out observing and comparing it with the things that had been taught and instilled him.
2.1.3. Anatomy and Function of Reproductive Organs
2.1.3.1. Woman
Divided into the female reproductive organs outside the reproductive organs and reproductive organs inside.
The outside of the reproductive organs:
A. Vulva, the area outside of the female genital organs including the labia majora, labia minora, mons pubis, bulbus vestibuli, vestibule vaginae, major and minor vestibular glands, and orificium vaginae.
2. Labia majora, which form two rounded folds of fatty tissue covered with skin and extends downward and backward from the mons pubis.
3. Mons pubis, which contains the fat pads are located on the anterior surface of the symphysis pubis. After puberty, the skin will be covered by the mons pubis curly hair that forms a particular pattern.
4. Breast / mammary gland organ that is useful for feeding.
Reproductive organs inside:
A. Labia minora, which is the inner labia of the labia majora, and ending with the clitoris, is identical to the penis during the period of fetal development which then undergoes atrophy. In the center there is a hole clitoris urethra to discharge urine only.
2. Hymen, which is a thin membrane elasticity varies regularly perforated in the middle, the outside world as a separator with internal organs. Hymen will disappear after a woman was torn and intercourse (coitus) or after delivery.
3. Vagina, which formed as a circular elongated tube composed of circular muscles in there kanankirinya gland (Bartolini) produces a lubricating fluid when sexual activity.
4. The uterus (womb), which is an organ shaped like fruit peer, the lower shrink and end up as the neck of the womb / cervix uteri. The uterus consists of a thick muscle layer as a place of conception, fetal development. On the inner wall of the uterus is always peel after menstruation.
5. Tuba uterine (fallopian), the channel on the left and right of the uterus, as the passage of the egg / ovum.
6. Ovary, which is the egg-producing organs and produce the hormones estrogen and progesterone. Organ consists of 2 pieces.
Organ function:
The reproductive organs begin to function as first menstruation at the age of 10-14 years and very varied. At that time, began to affect the pituitary gland and the ovaries start to work producing hormones estrogen and progesterone. This hormone will affect the inner wall of the uterus and menstruation occurs. Every month during the fertile period, ovulation occurs with resultant egg / ovum to be released into the uterus through the uterine tubes. The production of this hormone only lasts until menopause, then do not produce themselves. Mammary glands are also affected by this hormone so that the breast will be enlarged.
2.1.3.2. Man
Male genitalia are also divided into male genitals outside and inside of the male genitalia.
The outside of the reproductive organs:
A. Penis, which is elliptical reproductive organs changed in size during sexual activity. The inside of the penis contains blood vessels, muscle and nerve fibers. At its center there is a channel for urine and semen are also called the urethra.
2. Scrotum, which is an organ that looks from the outside is round, there are 2 pieces left and right, a shriveled skin and covered with pubic hair.
Reproductive organs inside:
A. Testis, which is the contents of the scrotum, totaling 2 pieces, consisting of small channels form a braid, as the formation of sperm cells.
2. Vas deferens, which is a channel that carries sperm cells, amounted to 2 pieces.
3. Prostate gland, which is a gland that produces a thick fluid that nourish sperm cells and produce enzymes.
4. Seminal vesicle gland, which is the gland that produces fluid for the life of sperm cells, together with spermatozoa liquid is fused into a product called cement, which is issued every time a man ejaculates.
Organ function:
These organs begin to function as a reproductive system during puberty begins around age 11 -14 years. Activities are regulated by the organs are:
A. Discharge of semen or seminal fluid was first. This went on for life. 2. Testis organ that produces sperm cells will work after obtaining the effect of testosterone produced by Leydig cells in the interstitial.
2.1.4. Factors affecting the reproductive health of adolescents
Adolescent reproductive health is influenced by several things: the tools genital hygiene, access to health education, premarital sexual relations, sexually transmitted diseases (STDs), the influence of mass media, access to affordable reproductive health services, and a harmonious relationship between adolescents with family.
