Relationship of Knowledge, Attitude and Behavior Care Hygiene

Organ External Genitalia with Vaginal Discharge at SMK Al-Jihad

Schoolgirl Jakarta 2020

Restu Dinda Khairunnisa and Nur Asiah

Public Health Program, Faculty of Health Sciences, University of Muhammadiyah Prof. Dr. Hamka, Jakarta, Indonesia

Keyword: Vaginal Discharge, Knowledge, Attitude, Behavior.

Abstract: Indonesia is a country with warm weather, so mushrooms are easy to live. resulting in high cases of vaginal

discharge for women in Indonesia, as many as 90% of women experience vaginal discharge. In Ari

Komariah's research in 2018 at SMAN 1 Tambelang Bekasi as many as 43 students experienced vaginal

discharge around 53.8% has low knowledge about the care of external genital organs. Based on a preliminary

study conducted by researchers at SMK Al-Jihad Jakarta, it was found that 70% female students experienced

pathological vaginal discharge and were wrong in how to maintain the cleanliness of the external genitalia.

The purpose of this study was to determine the relationship between knowledge, attitudes and behavior in

maintaining the cleanliness of external genital organs with the incidence of pathological vaginal discharge in

students of SMK Al-Jihad Jakarta. This research uses quantitative methods with a cross sectional research

design . This research was conducted at SMK Al-Jihad Jakarta in 2020. The population in this study were all

students of SMK Al-Jihad Jakarta, as many as 238 students. The sampling technique was Proportional

Stratified Random Sampling, which consisted of 85 students. Data collection with Google forms. Data

analysis carried out in this study was univariate analysis and bivariate analysis. Univariate results showed that

respondents experienced pathological vaginal discharge (24.7%). Then the results of the bivariate variables

that showed a significant relationship with the incidence of pathological vaginal discharge were knowledge

( P-Value 0.000) and behavior ( P-Value 0.047).

1 INTRODUCTION

Decree of the Minister of Health No. 97 of 2015

adolescent reproductive health is included in one of

the 2015 Sustainable Development Goals (SDGs)

goal 5, namely, ensuring gender equality and

empowering all women as approved by the Program

of Action of the International Conference on

Population and Development and the Beijing

Platform for Action (Purwaningrum, 2017). Poor

female reproductive health problems have reached

33% of the total burden of disease suffered by women

in the world, one of which is vaginal discharge (Oriza

& Yulianty, 2018).

According to a World Health Study, adolescents

around the world experience sexually transmitted

infections, which is as much as 5% accompanied by

vaginal discharge. Indonesia is a country with warm

weather, so mushrooms live easily. resulting in high

cases of vaginal discharge for women in Indonesia, as

many as 90% of women experience vaginal discharge

(Abrori et al., 2017). Women aged 15-24 years will

face vaginal discharge around 31.8%, so that

adolescents have a greater risk of facing pathological

vaginal discharge (Azizah, 2015).

According to a study conducted by the World

Health Organization, women in the world do not pay

attention to hygiene and do not know about

reproductive health problems, resulting in

infections

the genital organs of 100 million women, around 10-

15% of women who experience candida bacterial

infections and experience vaginal discharge (Abrori

et al., 2017).

The case of vaginal discharge in Indonesia is

increasing. Based on the results of the study, it was

stated that in 2010, 52% of women in Indonesia

experienced vaginal discharge, then in 2011, 60% of

women had experienced vaginal discharge, while in

2012 almost 70% of women in Indonesia had

experienced vaginal discharge, and in 2013 from

January to August almost 55% of women have

Khairunnisa, R. and Asiah, N.

Relationship of Knowledge, Attitude and Behavior Care Hygiene Organ External Genitalia with Vaginal Discharge at SMK Al-Jihad Schoolgirl Jakarta 2020.

DOI: 10.5220/0010757600003235

In Proceedings of the 3rd International Conference on Social Determinants of Health (ICSDH 2021), pages 151-155

ISBN: 978-989-758-542-5

151

experienced vaginal discharge, then in 2017 around

76.5% of women had experienced vaginal discharge

(Darma et al., 2017).

Based on the results of Annisa Nurhayati's

research in 2013 in the Pondok Cabe Ilir area, as

many as 73 female students experienced pathological

vaginal discharge around 56.2% (Nurhayati, 2013).

