m.syafiqi

7/31/2019 M.Syafiqi

http://slidepdf.com/reader/full/msyafiqi 1/21

Health Promotion of The

Adolescence and Family

Muhammad Syafiqi A M

School of Nursing

Health Science Faculty

University of Muhammadiyah at Surakarta

March 12, 2012

7/31/2019 M.Syafiqi


Introduction

Adolescent is a period of transition betweenchildhood and adulthood, a time of profoundbiologic, intellectual, psychosocial, and economicchange.

This period individuals reach physical and sexualmaturity, develop more sophisticated reasoningabilities, and make educational and occupationaldecisions that will shape their adult careers.

Adolescence involves three distinct subphases :

early adolescence (ages 11 to 14), middleadolescence (ages 15 to 17), and lateadolescence (age 18 to 20).

7/31/2019 M.Syafiqi


Biologic Development

Neuroendocrine Events of puberty : Puberty involves a predictable sequence of hormonal and

physical changes that occur universally over a defined

period of time.

The events of puberty are triggered by hormonalinfluences and are controlled by the anterior pituitary

gland in response to a stimulus from the hypothalamus.

Hormone production such us : GnRH by hypothalamus, it

stimulates pituitary gland secretion of LH and FSH

7/31/2019 M.Syafiqi


Hormones

For femalesFSH stimulates growth of ovarian follicle, andproduction of estrogen. LH initiate ovulation, theformation of corpusluteum, and progesterone

production. For males

LH acts on testicular leydig cells, promptingmaturation of the testicle and testosterone

production. FSH acts with LH, stimulates spermproduction.

7/31/2019 M.Syafiqi


Change in Reproductive Hormones

Females• Menstruation (release of an egg, or ovum from ovaries

approximately 28 days).

• In early puberty, FSH stimulates estrogen production,

however concentration of estrogen don’t reach levels highenough to cause ovulation

• In mid puberty, the body produces estrogen in large

amounts that results in lining endometrial of the uterus

(first mens). One ovarian become dominant during each

menstruation cycle and increases the estrogen amount

during early cycle(follicular phases).

• The follicle then release ovum (ovulation process)

7/31/2019 M.Syafiqi


• By direct action, estrogen cause growth and

development of the vagina, uterus, and fallopian tubes.

The skin of labiamajora, as well as the breast areola and

nipples, grows and darkens under influences of

estrogen.

•Estrogen also responsible for breast enlargement andpromotes growth of pubis, axillary hair, and widening

of hip.

• At low levels estrogen tend to stimulate skeletal growth

in both boys and girls, but higher levels it inhibits

growth

7/31/2019 M.Syafiqi


Change in Reproductive Hormones Males

• Development of viable sperm. During puberty, FSH acts on testicular

cells, stimulating viable sperm production.

• FSH and LH, resulting in increased testosterone production. The

production of viable sperm tends to follow boys first ejaculation.

• The capacity to ejaculate appears relatively early in boys sexual

development, approximately 1 year after initial testicular enlargement

and the appearance of pubic hair.

• Testosterone and other androgens have direct impact on growth of the

penis, scrotum, prostate and seminal vesicles of the testicles. And also

result increases in muscle mass, skeletal growth, bone age and bone

density.

• In both sexes androgen responsible for development pubic, axillary,

facial, and body hair . Clinically increased activity of androgen is

associated with pubertal condition such us, acne, body odor,

deepening voice, spurt in height, and increased re blood cells levels

7/31/2019 M.Syafiqi


Hypothalamus

Anterior pituitary

Gonads

FSH +LH

GNRH

Estrogen,

Progesterone

Testosterone

Estrogen

(female)

Testosterone

(male)

Maturation and

Release ovum

Primary and

secondary sexcharacteristic

Spermatogenesis

7/31/2019 M.Syafiqi


Sexual Maturation

Girls

Appearance growth and development of pubis hair, breast

development, and increasing of normal vagina discharge,

associated with uterine development.

Girls or the parents may be concerned that this vaginal

discharge is sign of infection. The nurse ca reassure themthat the discharge is normal and sign that uterus prepare

of the menstruation.

• Late puberty is the first menstrual period (menarche).

Initial menstrual period are usually scanty and irregularand may not be accompanied by ovulation.

7/31/2019 M.Syafiqi


• Ovulation and regular menstruation periodusually begin 6 to 14 month after menarche.

