Factores psicosociales y psicoeducativos que afectan el embarazo en adolescentes en el municipio de La Romana
Author(s)Cruz Díaz, Melvin
Contributor(s)Cerviño Vázquez, Consuelo
Tomás Miguel, José Manuel
Departament de Metodologia de les Ciències del Comportament
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AbstractAbstract. At present, despite the few sexual and reproductive health prevention strategies in adolescents, the pregnancy rate in these countries is increasing in the countries that make up the Latin American and Caribbean region. In the year 2014, WHO registered a total of 1.5 million children born to adolescent mothers, of which the majority were concentrated in Africa and Latin America. Of the 1.5 million teenagers who have their children every year in the world, most of them range between the ages of 12 and 15. Approximately 60% of this population that reaches the world as children of adolescents will increase the situation of poverty and 65% is the product of an unwanted pregnancy (WHO, S.S.P. 2014). According to WHO reports, 50 million abortions are registered in the world in a year of which 4.2 million are in Latin American women. The reports coordinated by Tactuk (2014) in the Health Demographic Survey published by ENDESA-Dominicana, tells us that 23.3% of adolescents were ever pregnant (with at least one child born alive), or were pregnant at the time of the survey (ENDESA Dominicana, 2014). These figures are similar to those shown by ENDESA (Tactuk, 2008). As for age, there is an increase in the proportion between the ages of 15 and 19 years. In the 15-year group, 8.1% of adolescents have ever been pregnant, compared to 40.6% of 19-year-old girls. Regarding the educational level, it is observed that as the level of education is higher, the lower the percentage of adolescents who have ever been pregnant. In fact, 64.3% of adolescents with no education have ever been pregnant, compared to 14.4% of the secondary level and 10.6% of the upper level. These figures confirm that one of the main deprivations that accompany a pregnancy in adolescents is that of lack of education. In order to understand the significance of the phenomenon in all its complexity, it is necessary to understand the psychosocial, psychoeducational and family risk factors, to understand the education and sexuality of adolescents. In the present investigation we have selected the cross-sectional, descriptive, expost-facto research design whose objective is to describe the psychosocial and psychoeducational conditions that caused pregnancy or not pregnancy in adolescents in the municipality of La Romana, Dominican Republic, using methodological techniques to obtain in-depth data regarding the research problem. We used a non-experimental or correlational study between the pregnant and non-pregnant groups to compare the differences presented in the adolescents with respect to their variables. We used logistic regression in this research to predict how the influence of adolescent pregnancy on the probability of the presence or absence of several variables, verify the level of the variables in order to observe which variable or variables predict the problem in question. The study was carried out by taking a sample of pregnant women within the care centers of pregnant and no pregnant adolescents in educational centers. A sample of 441 young people aged 18-19 years was selected. Of which 220 young people were pregnant between 12 and 19 years old and another 221 have not been, which constituted the comparison group. The sources from which these samples were obtained were adolescents pregnant or not, from private schools, Catholic schools, evangelical schools, Anglican schools, public schools and high schools and medical centers for the care of pregnant adolescents in the municipality of La Romana. For the collection of information, we had a sociodemographic questionnaire that collected the personal and demographic data of the respondents, a self-report scale that collected the psychosocial and psychoeducational conditions in the adolescents and a qualitative questionnaire that collected the life history of the adolescents. The database where the data obtained from the questionnaires was entered was constructed using the SPSS-19 statistical package in Spanish for quantitative data. Results: of the respondents, 68% came from the urban context, 21% from the rural situation and only 4% were foreign; in terms of marital status, 62% of the adolescents are single, 21% are in a free union; when analyzing the area where they live, 30% were from the central zone followed by those from the west with 26% and 22% residing in the north; 62% lived in the house, 20% said they had lived in apartments and 12% had lived in a room or quarters; 72% of the adolescents studied and worked, while 28% only studied. As for the type of occupation, 17% work in other jobs, 10% in informal jobs or chiriperas, 9% work in free zone, 7% in brewery, 6% in lottery banking, department store and as secretary respectively; As for the study center, 48% of adolescents reported having studied in public schools, 18% in