While on Study of Nur Fadilah rahma in 2017 on

students of SMAs / MA in PPM Rahmatul Asri

Enrekang obtained 46 students experiencing

abnormal discharge approximately 71.9% (Rahmah,

2017). Then in Ari Komariah's research in 2018 at

SMAN 1 Tambelang Bekasi as many as 43 students

experienced vaginal discharge around 53.8% this was

due to low knowledge about the care of external

genital organs (Komariah & Widaningsih, 2018).

From several research results, the authors can

conclude that it is important to maintain the

cleanliness of the external genital organs in

adolescent girls.

Based on a preliminary study conducted by

researchers, all students of Al-Jihad Vocational

School experienced vaginal discharge but did not

know about the problem of vaginal discharge, they

also had never received reproductive health education

and had never received counseling on adolescent

reproductive health, especially regarding the

treatment of external genital organs. So from 10

students of SMK Al-Jihad Jakarta, 7 students (70%)

experienced pathological vaginal discharge and said it

was important to maintain the cleanliness of their

external genital organs but they were wrong in how

to keep the external genital organs clean, among

others, using tight underwear, cleaning the female

area from the Anal canal forward, not copying the

shame every 4 hours in a day when menstrual

bleeding is heavy, not shaving pubic hair once a

month, not drying the vaginal area when urinating

and defecating and 3 (30%) of the female students

experienced physiological vaginal discharge and said

it was important in maintaining the cleanliness of the

external genitalia but not correct in how to clean it.

From this description, the researcher is interested

in knowing the relationship between knowledge,

attitudes and behavior in maintaining the cleanliness

of the external genital organs with the incidence of

pathological vaginal discharge in Al-Jihad Jakarta

Vocational High School students in 2020.

2 RESEARCH METHODS

This research is a quantitative research with a cross-

sectional research design. This research conducted

from September 2019 to June 2020. The source of

data collection in this study is primary data, using

questionnaires and google forms as research tools.

The population of this study were all 238 female

students of SMK Al-Jihad, North Jakarta.

Determination of the sample size in this study was

determined by proportional random sampling with a

sample of 85 students of SMK Al-Jihad Jakarta. After

the samples in each class were taken

proportionally,

took into

account the considerations of the elements

in the research population, then the collection

continued by random choice, namely the sampling

technique by drawing each group to be used as

research samples.

3 RESEARCH RESULTS

3.1 Univariate Analysis

Table 1: Results of univariate analysis of relationship

knowledge, attitude and behavior of the external genitalia

Organ Care Cleanliness By Vaginal discharge.

Variable n

Whitish Occurrence

(

)

64 75.3

Knowledge (High) 55 64.7

Attitude (Negative ) 49 57.6

Behavior (Good) 52 61.2

3.2 Bivariate Analysis

Table 2: Results of Bivariate Analysis of the Relationship

of Knowledge, Attitude and Behavior of Maintaining

External Genitalia Organ Hygiene with Vaginal Discharge

in Al-Jihad Vocational High School Jakarta Students in

2020.

Independent

Variable

Pathological

Vaginal

Discharge

PR (95%

CI)

Value

Yes No

Knowledge

4,583

(1,987-

10,571)

Low 50.0% 50.0% 0.000

High 10.9% 89.1%

Attitude

0,808

(0,385-

1,695)

Negative 22.4% 77.6% 0.574

Positive 27.8% 72.2%

Behavio

2,101

(0,996-

4,431)

0.047

Bad 36.4% 63.6%

Good 17.3% 82.7%

ICSDH 2021 - International Conference on Social Determinants of Health

152

3.3 Knowledge

Based on the table above, it shows the distribution of

respondents in Al-Jihad Vocational School Jakarta in

2020. In the low knowledge group, 50.0%

experienced pathological vaginal discharge. In the

high knowledge group, 10.9% experienced

pathological vaginal discharge. The results of the Chi

square test showed that there was a significant

relationship between the knowledge of students in

maintaining external genital hygiene and the

incidence of pathological vaginal discharge (P- value

<0.05). The results of the calculation of the

prevalence ratio (PR) stated that respondents with

low knowledge had a 4.583 times greater chance of

experiencing pathological vaginal discharge than

respondents with high knowledge (95% CI 1.987-

10.571).

3.4 Attitude

Based on the table above, it shows the distribution of

respondents at Al-Jihad Vocational School Jakarta in

2020. In the group with negative attitudes towards

maintaining the cleanliness of the external genital

organs, as many as 22.4% experienced pathological

vaginal discharge. In the positive attitude group,

27.8% experienced pathological vaginal discharge.

