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Pengaruh Pendidikan Kesehatan Menstrual Hygiene (PMH) Terhadap Sikap Remaja Putri dalam Menjaga Kebersihan Diri Selama Menstruasi Meinarisa, Meinarisa
Jurnal Endurance Vol 4, No 1 (2019): Jurnal Endurance : Kajian Ilmiah Problema Kesehatan
Publisher : Lembaga Layanan Pendidikan Tinggi (LLDIKTI) Wilayah X

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.988 KB) | DOI: 10.22216/jen.v4i1.3542

Abstract

WHO reported that the women mortality and morbidity due to reproductive system disorders increased in last decade. One of the cause the reproductive tract infection is unhygiene during menstruation. This study aims to examine the effect of Menstrual Hygiene (PMH) health education on the attitudes of adolescent girls in maintaining personal hygiene during menstruation and this research is a quasi-experiment with pre-test and post-test with control group. 98 adolescent girls from junior high school has participate in this research, 48 respondents in intervention group  have been given the Menstrual Hygiene Education through lectures, direct demonstration using phantom, booklet and self-report filling during menstruation. The questionnaire that used is Adolescent Menstrual Attitude Questionnaire to measure the attitude of adolescent girls. The results showed Menstrual Hygiene Education (MHE) there was  influence  of adolescent girls in monitoring personal hygiene during menstruation p=0,001 (95% CI 223,38 – 234,17). MHE improved the attitude of adolescent girls and helps the adolescents to understand personal hygiene during menstruation. This research recommend MHE can use by nurses for health education in school health unit.Angka kematian dan kecacatan pada wanita karena gangguan sistem reproduksi semakin meningkat. Salah satu penyebabnya adalah infeksi organ reproduksi dan infeksi organ perkemihan. Penyakit infeksi disistem reproduksi dapat disebabkan karena kebersihan yang kurang dari wanita saat menstruasi. Penelitian ini bertujuan menguji pengaruh Pendidikan kesehatan Menstrual Hygiene (PMH) terhadap sikap remaja putri dalam menjaga kebersihan diri selama menstruasi dan merupakan penelitian quasi-experiment dengan pretest and posttest with control group. Sejumlah 98 remaja putri dari Sekolah Menengah Pertama (SMP) N 24 dan 3 kota Jambi berpartisipasi dalam penelitian, 48 orang pada kelompok intervensi diberikan Pendidikan kesehatan Menstrual Hygiene (PMH) melalui ceramah, demostrasi langsung menggunakan phantom dan pemberian booklet. Serta pengisian self-report selama menstruasi.  Kuesioner yang digunakan adalah Adolescent Menstrual Attitude Questionnaire untuk mengukur sikap remaja putri. Hasil penelitian menunjukkan ada pengaruh PMH terhadap sikap remaja putri dalam menjaga kebersihan diri selama menstruasi p=0,001 (95% CI 223,38 – 234,17). PMH meningkatkan sikap remaja putri dan membantu remaja untuk memahami kebersihan diri selama menstruasi. Penelitian ini merekomendasikan PMH digunakan oleh perawat dalam penyuluhan kesehatan di Unit Kesehatan Sekolah (UKS).
Edukasi Nutrisi Remaja: Menghitung Kalori Minuman Kekinian Meinarisa, Meinarisa; Sanuddin, Mukhlis; Husaini, Ahmad
Jurnal Pengabdian Harapan Ibu (JPHI) Vol 2 No 1 (2020): Jurnal Pengabdian Harapan Ibu (JPHI)
Publisher : Sekolah Tinggi Ilmu Kesehatan Harapan Ibu Jambi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30644/jphi.v2i1.366

