KNOWLEDGE ADOLESCENT GIRLS ABOUT VAGINAL DISCHARGE

Vaginal discharge is a reproductive health problem that occurs in most adolescence girls at school. Adolescence girls don't know that if they experience vaginal discharge, the symptoms heal on their own and are not a serious condition. The aim is to find out the knowledge of adolescence girls about vaginal discharge at SMPN 1 Wates. The design uses descriptive with a sample of 30 respondents, the inclusion criteria are adolescence gils aged 12-14 years who have their first menstruation and have vaginal discharge problems. The sampling technique was purposive sampling with questionnaire data collection instruments. Data was taken at SMPN 1 Wates in January-February 2021. The results showed that the knowledge of adolescent girls about vaginal discharge was in the good category as much as 77.5%, in the sufficient category as much as 16.5% and in the poor category as much as 6.2%. It is hoped that health workers will routinely provide health education and youth will actively increase their knowledge through various available media.


INTRODUCTION
Adolescence is a period of transition in life that begins to view oneself based on personal judgments and standards to find self-identity. Adolescence is a period of rapid growth and development, both physically, psychologically, and intellectually. One of the most prominent physical changes in adolescence is the reproductive organs. Adolescents will experience rapid physical growth to reach maturity, including their reproductive organs so that they are able to carry out their reproductive functions, such as the appearance of primary and secondary sex characteristics (Ningsih, Susila & Safitri, 2022). Reproductive health is a state of the absence of disease or disability related to the reproductive function and system. Its scope includes the handling and prevention of sexually transmitted diseases; adolescent reproductive health; premarital sex; prevention of abortion; early detection of cancer; or other reproductive problems. The most frequent problem which is often experienced by adolescents is vaginal discharge (Ningsih, Susila & Safitri, 2022) Vaginal discharge is the excessive discharge of fluid other than blood from the vagina, whether smelly or not, and is accompanied by itching. Normal vaginal discharge (physiological) is influenced by certain hormones, while abnormal vaginal discharge is associated with all genital infections (infections of the labia, vaginal opening, cervix, uterus, and sexually transmitted infections). Vaginal discharge is not a disease, yet it is a symptom of a disease. Therefore, its causes must be revealed (Sim, Logan & Goh, 2020).
As reported by WHO (2018), around 75% of women worldwide have experienced vaginal discharge. It is estimated that 1 in 20 adolescents in the world experience vaginal discharge every year. Since Indonesia is a tropical country, 90% of Indonesian women have the potential to experience vaginal discharge. Adolescents between the ages of 15 and 24 account for 31.8% of cases of vaginal discharge in Indonesia (Prabawati, Maryani & Meilani, 2020).
Vaginal discharge often occurs in adolescent girls. Besides being very disturbing, vaginal discharge can also cause complications in the reproductive organs (Komariyah, Sucipto & Izah, 2016;Spence & Melville (2007). Therefore, it is important for women, especially adolescent girls, to know everything related to vaginal discharge (Spence & Melville, 2007). To avoid serious complications of vaginal discharge, treatments should be carried out as early as possible, such as good personal hygiene and external genital care (Komariyah, Sucipto, Izah, 2016;Mitchell, 2004).
Nowadays, many adolescent girls are not well informed about vaginal discharge, so they think of vaginal discharge as a common and trivial thing. Besides, a sense of shame when experiencing vaginal discharge often makes women or adolescents reluctant to consult a doctor. In fact, vaginal discharge should not be considered trivial because its consequences are very fatal if handled too late, such as causing infertility and ectopic pregnancy. Vaginal discharge can also be an early symptom of cervical cancer, which can lead to death if it is not consulted early on with health experts (Ilmiawati & Kuntoro, 2016).
Based on a preliminary study conducted at SMP 1 Wates, it was found that out of 183 female students, 97 experienced vaginal discharge. At first, these adolescent girls did not know that what they were experiencing was a symptom of vaginal discharge. They thought that the symptoms were not a severe condition and would heal on their own. This case is supported by a study by Maysaroh & Mariza (2021). which discovered that 36% of respondents had less knowledge about vaginal discharge.
Adolescent girls who have less knowledge about vaginal discharge will not care about maintaining their reproductive organs. In addition, the lack of knowledge also affects the attitudes and behaviors of adolescents in carrying out a clean and healthy lifestyle (Susila & Kastar, 2020). Therefore, adolescent girls with vaginal discharge must be more vigilant and careful regarding the vaginal discharge they 3 experience. They have to get information from health experts about vaginal discharge and the importance of maintaining the cleanliness of the vagina in order to avoid vaginal discharge. Adolescent girls should also often seek information (by reading books or browsing through the internet about vaginal discharge) to avoid diseases caused by vaginal discharge (Maysaroh & Mariza, 2021;Susila & Kastar, 2020). Based on the background, the researchers are interested in investigating the knowledge of adolescent girls (aged 12-14 years) about vaginal discharge.

