NURSING STUDENT’S ATTITUDE TOWARDS TEENAGE PREGNANCY AND

SEXUALITY IN THE UNIVERSITY OF CAGAYAN VALLEY

_______________

A Thesis
Presented to the Faculty of
University of Cagayan Valley
Tuguegarao City

_______________

Jericho Cusit
Cris Ann Peralta
Mia Balualua
Jonaliza Palangdao
Jasmine Marjorie Kate Andres
Marivic Gatotos

2023
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Chapter 1

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION

A woman's pregnancy is a fantastic gift because she

gets to savor every second of holding her child.

Additionally, it creates a happy mood and a positive

environment among her close family. Arthur Campbell

stated, “The girl who has an illegitimate child at the

age of 16 suddenly has 90 percent of her life’s script

written for her” (Hoffman & Maynard, 2008). Besides, the

National Research Council Report has shown that underage

mothers have a higher chance of social and economic

detriment in their lives (Hoffman & Maynard, 2008).

Early pregnancy is viewed as an epidemic that

burdens the young person, her family, and the entire

planet. Teenage pregnancy is a socioeconomic problem that

has an impact on people and communities all around the

world. It is well known that teenage pregnancy can

negatively impact a young person's development in many

areas, including their ability to succeed in school.

Teenage pregnancies have an impact on teens' social and

academically, as well as in terms of health. One of the

most important parts of human existence is pregnancy

issue for life. It is related to both bodily and

psychosocial well-being of a population (Alubo, 2001;

Onifade, 1999; Sai, 1995).

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The world health organization (2022) revealed that

Adolescent pregnancy is a global phenomenon with clearly

known causes and serious health, social and economic

consequences. Globally, they also stated that the

adolescent birth rate (ABR) has decreased, but rates of

change have been uneven across regions. Adolescent

pregnancy tends to be higher among those with less

education or of low economic status. As of 2019,

adolescents aged 15-19 years in low- and middle-income

countries (LMICS) had an estimated 21 million pregnancies

each year, of which approximately 50% were unintended and

which resulted in an estimated 12 million births (Sully

EA. Biddlecom, A., Daroch, J., Riley, T., Ashford, L.,

Lince-Deroche, N. et al, 2022).

Teenage pregnancy among Filipino women aged 15 to 19

years declined from 8.6 percent in 2017 to 5.4 percent in

2022 as stated by the Philippine Statistics Authority

(PSA) in its 2022 National Demographic and Health Survey

(NDHS). In 2022, the Philippines posted that 5.4 percent

of women aged 15 to 19 years have ever been pregnant,

about 1.6 percent of them were currently pregnant, and

less than one percent (0.4%) have had a pregnancy loss.

By area of residence, the percentage of women aged 15 to

19 years who have ever been pregnant was slightly lower

in urban areas (4.8%) than in rural areas (6.1%). Across

regions, Region X-Northern Mindanao (10.9%) had the

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highest percentage of women aged 15 to 19 years who have

ever been pregnant, followed by Region XI-Davao Region

(8.2%), Central Luzon (8.0%), and Caraga (7.7%). The

lowest percentage of teenage pregnancy was in Region I-

Ilocos Region (2.4%) and Region V-Bicol Region (2.4%).

Teenage mothers are less likely to complete high

school, are more likely to live in poverty, and have

children who frequently experience health and

developmental problems. Girls who complete their studies

without getting pregnant are more likely to succeed in

finding decent jobs, improving their status and self-

esteem, and enhancing their livelihoods. However, for

those who do become young mothers, the re-entry policy is

meant to offer a second chance for them to correct their

mistakes and build a better future for themselves and

their children.

Nursing students represent the future workforce of

healthcare professionals who will be providing care to

pregnant adolescents. Their perceptions towards teenage

pregnancy can significantly influence the quality of care

and support provided to this vulnerable population. This

research aims to explore the perceptions of nursing

students towards teenage pregnancy and sexuality,

shedding light on their attitudes, beliefs, and

preparedness to address this complex issue.

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By examining the perceptions of nursing students

towards teenage pregnancy and sexuality, this study seeks

to identify gaps in their education and training, as well

as opportunities for improving the delivery of care to

pregnant adolescents. Ultimately, the findings of this

research can inform the development of targeted

educational interventions and clinical experiences to

better prepare nursing students to address the unique

needs of pregnant teenagers and promote positive maternal

and neonatal outcomes.