The results of Chi square show that there is no

significant relationship between the attitude of the

respondents in maintaining the cleanliness of the

external genital organs with the incidence of

pathological vaginal discharge (P- value> 0.05). The

results of the calculation of the prevalence ratio (PR)

stated that respondents with a negative attitude had a

0.808 times greater chance of experiencing

pathological vaginal discharge than respondents with

a positive attitude (95% CI 0.385- 1.695).

3.5 Behavior

Based on the table above, it shows the distribution of

respondents in Al-Jihad Vocational School Jakarta in

2020. In the bad behavior group, 36.4% they

experienced pathological vaginal discharge. In the

good behavior group, 17.3% experienced

pathological vaginal discharge. The results of Chi

square show that there is a significant relationship

between the behavior of the respondents in

maintaining the cleanliness of the external genital

organs with the incidence of pathological vaginal

discharge (P-value <0.05). The results of the

calculation of the prevalence ratio (PR) stated that

respondents with bad behavior had a 2,101 times

greater chance of experiencing pathological vaginal

discharge than respondents with good behavior (95%

CI 0.996-4.431).

4 DISCUSSION

Every research is inseparable from the limitations and

w e a k n e s s e s o f t h e s t u d y . T h e l i m i t a t i o n s o f t h i s s t u d y

among others:

1. The type of research used is a cross sectional

design, namely the independent variable and the

dependent variable are studied at the same time,

so they cannot find a causal relationship and can

only show interest or relationships between

variables.

2. This data collection uses Google forms is

subjective. So the truth of the data in this study is

very dependent on the honesty of the respondents.

3. Determination of the incidence of pathological

vaginal discharge is not a definite diagnosis

because the data is based on Google forms. Then

in order to make a definite diagnosis, it is should

be carried out with supporting examinations such

as macroscopic and microscopic.

4.1 Pathological Vaginal Discharge

Based on research has been done on Students at SMK

Al-Jihad Jakarta in 2020, found that there were 21

respondents (24.7%) who experience vaginal

discharge pathological and 64 respondents (75.3%)

had no pathological vaginal discharge. Adolescents

around the world experience sexually transmitted

infections as much as 5% accompanied by vaginal

discharge. Indonesia is a country with warm weather,

so mushrooms live easily resulting in high cases of

vaginal discharge for women in Indonesia, as many

as 90% of women experience vaginal discharge.

From the results of the study, it was found that 21

respondents (24.7%) experienced vaginal discharge

accompanied by itching, odor, experienced changes in

the color of the vaginal discharge such as

yellowish/greenish/brown. Chances are pathological

vaginal discharge. This figure is still quite high

considering the attitude of maintaining the cleanliness

of the external genital organs, the majority of which

are in the negative category. This is because the

knowledge they have is not the same as their attitude

and behavior. Attitude is a person's belief in the

object and has a certain feeling to choose. Factors that

influence attitudes towards the object of attitude

include: personal experience, the influence of others,

Relationship of Knowledge, Attitude and Behavior Care Hygiene Organ External Genitalia with Vaginal Discharge at SMK Al-Jihad

Schoolgirl Jakarta 2020

153

educational institutions and religious institutions,

mass media, cultural and emotional. Attitudes can

change according to the situation.

This study is in line with a research conducted by

Yuniati on FKIK students majoring in nursing at UIN

Alauddin Makasar in 2015 which stated that as many

as 27 respondents (21.8%) experienced pathological

vaginal discharge and 97 respondents (78.2%) did not

experience pathological vaginal discharge. However,

there are studies that are not in line with this study that

there are 73 respondents (56.2%) experiencing

abnormal vaginal discharge while 57 respondents

(48.3%) experiencing normal vaginal discharge

(Fallis, 2013).

Table 3: Pathological At SMK Al-Jihad School girl Jakarta

2020.

Variable n

Whitish Occurrence (No) 64 75.3

Knowledge (High) 55 64.7

Attitude (Negative ) 49 57.6

Behavior (Good) 52 61.2

The table above shows that respondents who did not

experience vaginal discharge were 75.3 %,

respondents who had high knowledge about

maintaining the cleanliness of external genital organs

64.7 %) respondents who had a negative attitude

towards maintaining the cleanliness of the genital

organs external as many as 57.6% and respondents

who have good behavior on the sanitation of the

external genitalia organs is 61.2 %.