private schools, 13% in Catholic schools, and 11% in distance programs. As for the group of studies in the teenagers we have that, 35% studied in morning and evening hours respectively, 18% in afternoon hours and 6% in Sunday hours. As for the academic degree in teenagers, 60% had a full-time bachelor's degree, 24% had only attended the eighth grade, 6%, were only in the seventh grade and the others in lower grades. CONCLUSIONS AND DISCUSSIONS: The means and deviations of the items most valued by the young women to visualize the influences of school education were: in the school they talked about pregnancy in adolescents, causes and consequences (M = 1.48, DT = 0, fifty); I was told about contraceptive methods at school (M = 1.40, DT = 0.49). Although they were told about pregnancy and contraceptive methods, they became pregnant; the lowest item evaluated by adolescents in the influences of school education was: they talked to me about sexual intercourse (M = 1.38, DT = 0.486); Regarding the influences of family characteristics, the items most valued by the adolescents were: she was a young girl who spent a lot of time with my parents (M = 1.59, DT = 0.493); I had parents who told me about sexually transmitted infections and HIV / AIDS (M = 1.52, DT = 0.50); in terms of family risk factors, we found that the items most valued by the adolescents were: I was pregnant between the ages of 12 and 13 (M = 1.95, DT = 0.227); with respect to the influences of the personal characteristics, the items with higher values by the adolescents were: I was a parrandera like my father and was a person who liked alcoholic beverages (M = 1.46, DT = 0.499 respectively); the item less valued by the adolescents was: I behaved well with my parents (M = 1.41; DT = .492 for adolescents was: I got pregnant by a schoolmate (M = 1.37; DT = 0.483) , the item less valued by the teenagers pondering the first pregnancy was: it was a person who liked the people a lot (M = 1.20, DT = 0.398) .The variable degree of young women's influence on pregnancies was analyzed of adolescents, II that measures the influence of family characteristics, III that measures influence of family risk factors and factor VII that measures the first pregnancy, were found statistically significant differences; in factor I that measures the characteristics of school education we find that there are statistically significant differences, presenting a higher average in young women who are in the primary room with a higher probability of becoming pregnant compared to those who presented their full- II that measures the influences of the familiar characteristics, we find that there are statistically significant differences, presenting a higher average of getting pregnant those young women who were in eighth grade compared to those of high school. The sociodemographic results of the questionnaire allowed us to know how many students were enrolled in each academic degree. We found that the number of students who were most relevant were the students who attended the eighth grade (45), the students who completed the full-time bachelor's degree (123), they were between the ages of 14 and 17 at the time of their pregnancy. In factor III that measures the influence of family risk factors, we find that there are statistically significant differences, presenting a higher mean in the young women who work in department stores in relation to those who work as chiriperas and in those who do not work in relation to the chiriperas; in the factor IV that measures the influences of the personal characteristics we find significant statistical differences, presenting a greater average in the young women who work in a hidden way in brothels in relation to those that work in: free zone, hotelier, domestic servant, chiriperas, store by department, brewery center, others and in those do not work; in factor V that measures the influence of the age of the menarche, we find that there are statistically significant differences, presenting a higher average in becoming pregnant those young women who work in a hidden way in brothels in relation to those who work in free zone, of which they work as chiriperas and those who work in other types of activity, we observe in the same factor, those that do not work in relation to those who work in other types of work activity; in factor VII that measures the first pregnancy, we find that there are statistically significant differences presenting a higher average in getting pregnant those young women who work in a hidden way in brothels with those who work in lottery banking, and in those that do not work with respect to who work in lottery banking. Factor VI, which measures the onset of sexual activity, found that there are statistically significant differences, presenting a higher average in pregnant women who study in the morning, compared to those who study at night. In the factor I that measures the characteristics of the School Education, it reveals that the respondents that live in pension are the ones that make the statistically significant difference in relation to the adolescents who live in houses. In