Theoretical framework

The ecological perspective places emphasis on the

interaction and interdependence between and across the

social spectrum. It regards health behaviour as a result

of the interaction between people and the environment

they are exposed to, hence the understanding of health is

incomplete without an appreciation of the environment

(National Institute of Health, 2005). The ecological

perspective has its roots in Urie Bronfenbrenner’s (1979)

Social Ecological Theory. Bronfenbrenner used his theory

to describe the development of children by studying the

external influences that aid or militate against child

development. The Social Ecology Model was later adapted

from Social Ecological Theory to suit public health

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communication and intervention design (McLeroy et al.,

1988).

Through the lens of the ecological perspective, an

opportunity to examine the effects the environment has on

social change and organization is afforded to the

researcher, making it easier to plan accordingly should

there be a need for intervention. Central to the

ecological perspective is the assumption that people are

affected by their environment, and they in turn affect it

too. “The problems people face or experiences in social

functions are a result of the people-environment exchange

rather than being a result of individual interaction”

(Sallis, Owen & Fisher, 2008: 92). This effect that

people and the environment have on each other is called

reciprocal causation (ibid).

Developed by Albert Bandura in 1986, reciprocal

causation also known as reciprocal determinism is a

concept stemming from Bandura’s Social Cognitive Theory

(1986). Bandura argues an individuals’ behaviour affects

and, is in turn, affected by the social environment and

personal factors. Personal factors such as beliefs and

expectations influence and affect behaviour change while

social environmental factors such as the economic, social

and health factors have been known to regulate human

behaviour. This connection between the individual and the

environment and how they affect and influence each other

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is then called reciprocal determinism or reciprocal

causation.

The last two decades have seen an increase in the

interest in ecological models, mainly because of the

promise ecological models offer of guiding comprehensive

health interventions that help reduce health problems

(Sallis, Owen & Fisher, 2008). Ecological models have

been credited with the successful improvement of health

behaviour such as repeat teenage pregnancy, cancer

screening, healthy eating and exercising (Sallis & Owen,

1997; Smedley & Syme, 2000; and 37Ranieri & Wiemann,

2008). This experience has prompted the application of

ecological models to health and social problems such as

diet, violence, bullying, malaria control and cancer

screening (Sallis, Owen & Fisher, 2008). This is because

the ecological perspective is the response to the gap

left by individual level theories and models such as the

Health Belief Model, Social Cognitive Theory, the Trans

theoretical Model and the Theory of Planned Behaviour

(Sallis, Owen & Fisher, 2008; McLeroy et al., 1988; and

Glanz, Rimer & Lewis, 2002)

The social ecological perspective is inherently

interdisciplinary as it has other disciplines embedded in

it such as economics, psychology, sociology, and

anthropology (McLeroy et al., 1988). This perspective

thus encourages researchers to include the socio-cultural

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contexts of people’s environments so as to come up with

comprehensive interventions. It is against this

background that this study draws from the social ecology

perspective and employs the Social Ecology Model to

explore nursing student’s attitudes and perceptions

towards teenage pregnancy in a school setting.

Paradigm of the Study

Input Process Output

1. What is the 1. What is the
profile of the profile of the
respondents
relative to: respondents
1.1 age relative to:
1.2 sex
1.1 age
1.3civil
status 1.2 sex
1.4religion Determined the
1.3civil
1.5 parents students attitude
highest status
educational 1.4religion on teenage
attainment 1.5 parents pregnancy
1.6 parents
occupation highest educational
2. What are the attainment
attitude of
1.6 parents
nursing students
on early occupation
pregnancy and 2. interpretation
teen sexuality?
3. Is there a and analysis of
relationship data trough:
between the 2.1 survey
profile of the
respondents and questionnaire
attitude towards
teen age
pregnancy and
sexuality?

FEEDBACK
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Figure1. Paradigm of the study showing the relationship

between the variables of the study

The Paradigm of the study is presented in the form of

input, process, and output.

The input frame includes the profile variables and

the attitude of nursing students on early pregnancy as

well as the relationship between the profile of the

respondents and attitude towards teen age pregnancy.