2.1.4.1. Cleanliness of the genital organs
Adolescent reproductive health is determined by how the teenager was in caring for and maintaining genital hygiene tools. When reproductive organs moist and wet, then the acidity increases and it facilitates the growth of fungi. Adolescent girls are more susceptible to genital infection if not maintain genital hygiene tools for vaginal organ that is located close to the anus.
2.1.4.2. Access to health education
Teens need to get the correct information about reproductive health to adolescents know the things that should be done and the things that should be avoided. Adolescents have the right to obtain correct information about reproductive health and the information must come from a trusted source. In order for teens to get the right information, adolescent reproductive health should be taught in schools and within the family. The things taught in the curriculum include adolescent reproductive health education about adolescent growth and development, reproductive organs, risk behaviors, sexually transmitted diseases (STDs), and abstinesia as pregnancy prevention, Knowing about adolescent reproductive health is true, we can avoid the negative things done by teenagers. Education on adolescent reproductive health is useful for adolescent health, particularly for preventing premarital sexual behavior, transmission of sexually transmitted diseases, abortion, cervical cancer, pregnancy outside marriage, the moral gradation, and the bleak future of the youth.
2.1.4.3. Premarital sexual relations
Pregnancy and childbirth carry risks of morbidity and mortality is greater in adolescents than in women aged over 20 years. Young women who are younger than 18 years have 2 to 5 times the risk of death compared with women aged 18-25 years old and due to stalled labor, bleeding, and other factors. Emergencies associated with pregnancy are also common in teenagers who are pregnant, for example, hypertension and anemia that adversely affect the body in general.
Unwanted pregnancy in teenagers often end in abortion. Many surveys have been conducted in developing countries showed that nearly 60% of pregnancies in women under 20 years is an unwanted pregnancy or any time (mistimed). Induced abortion are often at greater risk in young women than in those who are older. Many studies have been conducted also showed that the mortality and morbidity often occur due to complications of unsafe abortion. Complications of unsafe abortion, among others, as described in the book Facts of Life are:
A. Sudden death due to severe bleeding
2. Sudden death due to anesthesia failed
3. A slow death due to serious infection around the womb
4. A torn uterus (Uterine Perforation)
5. Damage to the cervix (Cervical Lacerations) which will cause defects in subsequent children
6. Breast cancer (due to an imbalance of estrogen in women)
7. Ovarian cancer (Ovarian Cancer)
8. Cervical cancer (Cervical Cancer)
9. Liver cancer (Liver Cancer)
10. Abnormalities in placental / umbilical cord (Placenta Previa) which will lead to subsequent defects in children and severe bleeding during pregnancy
11. Become infertile / unable to have children again (ectopic pregnancy)
12. Pelvic infection (Pelvic Inflammatory Disease)
13. Infection of the lining of the uterus (endometriosis)
Besides abortion can also cause mental disorders in adolescents is a sense of guilt, feeling lost self-esteem, personality disorders such as screaming, bad dream many times, can even lead to suicidal behavior trials.
2.1.4.4. Drug abuse
Stands for the narcotic drug, alcohol, psychotropic and other addictive substances. Examples of these drugs are addictive drugs: opioids, alcohol, ecstasy, marijuana, morphine, heroin, codeine, and others. If these substances enter the body will affect the central nervous system. The influence of these substances is a decrease or change of consciousness, loss of pain, addiction, pleasure and comfort is exceptional and other influences. The use of this drug on reproductive health at risk because of drug use will affect the increase in free sex. Injecting drug users also increases the risk of HIV / AIDS because the HIV virus can be transmitted by needles used interchangeably.
2.1.4.5. Influence of mass media
The mass media, both print and electronic have a significant role to provide information about the health of adolescent reproductive health in particular. Given the articles made in the mass media, young people will find things to do and avoid in order to maintain their reproductive health.
2.1.4.6. Access to reproductive health services
Health services also play a role in providing preventive and curative measures. Health services can be carried out in health centers, hospitals, clinics, posyandu, and other places are possible. With easy access to health services, youth can conduct consultations on health, especially reproductive health and knowing the correct information about reproductive health. Teens also can take action if the juvenile treatment was already getting the problems associated with their reproductive organs such as sexually transmitted diseases.
