ANALYSIS HEALTH REPRODUCTIVE KNOWLEDGE TOWARD ATTITUDE PREMENSTRUAL SYNDROME IN ADOLESCENT

Knowledge of adolescents in Indonesia about reproductive health is still very low. As example menstruation as the puberty of women. Boys who know menstruation are around 37% (20-24 years) and 32% (15-19 years). While girls around 78% (20-24 years) and 75% (15-19 years). The research method used was a non-experimental study with a cross-sectional design. The population in this study were junior high school students, who had menstruated as many as 46 children. The sampling technique uses purposive sampling where the researcher determines the sampling by determining the special characteristics of the randomly chosen sample selection that has been menstruating by the Guidance Counseling teacher that are class VII and VIII then analyzing the data using the Spearman Rank test. The results of the study using the Spearman rank test showed a significance of 0,000 (p = 0,000 <0.01) so that there is a relationship between reproductive health knowledge with attitudes toward premenstrual syndrome in adolescents at Prambanan junior High School.


Introduction
The adolescent phase is a phase of growth and development with the characteristics that are important changes in cognitive function, behavior, social, and emotional according to biological development, as well as the existence of new functions and demands in the family and social environment.
The transition from childhood to adolescence is known as puberty. Clinically puberty is characterized by the appearance of secondary abnormalities and ends if there is already the ability to reproduce. Important events in puberty are rapid physical growth, secondary sex characteristics, menarche, and psychological changes (Wiknjosastro, 2009).
Changes that indicate that adolescents have entered the stage of maturity of the sexual organs with the growth of secondary sex organs. The growth of secondary sex organs can be marked by breast enlargement, growth of armpit hair and genitals, the presence of pimples, stinging body odor, enlarged hips and also begin to develop several vital organs that are ready to be fertilized (Manuaba, 2010) Many women experience physical and emotional health problems during the luteal phase of the menstrual cycle. Symptoms include lethargy, irritability, bad mood, changes in eating patterns, body looks swollen, acne appears, breast pain, and insomnia. More than 70% of women in the world experience menstrual symptoms every year. The exact cause is not yet known, but the instability of the hormones estrogen and progesterone and neurobiological factors is believed to play an important role in the symptoms of pre-menstrual syndrome. Pre-menstruation syndrome is felt by more than 50% of productive women. Pre-menstruation syndrome is influenced by many other factors such as biological factors (length of the menstrual cycle, pregnancy), psychology, daily lifestyle (diet, exercise, use of oral contraceptives, smoking, alcohol), reproductive history (breastfeeding infants, age of menarche, previous pregnancy history), and socioeconomic (marriage, race, busyness, work). (Plinta, Drosdzol & Nowosielski, 2010).
Reproductive health is an important issue to get attention especially among adolescents. In adolescence, psychological and sexual growth began to develop rapidly. Adolescents who will later become parents should have good reproductive organ health so they can produce a healthy generation. In the community, both parents and adolescents themselves should be more open about health issues, especially reproductive health (Proverawati, 2009 Adolescents knowledge about reproductive health in Indonesia is still very low. As an example of adolescent knowledge of menstruation as a feature of puberty for women. Boys who know menstruation are around 37% (20-24 years) and 32% (15-19 years). While girls are around 78% (20-24 years) and 75% (15-19 years) (BKKBN, 2010).
Lack of knowledge about the characteristics of reproduction, can cause teens to have risky behavior. In general, girls' knowledge of pregnancy risk is higher than boys. But knowledge of this risk is still relatively low, at around 50%, even teenagers with an elementary school education of around 30%. Adolescent knowledge of the risk of pregnancy increases along with increasing of educational background (BKKBN, 2010).
Lack of knowledge about reproductive health in adolescents reflects the lack of knowledge of the risks that related to their bodies and how to avoid them (Pinem, 2009). One of the problems that are often found in adolescents is disorder before menstruation. About 80% to 95% of girl between 16 and 45 years experience symptoms of pre-menstrual syndrome (Wijaya, 2008).
Other evidence of adolescent ignorance about reproductive health can be seen from the many questions about reproductive organs, sexual behavior during courtship, sexually transmitted infections (STIs), unwanted pregnancy, contraception, sexual harassment, homosexuals until self-confidence issues (Ngestiningrum, 2010).
The survey reported, in the United States in 1980-1982 found cases of 50% of women who suffer from severe symptoms of pre-menstrual syndrome. A survey of women in France reported that approximately 38% of women suffer from premenstrual syndrome (Head, 2007). While a study on high school students in Indonesia was found 75.8%, that premenstrual syndrome is experienced in many types of menstrual disorders (Sianipar et al, 2010).
Based on the results of research on adolescent attitudes in dealing with pre-menstrual syndrome generally shows that 53% of female students are included in the sufficient category, while the attitudes of adolescents in dealing with pre-menstrual syndrome are in the good category as much as 46%, this shows that most of the female students have an attitude in dealing with sufficient premenstrual syndrome. (Nia, 2017).
Information about menstruation as well as about female reproductive organs needs to be taught early on every girls. Provision of information can be carried out with a variety of methods to provide knowledge to adolescents about reproductive health, in this case knowledge of pre-menstrual syndrome, is expected to be conducive to improving knowledge, attitudes and behaviors of healthy and responsible sexual lives in adolescents (Widyastuti, 2009) Researchers conducted research at Prambanan Junior High School because the level of students' knowledge about reproductive health and preparedness attitude in facing pre-menstruation syndrome was very lacking because the majority of students from junior high schools from rural areas were far from cities so information about health was lacking.
Based on a preliminary study on 12 December 2018 from interviews in Prambanan Junior High School through Counseling Guidance Teachers, researchers got supporting data on reproductive health knowledge and attitudes toward pre-menstruation syndrome among Prambanan Junior High School students that in class VII and VIII students still lack understanding of the importance of reproductive health and attitude to deal with pre-menstruation syndrome.
Based on the background above, the researchers are interested in conducting research on "The relationship of knowledge about reproductive health to attitudes toward pre-menstrual syndrome in adolescents at Prambanan Junior High School".