The profile variables include, Age,sex,civil

status ,religion, parents highest educational attainment,

parents occupation, and the attitude of nursing students

towards teenage pregnancy and sexuality.

The process includes assessing the profile variables

of the respondents and interpreting and analyzing

information gathered through questionnaires and surveys

given to the respondents.

Lastly, the output box captures the determined the

students attitude on teenage pregnancy and sexuality.

Statement of the Problem

The statement of the problem will address the

attitude of nursing students towards teenage pregnancy

and sexuality in the university of Cagayan valley.

Specifically, it seek to answer the following

questions:

1. What is the profile of the respondents relative to:

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1.1 Age

1.2 Sex

1.3 civil status

1.4 religion

1.5 parents highest educational attainment

1.6 parents occupation

2. What are the attitude of nursing students on early

pregnancy and sexuality?

3. Is there a relationship between the attitude towards

teenage pregnancy and sexuality and the profile variables

of the respondents?

Hypothesis

This study will be guided by a null hypothesis:

There is no relationship between the attitude of

towards teenage pregnancy and sexuality and the profile

variables of the respondents.

Significance of the Study

The researchers hope that the findings of this study

will benefit the following:

Department of Education. Information may be used by

the Department of Education's decision-makers and

authorities, derived from this study to develop

strategies to deal with teenage pregnancy.

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Department of health and social welfare. The

material or findings from this study may be used by the

Department of Health and Social Welfare (DSWD) to support

struggling students. The Department of Health and Social

Welfare can use the information or the results of this

study to assist the affected learners.

Social workers. Social workers would probably also

gain more insight into the phenomenon which will enable

them to respond positively and effectively towards

extending a helping hand to learners who fall victim to

teenage pregnancy.

Teachers. This study will help school teachers learn

the skills necessary to deal with the behavioral issues

caused by teenage pregnancy as well as handling pregnant

teens in school.

Teenage mothers. It will also help teenage mother

who goes to school to have ways to improve their academic

performances. This study will also contribute to building

teenage mother's self-esteem to stand and express

themselves at home and school without feeling of fear.

Researchers . This study would greatly benefit them

as they would gain new knowledge and insight, which they

could share with the teachers and students.

Future researchers. Future researchers can

potentially utilize the findings of this study as a

starting point for other research in the field.

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Scope and Delimitation of the Study

This study focuses on the perception of nursing

students towards teenage pregnancy and sexuality in the

university of cagayan valley. Moreover, the data

collection will be conducted on a sample of nursing

students from 3rd year enrolled in the University of

Cagayan Valley during the S.Y. 2023-2024 who will

represent the population.

In addition, this research work focuses on what are

the attitude of students on early pregnancy and

sexuality, and the relationship between the the attitude

of towards teenage pregnancy and sexuality and the

profile variables of the respondents.

The main source of data will be the survey

questionnaire which are prepared by the researchers.

Definition of Terms

The following terms are defined operationally for

clarity and easier understanding of the study.

Attitude. Attitude can be defined as the way in

which a person views and evaluates something o someone, a

predisposition or a tendency to respond positively or

negatively toward a certain idea, object, person, or

situation.
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Students Perception. Students perception is the

process of students treatment of information about an

object that applies in their environment, specially in

the classroom through observation with the sense owned,

so students can give meaning and interpret observed

object.

Pregnancy . pregnancy refers to a process whereby a

female carries a live offspring from the time of

conception to childbirth.

Teenage pregnancy. Teenage pregnancy is when a woman

under 20 gets pregnant. It usually refers to teens

between the age of 15-19. But it can include girls as

young as 10. It’s also called teen pregnancy or

adolescent pregnancy.

Sexuality . sexuality is about your sexual feelings,

thoughts, attractions and behaviours towards other

people. Sexuality is diverse and personal, and it is an

important part of who you are.

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Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the related studies and

important concepts gleaned from literature that have been

found useful in the conceptualization of the present

study. These related studies and literature offered

assessment and enrichment in the conduct of this research

work on teenage pregnancy.