2.1.4.7. Harmonious relationships with family
Closeness with both parents is an influential with adolescent behavior. Teens can share with parents about problems they experienced rejuvenation. The family is the most early education place for a child before she get an education elsewhere. Teens also can get correct information from their parents about proper behavior and good morals in life. In the family as well, teenagers can learn the things that need to be done and to be avoided. Parents also can provide early information about reproductive health care for a teenager.
2.1.4.8. Sexually Transmitted Diseases
Sexually transmitted disease is a disease that is transmitted primarily through sexual contact. Mode of transmission is not just limited to the genital-genital, but can also be oro-genital, or ano-genital. So the disorder arising from venereal disease is not confined to the genital area, but also in extra genital areas. Sexually transmitted diseases can also occur in other ways that direct contact with tools such as towels, clothing, thermometers and others. Besides sexually transmitted diseases can also be transmitted by mothers to their babies while in the womb.
Sexually transmitted diseases are common in Indonesia include: gonorrhea, bacterial vaginosis, herpes simplex, trichomoniasis, syphilis, lymphogranuloma venerium, mole ulcer, granuloma inguinale, and Acquired immune deficiency syndrome (AIDS).
2.2 Knowledge
Before someone new act, he must know in advance what the meaning or behavior benefits for himself or his family. Knowledge is the result of the idea, and this occurred after the conduct of a particular object sensing. Knowledge or cognitive domain is very important in shaping a person's actions (overt behavior). According to Rogers (1974) in Notoatmodjo (2003), before the new one's behavior (adopting the behavior), in the person's place within a sequential process, among others:
A. Consciousness (Awareness), the person is aware in the sense of knowing the stimulus (object) in advance
2. Interest, which the person became interested in the stimulus
3. Evaluation, namely whether or not the person is considering a stimulus for him
4. Trial, people began to try new behaviors
5. Adoption, the subject has to behave in accordance with the knowledge, awareness, and his attitude toward the stimulus.
Measurement of knowledge can be measured by interview or by using a questionnaire measuring instruments or questionnaires that ask about the content of the material to be measured from the research subjects or respondents (Notoadmojo, 2007).
Conclusion
Physical growth at adolescence on the mark with some of the indicators. Breast growth in young women (3-8 years), growth of pubic hair / genitalia (8 -14 years), body growth (9.5 to 14.5 years) menarche / menstruation (10-16 years old, sometimes 7 yrs), the growth of underarm hair (2 years after pubic hair), and sweat glands produce oil (equal to the growth of underarm hair). Whereas in men the mark with the growth of the testes (10 - 13.5 years), growth of pubic hair / genitalia (10-15 years), body enlargement (10.5 - 16 years), penis enlargement (11 to 14.5 years), voice changes due to the growth of the vocal cords (Same with penis enlargement).
Teens need to get the correct information about reproductive health to adolescents know the things that should be done and the things that should be avoided. Adolescents have the right to obtain correct information about reproductive health and the information must come from a trusted source. In order for teens to get the right information, adolescent reproductive health should be taught in schools and within the family. The things taught in the curriculum include adolescent reproductive health education about adolescent growth and development, reproductive organs, risk behaviors, sexually transmitted diseases (STDs), and abstinesia as pregnancy prevention, Knowing about adolescent reproductive health is true, we can avoid the negative things done by teenagers. Education on adolescent reproductive health is useful for adolescent health, particularly for preventing premarital sexual behavior, transmission of sexually transmitted diseases, abortion, cervical cancer, pregnancy outside marriage, the moral gradation, and the bleak future of the youth.
Bibliography
Sarwono, S.W. Of 2000. Adolescent psychology. London: King Grafindo Persada.
Sulaeman, D. Of 1995. Adolescent psychology: Dimensions Perkembangan.Bandung: Mandar CV Maju.
Alatas, Alwi. , 2005. (For) 13 +, Teens Can Also Be Happy, Successful, Independent. New York: Plume.
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