Abstract

Masa sekarang ini, remaja merupakan tumpuan utama untuk menjaga penduduk indonesia tumbuh seimbang setelah tahun 2020. Pada masa mendatang, remaja saat ini adalah yang akan menjadi dewasa dan meneruskan perubahan dan pembangunan negara. Untuk itu remaja saat ini harus disiapkan untuk menjadi produktif dan berkualitas. Salah satu hal yang penting dalam mempersiapkan remaja menjadi generasi berkualitas dan produktif adalah dengan mempersiapkan gizi dan kebutuhan makan remaja. Banyak negara saat ini mengalami masalah dalam pengendalian obesitas terutama pada remaja. 34% anak-anak usia diatas 12 tahun mengalami obesitas. Berkembangnya industri makanan dan sosial media berdampak besar pada remaja. Remaja sebaiknya mengetahui diet sehat bagi remaja. Karena jenis makanan akan sangat menentukan kesehatan remaja. Banyaknya jenis makanan dan minuman cepat saji akan meningkatkan daya konsumsi remaja terhadapa makanan cepat saji. Sehingga dalam pengabdian masyarakat kali ini kami dalam tim mengangkat pemaparan hitung kalori makanan kekinian.
SKRINING ANEMIA DEFISIENSI BESI, PEMBERIAN TABLET FE DAN PENGENALAN BAHAN BAKU MAKANAN TINGGI BESI KEPADA MASYARAKAT DI DESA MUARA JAMBI, KECAMATAN MARO SEBO, KABUPATEN MUARO JAMBI Wahyu Indah Dewi Aurora; Hubaybah Hubaybah; Meinarisa Meinarisa; Hasna Dewi; Siti Raudhah
Medical Dedication (medic) : Jurnal Pengabdian kepada Masyarakat FKIK UNJA Vol. 4 No. 2 (2021): MEDIC. Medical dedication
Publisher : Universitas Jambi

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Abstract

ABSTRACT Introduction: Anemia is a condition characterized by a reduced concentration of hemoglobin in the blood. There are various causes of anemia, both physiological due to pregnancy or high activity, as well as the result of pathological Mild to moderate anemia rarely causes symptoms so it is considered that there are no problems in the body. Anemia is a problem that occurs almost all over the world. The global prevalence of anemia in 2019 was 22.8%, with the highest prevalence in children under five years of age 39.7%. Method: This activity has been carried out on July 27, 2021. The location of the activity will be in Muara Jambi Village, Maro Sebo District, Muaro Jambi Regency. The method of activity is anemia screening, by gathering the community with the application of health protocols, conducting anemia screening by checking hemoglobin levels for free for the community, giving iron tablets to the community and introducing raw materials for high-iron foods to the community in the form of leaflets, counseling and discussion groups. Results and Discussion: The age of participants in this service is 18 participants who are less than 40 years old, and 12 participants who are more than 41 years old. After the Hemoglobin examination, the average participants had normal Hemoglobin with a value of more than 11 mg/dL. But there were 3 participants who had HB below 11 mg/dL. These 3 participants are at risk for iron deficiency anemia Conclusion: The implementation of this service was welcomed by the village government and the local community. This service is one solution that wants to be given to the community, regarding the problem of anemia that has been happening so far. From the screening results, the majority of the population's HB was normal. It is hoped that this research can increase public knowledge about raw materials for high-iron foods and the prevention of anemia, especially in pregnant women, children and other communities. Keywords: Iron Deficiency Anemia, High Iron Food Ingredients ABSTRAK Pendahuluan: Anemia adalah kondisi yang ditandai dengan berkurangnya konsentrasi hemoglobin di dalam darah. Penyebab anemia ada bermacam-macam, baik bersifat fisiologis akibat kehamilan atau aktifitas yang tinggi, maupun akibat dari patologis Anemia ringan hingga sedang jarang menimbulkan gejala sehingga dianggap tidak ada masalah di dalam tubuhnya. Anemia merupakan permasalahan yang terjadi hampir di seluruh dunia. Prevalensi Anemia secara global pada tahun 2019 adalah 22,8%, dengan prevalensi tertinggi pada anak di bawah lima tahun 39,7%. Metode: Kegiatan ini telah dilaksanakan pada tanggal 27 Juli 2021. Lokasi kegiatan akan dilakukan di Desa Muara Jambi, Kecamatan Maro Sebo, Kabupaten Muaro Jambi. Metode kegiatannya adalah skrining anemia, dengan mengumpulkan masyarakat dengan penerapan protocol kesehatan, melakukan skrining anemia dengan pemeriksaan kadar hemoglobin gratis bagi masyarakat, pemberian tablet besi kepada masyarakat dan mengenalkan bahan baku makanan tinggi besi kepada masyarakat dalam bentuk leaflet, penyuluhan dan grup diskusi. Hasil dan Pembahasan: Usia peserta pada pengabdian ini di mana peserta yang berusia kurang dari 40 tahun ada 18 peserta, dan peserta yang lebih dari 41 tahun ada 12 orang. Setelah dilakukan pemeriksaan Hemoglobin, rata-rata peserta memiliki Hemoglobin yang normal dengan nilai lebih dari 11 mg/dL. Tetapi ada 3 peserta yang memiliki HB di bawah 11 mg/dL. 3 peserta ini memiliki risiko untuk terjadi anemia defisiensi besi Kesimpulan: Pelaksanaan pengabdian ini disambut baik oleh pemerintah desa dan masyarakat setempat. Pengabdian ini adalah salah satu solusi yang ingin diberikan kepada masyarakat, tentang permasalahan anemia yang selama ini terjadi. Dari hasil skrining didaptkan HB masyarakat mayoritas normal. Diharapkan penelitian ini dapat meningkatkan pengetahuan masyarakat tentang bahan baku makanan tinggi zat besi dan pencegahan terjadinya anemia terutama pada wanita hamil, anak-anak dan masyarakt lainnya. Kata Kunci: Anemia Defisiensi Besi, Bahan Makanan Tinggi Besi
Hubungan Pengetahuan, Perilaku Ibu Dan Usia Anak Terhadap Kejadian Diaper Rush Pada Anak Balita Di Kota Jambi Meinarisa Meinarisa; Mefrie Puspita; Jelori Jalal
Malahayati Nursing Journal Volume 2 Nomor 4 Tahun 2020
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (169.057 KB) | DOI: 10.33024/manuju.v2i4.3047