METHOD
This study applied a descriptive research design. The population in this study were students of SMPN 1 Wates, with a sample of 30 respondents. They were adolescent girls aged 12-14 years who had their first menstruation. The sampling technique applied was purposive sampling. The data were collected between January 27 and February 13, 2021, under the research permit number: UM.01.05/3.5/228/2021. The key instrument for collecting the data was a questionnaire, which consisted of 12 questions. In filling out this questionnaire, a correct answer was given 1 point, and an incorrect answer was given 0 points. The questionnaire consisted of 2 parts, namely general data and specific data. General data included the identity of the respondent, such as name (initials), age, and gender. Specific data covered the definition, causes, signs, symptoms, and prevention of vaginal discharge. The collected data were then organized and descriptively analyzed before being presented in tables.  Knowledge is the result of 'knowing' and it appears after people have sensed a certain object. Sensing of objects occurs through the five human senses, namely sight, hearing, smell, taste, and touch. The process of sensing and producing knowledge is strongly influenced by the intensity of attention and perception of an object. Humans obtain most of their knowledge through their eyes and ears (Notoatmodjo, 2012). 77.5% of the respondents had good knowledge of vaginal discharge, which is indicated by 14 respondents being able to answer all the questions correctly. This good knowledge is possibly influenced by age, education, and sources of information. Age affects a person's perception and mindset. When people get older, their grasping power and mindset will develop. As a result, the knowledge they gain is getting better. This is in accordance with the result of a study showing that 63.3% of the respondents aged 14 years of age, who were potentially in a developmental period centering on the acceptance of physical condition, used their bodies effectively to achieve emotional independence and develop intellectual abilities that are indispensable in playing an active role in society. In addition, at the age of 14, there is a tendency to stay curious, so that adolescents will spend more time reading, which will ultimately improve intellectual abilities, problem-solving skills, and verbal abilities (Agustriyana & Suwanto, 2017;Christie & Viner, 2005;Batubara, 2010) Good knowledge is also likely to be influenced by education. Education affects a person's perspective on the new information and influences a person's behavior to do something better. Education helps someone absorb and understand knowledge so that he/she will become more knowledgeable (Notoatmodjo, 2012). This is in line with the result of a study showing that 89.8% of the respondents, who were grade VIII students, were able to absorb the information more straightforwardly to expand their knowledge. Formal education will further explore and provide access to information about vaginal discharge, thereby enabling better knowledge of it.

RESULTS
Another factor that may have an effect is the source of information. This can be seen from the result of the study, which showed that 89.8% of the respondents had received information about vaginal discharge. Sources of information obtained by adolescent girls contribute to increasing the knowledge, attitudes and practices of young women regarding health reproductive especially vaginal discharge. Repeated information, clear messages, and focus on a single object will form new opinions for the formation of knowledge (Hodgson, Lindsay, Rubini, 2007;Rakhmilla et al, 2016). Reinforced by good information will have a positive effect on knowledge, attitudes and practices. Kontras with wrong information will have a negative effect on attitudes and practices regarding health of reproductive (Rakhmilla et al, 2016).
The repeated information leads individuals to receive a variety of information continuously and integrate all the information to form knowledge, skills, and attitudes that ultimately shape behavior (Notoatmodjo, 2012). Knowledge is one of the basic and predisposing factors for changing one's behavior. This knowledge is considered as an important attribute of a person's behavioral description and higher knowledge is associated with higher levels of positive behavior (Geraee et al, 2015). Expanding knowledge can be done by providing health education either individually or publicly. Continuous media exposure can significantly increase knowledge. Media exposure can be through radio, television, health education, employment and wealth (Mutumba, 2022). This is evident in a study, which revealed that 43% of the respondent received information about vaginal discharge from health experts. Rachmawati (2014) also suggested that providing health education through the lecture method was able to increase the knowledge of SMK 3 Blitar students about free sex.
At SMPN 1 Wates, 16.3% of the respondents had moderate knowledge of vaginal discharge because 3 respondents had previously received information about vaginal discharge especially from family or friends and 2 respondents barely received information about it. Information obtained from family or friends may only be obtained once or twice so that it does not increase knowledge of the respondent's, it is different if the information is obtained from the mass media or the internet which can be read or viewed repeatedly which will eventually form an idea or new opinions and influence someone to act according to the information obtained so that it ultimately increases of the knowledge (Geraee et al, 2015;Hodgson et al, 2007). Whereas 2 people who never received any information so they answered the questions according to had experienced and known. As a result, they were unable to correctly answer the questions. 6.2% of the respondents with less knowledge about vaginal discharge also never received any information about vaginal discharge and never have experienced vaginal discharge so the knowledge is less regarding vaginal discharge, which resulted in their inability to answer the questions.

CONCLUSION
The knowledge of the students of SMPN 1 Wates is good because the respondents entered the age of teenagers who have the ability to capture and develop a mindset so that it is easier to capture and receiving information. Meanwhile, the students have enough and lack of knowledge about vaginal discharge because respondents never get information about vaginal discharge so it is possible not to be able to answer the questions that given.