The role of the nurse in preventing changes in the reproductive health of children in adolescence

Growing up is becoming a person. In total, there are more than 1 billion on Earth. a person aged 10-19 years. Adolescence is associated with rapid physiological and psychological changes in the body. This is at the same time a period of inexperience, experimentation, self-will, indiscipline, asociality combined with determination and a desire to learn. It is the latter qualities that specialists need to use to teach the preservation of reproductive health.

The growth of sexual activity of young people is a global trend. Every year in the world 5-10% of girls aged 13-17 years get pregnant. In girls under 14 years of age, the proportion of termination of pregnancy from the total number of abortions is 0.05-0.06%.

Every year in Uzbekistan, every tenth newborn child is born to a mother younger than 15 years old, most often outside of a legal marriage.

The early onset of adolescent sexual life occurs in rather specific conditions, including a low contraceptive culture, a small number of special medical, counseling, psychological services and sexual education programs for adolescents, and the lack of special training for teachers. Adolescents are characterized by the casual nature of sexual relations, illiteracy in the prevention of sexually transmitted infections and the prevention of unwanted pregnancy.

According to statistics, by the beginning of family life, almost every second person has chronic diseases that can directly or indirectly affect a person's reproductive health. That is why recently this issue has been of such concern not only to medical professionals, but also to the whole society. Healthy children are our future, and how can they be born as such when their future parents cannot boast of their reproductive health? The reproductive health of a person and society are closely interrelated. The question arises, but what can be done to ensure that the future generation is born healthy and able to give birth to the same healthy children?

In the modern world, when the pace of society and technology development has accelerated, the level and quality of education begins to play a special role. The awareness of adolescents about the consequences of early sexual life is quite low. Prevention of the early onset of sexual activity should be carried out both in high schools and in vocational education institutions. Preventive work may include conversations, class hours devoted to issues of morality, hygiene, prevention of unwanted pregnancy, prevention of infection with sexually transmitted infections.

After analyzing the study, it is possible to come to the conclusion that there is an insufficient (low) level of knowledge of information by adolescents about issues of preserving reproductive health, proper reproductive behavior, and possession of hygiene techniques. Our educational work continues, classes on the hygiene of girls and boys are planned, the survey revealed the need for such knowledge, in addition, it turned out that respondents are in no hurry to get rid of their bad habits, drink alcohol, smoke, understanding the consequences.

An important role in improving the culture of reproductive health in adolescence is assigned to medical workers with secondary education, namely nurses who often come into contact with adolescents, as well as midwives who work with girls in centers and offices in polyclinics of family planning and reproduction. In the family planning program, high hopes are placed on the secondary medical staff, namely, on their active educational and informational work with the population and direct training in methods and means of contraception and hygiene techniques. It is also alarming that the role assigned by students to the teacher in receiving urgent advice or assistance on sanitary and hygienic issues is extremely low and, on the contrary, there is a great negative attitude towards teachers. According to the results of other surveys, it was found out that schoolchildren consider the information received from teachers to be very "innocent", many teachers avoid discussing issues of gender relations with their students. The explanation for this may be the very poor training of education workers, which does not meet modern requirements and the existing rates of dissemination. The practical role of school staff is to familiarize adolescents with the literature on reproductive health, dedicated to. A relatively small number of schoolchildren who prefer to receive information and help in psychological services, a rather high percentage of negative attitude towards it can be partly explained by the unwillingness of employees of these services to conduct sanitary and hygienic and preventive work.

The negative attitude of adolescents with risky behavior towards their parents can be explained by the existing unfavorable relationships in the family and psychological traumas in childhood inflicted or by one of the parents. In particular, the relationship between adolescent deviance and abuse in the family in childhood was revealed. This issue requires further study, which may clarify the reasons for the risky behavior of the adolescent subpopulation. At the same time, it should be noted the low educational role of parents. Only a few parents adequately assess the real situation and reproductive health of young people that has developed in many regions of the country in recent years. The participation of parents in the sexual education of their children is becoming increasingly important. According to official WHO statistics, over the past decade there has been a significant increase in the incidence of syphilis, gonorrhea and other sexually transmitted diseases. The main reasons for this are:

• -    an increasingly early age of the beginning of sexual relations with a low level of contraceptive use, the spread of unsafe sex;

• -    increase in the number of sexual partners;

• -    the fall of moral restrictions;

• -    insufficient effectiveness of preventive measures in the field of combating;

• -    low level of sanitary and hygienic literacy of adolescents in relation to sexual life, the nature of sexually transmitted diseases, their manifestations and consequences;

• -    irresponsible attitude to one's own health.

By engaging in such educational work, a nurse will help teenagers maintain their health, prepare for family life, and feel responsible for their future and the future of their children. One of the elements of the formation of a healthy lifestyle is hygienic education in general and sexual education in particular. The study of this aspect of the lifestyle of adolescents has shown the crucial role of the family in the formation of behavioral attitudes. The main role in providing information on sexual relations and dissemination belongs to the media, mainly television, pornographic and erotic literature, and only a small part falls on scientific literature. It is not surprising that, not knowing other aspects of human relations, having a very vague idea of moral values, teenagers will extrapolate the received behavioral attitudes to adulthood.

Thus, the issue of preparing teenagers for adulthood in general and for family life in particular is particularly acute at the moment. Extensive medical and social research is required to determine risk factors for adolescents in order to develop a comprehensive preventive program involving teachers, doctors, social workers, the media, law enforcement agencies and, of course, adolescents themselves.

In general, the data obtained indicate the need for targeted and intelligible propaganda not only in the media, but also in educational institutions, in the family, from the side of secondary medical personnel. Having studied the factors influencing the spread, we came to the conclusion that demographic, medical, social, economic, cultural, and behavioral trends have an important role in the spread of diseases. Highlighting the diseases, they presented a group of infections that are transmitted mainly through sexual contact. All diseases have mainly common symptoms, the causative agents of which can be parasites.

Currently, more and more teenagers are entering into early sexual relationships. At the same time, it is alarming that the age of the first sexual experience has significantly decreased. We studied the directions of the nurse's work on prevention in adolescents. The goal has been achieved. The hypothesis has been confirmed, the role of nursing staff in prevention in adolescents has been proven.