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ABSTRACT: THE RELATIONSHIP OF KNOWLEDGE, MATERNAL BEHAVIOR, AND AGE OF THECHILD TO THE INCIDENCE OF DIAPER FEVER IN CHILDREN UNDER FIVE IN JAMBI CITY Background Toddlers have extensive problems especially with the sjon. Toddlers susceptible to diaper rush to the use of disposible diapers and no treatmenr done by mothers using disposible diapers, mothers just let it go and not given medication becuase of a lack of maternal knwoledge and behavior that is wrong with diaper rush. The purpose of this study was to determine the relationship of knowledge, mother's behavior and age of children to the incidence of diaper rush in children under five at Posyandu Kota Baru Indah Jambi City in 2019.Method : This research method is descriptive quantitative using a cross sectional study design. This research was conductet on june 2019. Puposive sampling technique with a population of 148 toddlers. Respondent in this study were mothers who has children under five who used disposible diapers in teh work area posyandu kota baru indah with amounted to 60 respondent. Data collection methods using a questionnaire. Univariate and bivariate data analysis, statistical test using the chi square test.Result : The study found that there was a significant relationship between maternal behavior with the occurrance of diaper rush in children under five with a p-value 0,002. The results of the study found that respondents who had poor knowledge were 34 respondents (56,7%) children, respondents with bad behavior as many as 13 respondents (55,0%), and description of the age of the child against the occurence of diaper rush is the age between 0-1 years 24 (40%) children, 2-3 years 19 (32%) children, ages between 4-5 years 17 (28) childrenConclution : Mother's knowledge and behavior related to diaper rush events in children under five and age are not related to diaper rush events in children under five in Posyandu Kota Baru Indah Kota Jambi.  Keywords     : Knowledge, Mother's Behavior, Diaper Rush, age of the child.     INTISARI: HUBUNGAN PENGETAHUAN, PERILAKU IBU DAN USIA ANAK TERHADAPKEJADIAN DIAPER RUSH PADA ANAK BALITA DI KOTA JAMBI Latar Belakang : Balita memiliki masalah yang luas terutama pada kulit. Balita rentan terkena Diaper Rush akibat penggunaan disposible diaper dan tidak adanya perawatan yang dilakukan ibu saat menggunakan disposible diaper, ibu hanya membiarkannya saja dan tidak diberi obat karena kurangnya pengetahuan dan prilaku ibu yang salah terhadap kejadian diaper rush Tujuan penelitian ini adalah mengetahui hubungan pengetahuan, perilaku ibu dan usia anak terhadap kejadian diaper rush pada anak balita di Posyandu Kota Baru Indah Kota Jambi Tahun 2019Metode : Metode penelitian ini bersifat deskriptif kuantitatif menggunakan desain studi cross sectional. Penelitian ini dilakukan pada tanggal 3 Juni 2019. Teknik pengambilan sampel purposive sampling dengan jumlah populasi 148 Balita. Responden pada penelitian ini adalah ibu yang memiliki anak balita yang menggunakan diaper disposibel diwilayah kerja posyandu Kota Baru Indah yang berjumlah 60 responden. Metode pengumpulan data menggunakan kuesioner. Analisa data univariat dan bivariat, uji statistik menggunakan uji Chi square.Hasil : Penelitian didapatkan bahwa ada hubungan yang siginifikan antara prilaku ibu  dengan kejadian Diaper rush  pada anak balita dengan nilai p-value  0.002. Hasil penelitian diperoleh bahwa responden yang memiliki pengetahuan kurang baik sebanyak 34 responden (56%,7%). Responden dengan prilaku kurang baik sebanyak 33 responden (55%), dan gambaran usia anak terhadap kejadian diaper rush adalah anak usia antara 0-1 tahun 24 (40%) orang anak, usia 2-3 tahun 19 (32%) orang anak, usia antara 4-5 tahun 17 (28%) orang anak.Kesimpulan : Pengetahuan dan perilaku ibu berhubungan dengan kejadian diaper rush pada anak balita dan umur tidak berhubungan dengan kejadian diaper rush pada anak balita di Posyandu Kota Baru Indah Kota Jambi   Kata Kunci    : Pengetahuan, Perilaku Ibu, Diaper Rush, usia anak
INTERVENSI PAKET MODUL DAN AUDIOVISUAL PADA PENINGKATAN PENGETAHUAN DAN HARD SKILL MAHASISWA PADA MATA KULIAH KEPERERAWATAN MATERNITAS Meinarisa Meinarisa; Muthia Mutmainnah; sri mulyani
Media Keperawatan:Politeknik Kesehatan Makassar Vol 13, No 1 (2022): Media Keperawatan: Politeknik Kesehatan Makassar
Publisher : Jurusan Keperawatan Poltekkes Kemenkes Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32382/jmk.v13i1.2701