4.2 Knowledge

Based on the results of research that has been

conducted on students at SMK Al-Jihad Jakarta in

2020, it shows that respondents who have low

knowledge are 35.3%. This study is in line with other

studies which found that respondents with low

knowledge were 4.8%, while those with high

knowledge were 95.2% (Yunianti, 2015). The results

of the bivariate analysis showed a p-value of 0.000,

there was a significant relationship between

knowledge and the incidence of pathological vaginal

discharge. With a PR value of 4.583 (95% CI 1.987-

10.571), this means that respondents with low

knowledge are 4.583 times more at risk than

respondents with high knowledge.

This study is in line

with other studies which say that

there is a relationship

between knowledge and the incidence of pathological

vaginal discharge with a p-value of 0.002 (Yunianti,

2015).

This shows that although adolescents have high

knowledge, they experience vaginal discharge this is

due to their negative attitude in protecting the genital

organs as a result of lack of understanding, because

knowing does not necessarily understand. Purwanto

(2010) states that knowledge alone has not become a

driving force, as is the case with attitude, knowledge

of a new object becomes an attitude if that knowledge

is accompanied by readiness and awareness to act in

accordance with knowledge of the object.

4.3 Attitude

Based on the results of research that has been carried

out on students at Al-Jihad Vocational School Jakarta

in 2020, it shows that respondents who have a

negative attitude are 57.6%. This study is in line with

other studies which found that respondents

who had a

negative attitude were 53.8%, while those

who had a

positive attitude were 46.2% (Fallis, 2013).

The results of the bivariate analysis obtained a p-

value of 0.574, which means that there is no

significant relationship between attitudes and the

incidence of pathological vaginal discharge. With a

PR value of 0.808 (95% CI 0.385-1.695) this means

that respondents who have a negative attitude are

0.808 times more at risk than respondents who have

positive attitude. The same study in other studies

found that there was no relationship between attitude

and the incidence of pathological vaginal discharge

with a p-value of 0.806 (Fallis, 2013).

Attitudes are not only obtained from high

knowledge, they can also be obtained from age,

education and economy which ultimately lead to

inappropriate attitudes.

4.4 Behavior

Based on the results of the study, which was carried

out on students at Al-Jihad Vocational School

Jakarta

in 2020, it showed that 38.8% of respondents

who had

bad behavior. This study is in line with other studies

which found that respondents who had bad behavior

were 40.7%, while those who had good behavior

were 59.3% (Adawiyah, 2015).

The results of the bivariate analysis showed a p-

value of 0.047, there was a significant relationship

between behavior and the incidence of pathological

vaginal discharge. With a PR value of 2.101 (95% CI

0.996-4.431) this means that respondents who have

bad behavior are 2.101 times more at risk than

respondents who have good behavior. The research is

the same with other studies that shows there is a

relationship between behavior and the incidence of

ICSDH 2021 - International Conference on Social Determinants of Health

154

pathological vaginal discharge with a p-value of 0.007

(Adawiyah, 2015).

Behavior is a human response based on

experience or a person's reaction to external stimuli

then accompanied by human interaction in the form

of knowledge, attitudes and actions. Respondents

have high knowledge but some things have not been

practiced well. This can happen due to a lack of

motivation to practice the knowledge that the

respondent knows. In addition, there are several

factors that can influence this behavior, such as public

trust, socioeconomic level, availability of health

facilities and infrastructure for the community, such

as clean water.

5 CONCLUSIONS

Based on the results of research on "Relationship of

Knowledge, Attitude and Behavior Care Hygiene

Organ external genitalia with Vaginal Discharge at

SMK Al-Jihad Schoolgirl Jakarta 2020" it can be

concluded that:

1. As many as 24.7% of Al-Jihad Jakarta

Vocational School students experienced

pathological vaginal discharge.

2. There is a significant relationship between

knowledge of maintaining cleanliness of external

genital organs and the incidence of pathological

vaginal discharge at SMK Al-Jihad Jakarta in

2020 (P-value 0.000).

3. There is no significant relationship between the

attitude of maintaining the cleanliness of the

external genital organs with the incidence of

pathological vaginal discharge at SMK Al-Jihad

Jakarta in 2020 (P-value 0.574).

4. There is a significant relationship between the

behavior of maintaining the cleanliness of the

external genital organs with the incidence of

pathological vaginal discharge at SMK Al-Jihad

Jakarta in 2020 (P-value 0.047).

6 RECOMMENDATION

It is necessary to provide information on how to

maintain good and correct hygiene of the

reproductive organs to young women and be given

encouragement to actively seek information about

reproductive health. For further research, it is

necessary to establish a diagnosis of vaginal

discharge based on clinical features and supporting

examinations to determine physiological or

pathological vaginal discharge with a wider variety of

characteristics and a wider location, so as to add more

accurate information.

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