factor II that measures the Influences of Family Characteristics, it shows that there are statistically significant differences, with a higher average of the adolescents living in quarters, contrasting with those living in apartments and houses; in factor III that measures the Influence of family risk factors shows that there are statistically significant differences presenting a higher average of becoming pregnant, adolescents living in apartments compared to those living in quarters; in factor IV that measures the influence of personal characteristics, reveals that there are statistically significant differences, presenting a higher average of getting pregnant those who live in quarters than those who live in houses; in factor VI that measures the onset of sexual activity, shows that there is a statistically significant difference, with a higher mean of getting pregnant, the young women who live in houses in relation to those who live in a room or rooms. Conclusions of the qualitative study. The study provided us with information that made it possible to deepen the causes of adolescent pregnancy, leading us to conclusions in the concepts selected through the items, we obtained the following results: in the dimension 2 that measures the life of adolescents, most expressed rebelliousness, authoritarianism and promiscuity; the dimension 3 (influence of the environment on the adolescent pregnancy), they answered that yes, the environment influenced them and that the pregnancy occurred to the extent that their friends took her for a walk, that they left the school to drink and that always they had juntiñas with the boys in the corner of a street of their neighborhood; the dimension 5 (class bundles in the adolescent pregnancy situation), responded that in the afternoon and evening, when they left school they were going to have fun; dimension 6 (feeling in the adolescents when leaving pregnant), they responded to have felt depressed and with desires to abort; dimension 7 (life of adolescents after pregnancy), responded that they cannot do what they want, they feel bad because they are swallowing a wire and bad because the boyfriend they have are very jealous and cannot do anything; dimension 8 (sex for the first time without the use of condoms), responded that they had been afraid of the infection of a sexually transmitted infection, followed by those who were in control under the effects of alcohol; dimension 9 (sex education learned by parents or guardians), expressed that in their homes the talk of sex was sin; dimension 10 (sex education learned by their teachers), most spoke more about religion than about sex; dimension 11 (incidence of the place where she works with respect to her pregnancy), responded that as they worked in lottery benches, these places had a great impact on their pregnancy because they were always alone and locked in the room and that many things were done; dimension 12 (life after having become pregnant and aborted), responded that they felt failed. Prospective: After the analysis of the different variables and objectives, we find that beyond the psychosocial and psychoeducational factors that adolescents present in the research, we can see that they generate the problem in question. First, we consider it relevant that the Ministry of Education take into account the results of this research for the valuation and transformation of sex education, involving a multidisciplinary team such as the Ministry of Public Health and Social Assistance and other institutions that include parents to make progress in their children effective, generate proposals that allow a deeper analysis on the construction of subjectivity in adolescents, particularly when they lead to exclusion and marginalization, working values, stereotypes and prejudices regarding sexuality, open a line of future research that allows the creation of a sexual education program that allows understanding and linking adolescents to programs oriented to: the development of the ability to resist, communicate and reflect in the prevention of risk situations; promote the creation of institutions, services and available resources that provide specialized care for girls and adolescents, especially aimed at situations that cannot be prevented with adequate school intervention, accept that sexuality and desire have an unconscious dimension, adults should have more focus and attention on the vital interests of girls and adolescents; to install critical analysis in everyday communication so that sermoneus, taboos and religiosity do not take force in these matters, since they in a certain way, encapsulate knowledge with prejudices, another important aspect that cannot be missed is to do that the girls and adolescents build their autonomy allowing the reflection in them, so that they can participate in questioning the traditional sexual roles in which they have been continuously socialized. This can be achieved by strengthening decision-making and promoting assertive communication between parents and adolescents apart from education and sexual orientation that they can capture in other contexts.