•

Menarche occur about 2 years after theappearance of breast buds approximately monthafter attainment of peak height and velocity, and3 month after attainment of peak weight velocity.

• Sexual maturation influences young peoplesatisfaction with their appearance but the effectappear to differ for girls and boys.

• Health promotion efforts related to pubertalgrowth, eating behavior, and body image areimportant for adolescence, especially earlymaturing girl.

7/31/2019 M.Syafiqi


Sexual Maturation in Boys

• The first pubescent change in boys are testicular

enlargement with thinning, reddening, and increasinglooseness of the scrotum. (9,5 and 14 years of age)

• The initial change appearance growth anddevelopment of pubic hair, penile and testicularenlargement. This period boys will undergo increasingmuscularity, voice changes and dev of facial hair. Alsofunctioning of genital will affect the ejaculation inpuberty.

• Ejaculation may occur spontaneously as nocturnal

emissions or wet dreams

• Health care professional can be resource for boysand provide appropriate information, and guidannce.

7/31/2019 M.Syafiqi


Cognitive DevelopmentEmergence of Formal Operational Thought

• The sift from childhood to adolescence as amovement from concrete to formal operationalthought

• For most young people emergence of formaloperational thinking occurs between ages of 11 and

14. formal operational thought includes being be ableto think in abstract terms, possibilities, think troughhypothese.

• Hypothetical reasoning is aligned with thinkingpossibilities and allows adolescent to systematicallygenerate alternative possibility. And explanation andto compare what actually observe and possiblebelieve

7/31/2019 M.Syafiqi


Adolescence conceptions of self

• Adolescence be able to integrate these disparate

observations of self into abstract personalcharacterizations.

• Being able to think about one’s own thoughts andemotion can lead to periods of extreme self absorption.(cent egocentrism)

• Imaginary audience

involves having heightened sense of self consciousness that an adolescent imagine everyonenotice and focused on his or her behavior

• Thinking, called the personal fable, is the belief thatone’s feelings and experiences are completely unique,or that one is all knowing or invulnerable.

7/31/2019 M.Syafiqi


Development of value autonomy

• Advance in cognitive development, adolescence

belief become more abstract and increasingly

root in general ideologic principles.

• The adolescence will face with many conflict and

should compare the advice from friends, teacher

or parents.

• They have to make decision point that can be

accepted in their environment. Adolescencebegin to substitute a set of values distinct from

those significant adults in their live.

7/31/2019 M.Syafiqi


Body Image• Characteristics of personality boys or girls

manifested during childhood usually remainstable in the teenage years.

• The adolescence become more difficult becauseof the psychologic changes of adolescence andneed to assert independence.

• Have sensitive response with act or influencerelated to negative characteristic or weakness.

• The nurse role may be to inform parents of different personality types and to help thesupport the teens uniqueness

providing necessary structure and feedback

7/31/2019 M.Syafiqi


Gender Identity• These relationship become the basis for identity

formation and generally a period of stress or crisisbefore strong identity can emerge

• The adolescence increasingly leaves the home baseand establishes close ties with peers

• The adolescence try out new sport or skills,experimenting with alcohol, wearing different style of clothing and etc, related with their environment.

• Start realizing the duties and role of boys and girl inhome or school. Also adolescence start have love andconsideration feeling with their groups or friend.

• Privacy should be ensured during the taking of healthhistories or intervention with teens,

7/31/2019 M.Syafiqi


Social Development

• The social environment provides opportunity,

barriers, role models, and support individuals

development.

• System within the social are family, peers,

schools and community. All contribute

uniquely to an adolescence health and

development

7/31/2019 M.Syafiqi


Family

Parent have a big role when the adolescence startnew all change of physical and psychological.

Close communication and attention to

adolescence as helping process the adolescence

find their identity.

Adolescence prefer spend their time in no home

to do new things. The health professional may

give promotion to parents so that always observeand teach the adolescence.

7/31/2019 M.Syafiqi


Peers

• Belief and make relationship with close friend

and trust each other are usual behavior if the

adolescence entrance new environment.

• Adolescence can decide the choices of

relation with friend.

7/31/2019 M.Syafiqi


• Remaja masih mencari role models untuk

membentuk kedewasaan

• Coping related choose the good role models

7/31/2019 M.Syafiqi


Thank You

Wasslamu’alaikum Wr.wb

m.syafiqi

Documents