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COVID-19 has changed the order of education in Indonesia. There is a big change in learning from formal education in the classroom to learning from home, with an online system. The online education system is certainly not easy. In addition to the personal discipline to study independently, there are facilities and resources that must be provided. Laboratory activities that hone students' abilities in developing skills for patients were forced to turn into audiovisual learning. In maternity nursing learning there are practices carried out in laboratories that develop students' hard skills and knowledge The design of this research is pre eksperiment, with pretest and posttest without control group. The implementation of the audiovisual learning and module intervention was given in 4 sessions consisting of pregnancy, childbirth, newborns and the postpartum period. The questionnaire used in this study was a knowledge questionnaire and hard skill assessment on students using zoom. Number of respondents are 63 respondents. The results of the study show that there is an effect of audiovisual learning on students’ knowledge p=0,001   and soft skill p=0,001. This study shows an increase in the score of 80% of the number of respondents. This research recommends giving audiovisual learning to improve knowledge laboratory skills in maternity nursing.
PEMILIHAN KONTRASEPSI OLEH ASEPTOR KB SELAMA MASA PANDEMI COVID-19 DALAM MENJAGA KESEHATAN REPRODUKSI Meinarisa Meinarisa; Riska Amalya Nasution; Citra Indah Fitriwati; Miftahul Jannah
Medical Dedication (medic) : Jurnal Pengabdian kepada Masyarakat FKIK UNJA Vol. 5 No. 1 (2022): MEDIC. Medical dedication
Publisher : Universitas Jambi

