Document Type : Original Article

Authors

1 School of Nursing, University of Connecticut, Storrs, CT, USA

2 School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran

Abstract

BACKGROUND: Adolescent girls experience physical, psychological, and social changes during
puberty. Lack of sufficient information, skills, and readiness to overcome this stressful situation make
them vulnerable. The present study aims to assess the level of knowledge, attitude, and strategy
used for coping with puberty crises of female secondary school students in Karaj, Iran.
MATERIALS AND METHODS: Five‑hundred and seventy female secondary school students from
Karaj, Iran participated in this cross‑sectional study. Knowledge, attitudes, and coping strategies of
adolescents about puberty were evaluated using various questionnaires. The obtained data were
analyzed using Chi‑square, Fisher’s exact, Kruskal–Wallis, Mann–Whitney, and Spearman tests.
RESULTS: The average age of participants was 15.28 ± 1.58 years old. About 85.1% of the
participants had high knowledge about puberty and 66.7% had a good attitude toward it. Nearly, 54.2%
of the girls used the avoidance‑oriented coping strategy. There was no significant relationship between
knowledge and attitude regarding selective strategies to cope with stressful situations in puberty.
CONCLUSION: According to the results, continuous training in secondary schools is necessary to
improve adolescents’ knowledge and attitudes toward puberty. Moreover, more training is required
to change the dominant avoidance‑oriented coping strategy to a task‑oriented approach, especially
at the first‑grade level in secondary school.