Research Methods
Researchers used a non-experimental research method with cross sectional design. The source population in this study is 46 junior high school students who have menstruated. The sampling technique uses purposive sampling where the researcher determines the sampling by determining the special characteristics of random sample selection which have been menstruating by the Guidance Counseling teacher that are class VII and VIII then analyzing the data using the Spearman Rank test with p <0.01. Based on the results of the study, there is a relation of reproductive health knowledge toward attitudes facing pre-menstrual syndrome, with a significance value on the results showed (p = 0,000 <0.01).

Results And Discussion
Where there are 3 respondents with enough knowledge but good attitude, and there are 22 respondents with enough knowledge and enough attitude.
The results showed that there were 20 respondents aged 13 years (43.5%) and 14 years there were 26 people (56.5%). As stated by Wawan and Dewi (2011) Saying that as one gets older so one's knowledge also updates the mindset that is also developing. According to Siahaan (2008), the results of the study show that there is a relationship between knowledge and attitudes and behaviors about reproductive health. According to Wiknjosastro (2010), women who have a good psychoemosional balance assume that menstruation is normal, it is not easy to suffer from pre-menstrual syndrome. Conversely, psychoneurotic women who regard menstruation as a disorder, are more likely to show excessive symptoms.Based on the theories supporting the results of previous studies and research, the researchers opinion that the higher the knowledge about reproductive health the better the attitude to face the premenstrual syndrome.

Conclusion
The level of reproductive health knowledge of the Class VII and VIII students of Prambanan Junior High School was mostly included in the category of Enough knowledge level as many as 25 female students and the attitude of class VII and VIII students facing premenstrual syndrome is mostly included in the category of Enough are 27 female students. There is a significant relationship between the level of knowledge of reproductive health with the attitude of facing premenstrual syndrome in Prambanan Middle School students with p = 0,000 <0.0.