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Abstract

ABSTRACT The number of women of childbearing age in Indonesia is the highest number of WUS in Southeast Asia. However, Indonesia is the largest user of contraception. The COVID-19 outbreak has also affected the use of contraception. This outbreak was declared a global health emergency that required restrictions on activities and physical and social contact, up to quarantine on a large scale. This has led to major changes in the social order, which usually involves activities outside the home, turning into activities at home. In addition, the pandemic also increases sexual contact, thereby allowing an increase in the number of pregnancies. So it is necessary to strengthen knowledge on the use of contraception. Keywords: user of contraception, contraception, pandemic Covid-19, reproduction health ABSTRAK Jumlah Wanita Usia Subur di Indonesia merupakan jumlah WUS terbanyak di Asia Tenggara. Namun Indonesia merupakan pengguna terbesar kontrasepsi. Wabah covid-19 juga berpengaruh pada peggunaan kontrasepsi. Wabah ini dinyatakan sebagai darurat Kesehatan global sehingga mengharuskan pembatasan aktifitas dan kontak fisik dan social, sampai karantina dalam sekala besar. Hal ini menyebabkan terjadinya perubahan besar pada tatanan masyarakat yang biasanya berkegiatan di luar rumah, berubah menjadi berkegiatan di rumah. Selain itu pandemic juga meningkatkan kontak seksual sehingga memungkinkan peningkatan jumlah kehamilan. Sehingga perlu penguatan pengetahuan pada penggunaan kontrasepsi. Kata Kunci: Aseptor KB, Kontrasepsi, Pandemi Covid-19, Kesehatan Reproduksi
Gambaran Pengetahuan Orang Tua Tentang Stimulasi Dini Perkembangan Balita (Usia 12-59 Bulan) Haryanti Haryanti; Mefrie Puspita; Meinarisa Meinarisa
Jurnal Medika Cendikia Vol 8 No 2 (2021): Jurnal Medika Cendikia
Publisher : STIKes Karsa Husada Garut

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33482/medika.v8i2.159

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ABSTRACT Background Stimulation of growth and development of toddlers is very important given by parents. If the stimulation is inadequate, the growth and development of children under five will be disrupted. Children aged 12-59 months need stimulation to optimize development. One of the causes of delayed child development is parents' ignorance of the importance of developmental stimulation. This study aims to describe the knowledge of parents about the early stimulation of toddler development (aged 12-59 months). Methods: This research is a quantitative descriptive study. The population in this study were all parents who have toddlers aged 12-59 months in the Kenali Besar Public Health Center working area as of October 2019, totaling 3369 people. The sample in this study were 97 people who were taken by accidental sampling technique. This research was conducted on 3 to 18 August 2020 in the Work Area of ​​the Kenali Besar Community Health Center, Jambi City. The data was collected using a questionnaire sheet and the results of this study were analyzed univariately. Results: The results of the univariate analysis showed that there were 52 (53.6%) respondents who had knowledge about early stimulation of toddler development (aged 12-59 months) in a fairly good category in the Work Area of ​​the Kenali Besar Health Center in Jambi City in 2020. Conclusion: Based on the research results, it can be concluded that parents' knowledge about early stimulation can affect the development of toddlers Keywords: Knowledge, Developmental Stimulation, Toddler
Hubungan Faktor Lingkungan, Kebijakan Pemerintah Dan Pengetahuan Orang Tua Dengan Pencegahan Penyakit TBC Pada Anak Susi Widiawati; Mefrie Puspita; Meinarisa Meinarisa
Jurnal Ilmiah Keperawatan STIKES Hang Tuah Surabaya Vol 16, No 2 (2021): October
Publisher : Sekolah Tinggi Ilmu Kesehatan Hang Tuah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (408.09 KB) | DOI: 10.30643/jiksht.v16i2.140