Keywords

1. Kipke, Michele D. Adolescent Development and the Biology of
Puberty: Summary of a Workshop on New Research. National
Academy Press, 2101 Constitution Ave., NW, Washington, DC
20418, 1999.
2. World Health Organization. Adolescent Health. World Health
Organization; 2013. Available from: http://www.who.int/
topics/adolescenthealth/en/. [Last accessed on 2017 Feb 04].
3. Anthony, David. The state of the world’s children 2011‑adolescence:
an age of opportunity. United Nations Children’s Fund (UNICEF),
2011.
4. Nourolahi T, Ghaemi Z, Moazzami Goodarzi H. The Technical
Report of 2011 National Census of Population and Housing
Statistical Center of Iran. Published by Technical Design and
Statistical Methods Research Group; 2013. Available from: http://
www.amar.org.ir/Portals/1/Files/technical%20report‑%20
with%20cover.pdf. [Last accessed on 2016 Dec 07].
5. Parvizy S, Ahmadi F. Nikbakht A. An identity‑based model for
adolescent health in the Islamic Republic of Iran: a qualitative
study. Payesh 2003; 2(4):245‑252.
6. Alimordi Z, Simbar M. Puberty health education for Iranian
adolescent girls: Challenges and priorities to design school‑based
interventions for mothers and daughters. Payesh 2014;13:621‑36.
7. Amidi MM, Ghofranipour F, Anooshe M. Home town of
elementary school girls. J Health Health 2005;1:1‑6.
8. Sandhya P, Bimala P. Awareness and attitude on pubertal changes
among community adolescents. Int J Caring Sci 2017;10:1255.
9. Moodi M, Zamanipour N, Sharifirad GR, Shahnazi H. Evaluating
puberty health program effect on knowledge increase among
female intermediate and high school students in Birjand, Iran.
J Educ Health Promot 2013;2:57.
10. Balali Meibodi F, Mahmodi M, Hasani M. Knowledge and practice
of Kerman primary secondary school girls on menstrual health
in the academic year of 2008‑2009. Dena 2009;4:53‑62.
11. Faramarzi S, Abedi MR, Karimi M. The relationship between
coping styles and adolescents’ depression. Res Cogn Behav Sci
2013‑2014;3:17‑26.
12. Kadivar P, Eslami A, Farahani MN. Examine the relationship
between family structure and interactions of coping with stress
and gender differences in college students. J Psychol Educ Sci
2005;34:123‑97.
13. Huli PR. Stress management in adolescence. J Res Hum Soc Sci
2014;2:50‑7.
14. Raheel H. Coping strategies for stress used by adolescent girls in
Riyadh, Kingdom of Saudi Arabia. Pak J Med Sci 2014;30:958‑62.
15. Karekla M, Panayiotou G. Coping and experiential avoidance:
Unique or overlapping constructs? J Behav Ther Exp Psychiatry
2011;42:163‑70.
16. Hockenberry MJ, Wilson D, Rodgers CC. Wong’s Essentials of
Pediatric Nursing‑E‑Book; 2016.
17. Khalili SH, Bakhtiyari A. A psychological approach to girls’
maturity. Womens Soc Cult Council Q 2008;11:197‑218.
18. Grey M, Boland EA, Davidson M, Yu C, Tamborlane WV. Coping
skills training for youths with diabetes on intensive therapy. Appl
Nurs Res 1999;12:3‑12.
19. Mokari H, KheirkhahM, Neissani L. Impact of health education on
self‑esteem in adolescents during puberty. Nurs Res 2013;8:57‑47.
20. Xu W, Sun G, Lin Z, Chen M, Yang B, Chen H, et al. Knowledge,
attitude, and behavior in patients with atrial fibrillation
undergoing radiofrequency catheter ablation. J Interv Card
Electrophysiol 2010;28:199‑207.
21. Liu L, Liu YP, Wang J, An LW, Jiao JM. Use of a
knowledge‑attitude‑behaviour education programme for Chinese
adults undergoing maintenance haemodialysis: Randomized
controlled trial. J Int Med Res 2016;44:557‑68.
22. Majlessi F, Rahimi A, Mahmoudi M, Hosseinzadeh P. The impact
of lecture and educational package methods in knowledge and
attitude of teenage girls on puberty health. Hormozgan Medical
Journal 2012; 15 (4) 327‑332.
23. Ghoreyshi Rad F. Validation of Endler and Parker coping scale
of stressful situations. Olome Tarbiyati 2010;1:1‑7.
24. Endler NS, Parker JD. Multidimensional assessment of coping:
A critical evaluation. J Pers Soc Psychol 1990;58:844‑54.
25. Endler NS, Parker JD. Coping Inventory for Stressful
Situations (CISS): Manual. 2nd ed. Toronto: Multi‑Health Systems;
1999.
26. Endler SJ. The Validity of the CISS: Predicted Coping Strategies
for Two Coping Scales, Task and Emotion. Toronto: Multi‑Health
Systems; 1998.
27. RaniM, Sheoran P, KumarY, Singh N. Evaluating the effectiveness
of pubertal preparedness program in terms of knowledge and
attitude regarding pubertal changes among pre‑adolescent girls.
J Family Reprod Health 2016;10:122‑8.
28. Olfati F, Aligholi S. A study on educational needs of teenager girls
regarding to reproductive health and determination of proper
strategies in achieving the target goals in Qazvin. J Qazvin Univ
Med Sci 2008;12:76‑82.
29. Alavi M, Poshneh K, Khosravi A. Puberty health: Knowledge,
attitude and practice of the adolescent girls in Tehran, Iran. Payesh
2009;8:59‑65.
30. Sedighi Sabet M, Hasavary F, Sayed Fazel F. Knowledge, attitudes
and behavior in adolescent female students. J Med Guilan Univ
Med Sci 2003;12:31‑7.
31. Najafi F, Mozafari S, Mirzaee S. Assessment of 3rd grade junior
school girl students’ knowledge and attitude toward puberty age
sanitation. J Guilan Univ Med Sci 2012;21:22‑8.
32. Naisi N, Aivazi AA, Hoseiny Rad M, Direkvand Moghadam A,
Pournajaf A. Knowledge, attitude and performance of K‑9 girl
students of Ilam city toward puberty health in 2013‑14. J Ilam Univ Med Sci 2016;24:28‑34.
33. Afshari P, Pazhohideh SZ, Javadnoori M, Mohamadi S, Hatami Z,
Tabesh H. The knowledge of Iranian high school girls about needs
of puberty and menstruation. J Res Health Soc 2016;6:205‑12.
34. Simbar M, Alizadeh SH, Hajifoghaha M, Golezar S. Review
of Iranian adolescents’ educational needs for sexual and
reproductive health. J Isfahan Med Sch 2017;34:1563‑72.
35. Kazemi Z. The effect of family variables information rate of
guidance school female students about maturity health. J Fam
Res 2012;8:319‑35.
36. Abdollahi F, Shabankhni B, Khani S. Assessment of educational
needs of hygen of puberty in elementary school girls in
Mazandaran. J Mazandaran Univ Med Sci 2003;14:56‑63.
37. Malekshahi F, Farhadi A. Knowledge, attitude and practice of
high school girls about menstrual hygiene. Q Lorestan Univ Med
Sci 2005;8:73‑8.
38. Bafekri KH, Taghavi T, Seyedfatemi N, Movaghari M. The
effects of group discussion‑based education on coping skills in
stressful situations among high schools students. Iran J Nurs Res
2017;12:1‑7.
39. Hojjatkhah SM, Asgari S, Feizollahi J. The relationship styles of
coping styles with tendency towards delinquency in adolescent
boys. Crime Prev Stud Q 2013;8:145‑64.
40. Akbari Kamrani M, Farid M. Chronological age and puberty
coping strategy among Iranian adolescent females. Int J Sch Health
2017;4:1‑6.
41. Afsari A, Valizadeh R, Abbasnezhad M, Rizehvandi P, Fatahi S.
Predictors of knowledge and practice of girl students about
puberty health. Biosci Biotech Res Commun 2017;10:264‑9.
42. Sajjadi M, Moshki M, Abasnezhad A, Bahri N. Educational needs
of fathers about boys puberty period and its related factors.
Zahedan J Res Med Sci 2012;14:66‑70.
43. Kashefi F, Nasiry ZG, Bavandi H, Aliakbari R, Akaberi A,
Sharafi A. Knowledge and performance about menstrual hygiene
in high school students in Bojnourd. J North Khorasan Univ Med
Sci 2013;5:989‑96.