Related literature

Teenage pregnancy

According to The journal of gyriecological research

and obstetrics, (2018), Teenage pregnancies can harm

girls, their families, and communities in negative social

and economic ways. Teenagers who are not married and are

pregnant may experience bullying, rejection, or violence

from their parents and peers. The likelihood of violence

in marriage or a partnership is also higher for girls who

become pregnant before age 18. In terms of education,

dropping out of school can either be a decision made by a

girl who. decides that getting pregnant is a better

alternative for her given situation than finishing her

education, or it can be a direct cause of pregnancy or an

early marriage. An estimated 5% to 33% of gir's ages 15

to 24 years who drop out of school in some countries do

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so because of early pregnancy or mariage. (Franjić S.

2018).

In addition Berrington (2013) emphasized that:

policies aimed at reducing inequalities in adult health

need to take a life-long perspective and tackle social

disadvantages across the life course. Teenage motherhood

is an important independent pathway through which poor

socioeconomic conditions in childhood translate into

higher rates of both mental and overall ill health in

adulthood. The poorer mental health of teenage mothers

has implications for the subsequent generation and hence

contributes to the inter-generational transmission of

disadvantage.

Sexuality

Kumalasari et al. (2020) explained that the teenage

phase is equated to delinquency, especially in terms of

sexuality. Sexuality which is still considered taboo

during this stage, makes the lack of knowledge and low

perceived behavior control in adolescents so that more

teenagers have had sexual relations before marriage.

Premarital sexual behavior impacts health, that is, the

transmission of sexually transmitted diseases/infections

and teenage pregnancy, which can result in dropping out

of school, other social sanctions or complications during

pregnancy, childbirth, and puerperal. The authors added

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that it is essential for teenagers to get the necessary

education and information to ensure better awareness of

sexual and reproductive health.

Sex education

Torivillas (2013) The Philippine Star noted that

there is evidence supporting the Reproductive health law

that calls for sex education among young students. Not

that for teaching the kids to engage in "safe" sex, but

rather, for telling them why they should not engage in

early sex, and yes, before marriage. With regulated sex

education, the young are informed about sex, pregnancy,

unplanned and planned, instead of through the internet or

pornographic magazines that somehow manage to reach them.

The Australian journal of General Practice suggested

that a combination of sexuality education and

contraception interventions is effective in reducing

unintended pregnancies in teenagers. Use of contraception

at first intercourse has been reported by 90% of

Australians, and condoms are the most common method used

by young people; this is followed by the oral

contraceptive pill, which is often initiated for non-

contraceptive indications. General practitioners (GPS)

play a part in recognizing such vulnerability and

improving the health literacy of these young people to

support them in what is often ascary time, which can

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enhance the outcome for this pregnancy and for a future

family. (AJGP, 2020)

Factors influencing teenage pregnancy / ATTITUDE

The factors that trigger Teenage pregnancy in the

country are Family problems, broken family/complicated

family, peer pressure/bad influence,

Media/Television/Movies Influential Trends (regarding

sex), pornography, lack of attention, love, caring, lack

of moral values, failure to nurture with good principle,

curiosity, lack of information about Sex (sex education),

use of illegal drugs, lack of Guidance, prostitution

(involve poverty), unintelligent decision, etc. (Discover

questions in the Philippines, 2013).

Related studies

According to the Handayani et al. (2019) explained

in their study that 50% of teenagers had premarital

sexual intercourse at 10-15 years old. Adverse outcomes

such as teenage pregnancies and increased incidence of

STDs are most common amongst those who engage in risky

sexual behaviors due to curiosity and lack of information

regarding the risks of their behaviors. The authors

suggested the significant role of school and education in

preventing and addressing the problems brought about by

inappropriate sexual behaviors, especially among

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adolescents. This means that the attitude of the

respondents on reproductive health is based on the

perception that having premarital is against their

values.

Kyilleh et al. (2018), in their study, identified

that adolescents generally engaged in risky reproductive

health choices, which can negatively affect their health

because of their lack of knowledge about reproductive

health. Teenagers also have difficulties getting the

correct information on reproductive health because they

are reluctant to talk about reproductive health to

informed adults such as health workers and teachers for

the reason that they are uncomfortable with the topic and

would instead the information on their own even if that

information are inaccurate or wrong. Adolescents also

face challenges utilizing available reproductive health

services because of barriers to socio- cultural and

health systems.