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Introduction: The prevalence of TB cases was recorded to increase in 2019 in Jambi City reaching 3,423 cases, while the incidence of TB in children was 84 (confirmed).Objectives:  The purpose of this study was to determine the relationship between environmental factors, government policies, and parental knowledge with the prevention of TB in children in Jambi City. Methods: This research is a quantitative study with a cross-sectional design, the sample is the parents who have children aged 0 years to 18 years in Jambi City with a purposive sampling technique, the number of samples is 82 people. Data collection using online questionnaires, namely environmental factors, government policies, knowledge, and prevention of tuberculosis in children, the data were analyzed univariately and bivariate with the Spearman Correlation test Results: The univariate results of environmental factors met the requirements of 56.1% of respondents, getting information on government policies was 53.7%, moderate knowledge was 43.9%, good TB prevention was 65.9%. The results of the bivariate analysis, there is a relationship and correlation between environmental factors P-value 0.007 and r = 0.296, government policy 0.019 and r = 0.259, and knowledge of p-value 0.043 and r-0.224 with the prevention of TP in children. Conclusions:  in this study is the prevention of pulmonary TB in children is supported by environmental factors, government policies, and parental knowledge.
Hubungan Pengetahuan, Kedekatan Ibu dan Pola Asuh Terhadap Kesiapan Remaja Menghadapi Menstruasi Pertama (Menarche) di SMP Negeri 04, 06, dan 17 Kota Jambi Meinarisa Meinarisa; Lisa Anita Sari; Bella Mardiantika
Jurnal Ilmiah Ners Indonesia Vol 2 No 2 (2021): JURNAL ILMIAH NERS INDONESIA
Publisher : Program Studi Keperawatan Fakultas Kedokteran dan Ilmu Kesehatan Universitas Jambi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (71.416 KB) | DOI: 10.22437/jini.v2i2.15572

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Young women who experience menarche often feel confused and sad. Adolescents who are not ready to face menarche will have a desire to refuse, they will feel menstruation as something cruel and threatening, this situation can continue in a more negative direction. SMP did not dare talk to his parents when experienced menarche. This research is a quantitative research with cross sectional design which aims to determine the relationship between knowledge, closeness of mother and child to the readiness of adolescents to face first menstruation ( menarche ) in SMP Negeri 04, 06 and 17 Jambi City. Population of 172 people with a sample size of 119 people, the sampling technique is proportional random sampling technique. The data was obtained by using a questionnaire for SMPN 04 and 0 6 students and google form on the SPN 17 student. Data were analyzed univariate and bivariate using the Chi-Square test. The results show that s ebanyak 45 (37,8 %) respondents have less knowledge, 71 (59,7 %) closeness to the mother well, 52 (43,7 %) mothers parenting is democratic, as many as 62 (52,1 %) said they were ready to face the first menstruation (menarche). The results of the test statisti k showed no significant relationship between knowledge ( p-value 0,001) , the proximity of the mother ( p-value 0,003 ) and the pattern of parenting (p-value 0,007) with the readiness of teenagers face first menstruation (menarche) in SMP Negeri 04, 06, and 17 Jambi City. It is expected that the schools work together with teachers BK to do counseling as scheduled and periodical about menstruation first (menarche) to increase the knowledge of adolescent and do consul about health reproduction in adolescents at school.
Penerapan Intervensi Pemberdayaan Teman Sebaya (PERSEBAYA) untuk Mengatasi Perilaku Mencederai Diri pada Remaja di SMP Negeri 21 Kabupaten Tanjung Jabung Timur, Jambi Riska Amalya Nasution; Meinarisa Meinarisa; Kamariyah Kamariyah; Indah Mawarti; Ilham Falani
Journal of Community Engagement Research for Sustainability Vol. 2 No. 6 (2022): November
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31258/cers.2.6.321-328

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Adolescent is a period of transition to adulthood. At this age, adolescents are prone to experiencing mental health problems, one of which is self-injurious behavior. Adolescents who have self-injurious behavior need social and emotional support from various parties such as parents, health workers, schools, teachers and peers. Peer empowerment helps to train adolescents to recognize their potential, learn to be responsible, lead, and other positive activities that can overcome the problems of adolescents who have self-injurious behavior. The problems encountered in partner groups are; there is no use of peers to solve problems in adolescents, the school has never held special education about PERSEBAYA, and the incidence of students dropping out of school. This community service activity was carried out at Junior High School 21 Tanjung Jabung Timur Regency as a health partner. The purpose of this service is to carry out prevention efforts in adolescents by providing PERSEBAYA intervention. The method used is an experimental method where adolescents are given treatment in the form of PERSEBAYA intervention. The results of this service are expected that adolescents recognize the growth and development that must be achieved by adolescents and are able to control the desire to injure themselves