Kassa, G.M., Arowojolu, A.O., Odukogbe, A.A. et al

(2018) study shows that Some of the factors contributing

to the higher prevalence of adolescent pregnancy in

Africa include the inaccessibility of contraceptive

services, the community's negative attitude toward

adolescent contraceptive use, adolescents' lack of

knowledge of SRH issues, and the prevalence of sexual

violence in developing nations. Another significant

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factor in the generational cycle of poverty and poor

health outcomes is adolescent pregnancy. Therefore, a

focus on preventing adolescent pregnancy through improved

access to contraceptives, teen-friendly health services,

and sexuality education is necessary. The Study found

that educational programs designed to lower sexual risk.

behaviors and prevent pregnancy among young people can

successfully lower the rate of adolescent pregnancy.

The study in Rwanda, shows that Despite legislative

advances for women's empowerment and initiatives to stop

child sexual abuse, there has been a sharp rise over the

past 2 decades. It suggests that in order to lower the

rate of teenage pregnancies, social and economic

assistance for teen females, including parental

supervision, counseling, and financial care, is a crucial

factor to take into account. The study recommends that in

addition to efforts made specifically for youth; methods

for minimizing teen pregnancies should concentrate on a

variety of household-level situations falling into two

main categories: empowering parents and maintaining

parents' harmonious decisions on teen girls. Uwizeye D.,

Muhayiteto R., Kantarama E., Wiehler S., Murangwa Y.

(2020)

Jones, C., Whitfield, C., Seymour, J. et al (2019)

conducted a study where 40 young mothers, living in the

North of England, who gave birth to their babies aged 16-

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19, and who used a homebased contraceptive and sexual

health service following childbirth. The study has showed

that Teenage mother contemporaries are judged, and

stigmatized for having children when still in their

teenage years. Furthermore, a few of the adolescent

mothers in their study employed coping mechanisms to keep

themselves away from this negativity. The research

revealed two main characteristics that explain how

teenage mothers feel about pregnancies in other teenage

mothers; constructions of moral judgement and maintaining

positive self-representations.

According to the study in lira district of Uganda,

Multiple sexual partners, frequent intercourse, and

erratic use of contraception were found to enhance the

risk of teenage pregnancy among the behavioral factors

evaluated. Being married has been demonstrated to enhance

the likelihood of teenage pregnancy among familial

circumstances. Teenage pregnancies have been found to be

more likely in situations where there is peer pressure,

sexual abuse, or lack of control over sex. (Ochen, A.M...

Chi, P.C. & Lawoko, S., 2019)

Gregorio V. (2018), who studied about the alarming

situation of teenage. pregnancy in the Philippines. Found

that Based on the discussions, adolescent sexuality is

learned by young women not in school but through their

partners or friends, who, most probably learned it from

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other resources (e.g., pornography). Young women's

parents. typically wait until they are pregnant before

having a conversation with their daughter about sex,

family planning, and pregnancy. This fosters a culture of

silence among young women and results in their lack of

access to any reliable sources of information. The

economic situation of the teenage mothers in Tondo

greatly affects their opinions on adolescent sexuality,

romantic relationships, and parenting. Their primary

reason for dropping out of school and being made to work

as adults was extreme poverty.

Others may also claim that societal factors and the

media may also play a role in the rise of teenage

pregnancies. Journalist Teddy Losin Jr. (2014) even

blamed the rise of teenage pregnancy on showbiz. He cited

the prominence of sexual themes in television and movies,

day in and day out, and states this as the reason why the

desire for physical contact is ingrained into the minds

of the youth. While people can speculate on the true

reasons behind it, the reality is that teenage pregnancy

in the Philippines is becoming far too common. Not only

this, but the teenage moms are getting younger as well.

Synthesis
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Teenage pregnancy occurs when partner did not use

reliable contraceptive methods and when poor coitus

communication is present between partners. Mostly teenage

mothers have careless attitude towards sex and fear of

using contraceptive methods. If teenage girls have low

education and they belongs to poor family that it can

become a reason of teenage pregnancy. (Kanku.T, 2009).

Some studies indicated that teenagers are sexually

active in their puberty life. During puberty time they

are facing many challenges such as females are having

menstruation and in boys are having wet dreams and during

this period they are active to make sexual relationship

and they may do it even using of safety methods. Some

adolescent’s are having the perception that teenage

pregnancy is not good for their health because it cause

many diseases which can threat to their life. Teenage

pregnancy can be a barrier to achieve goals in education

field. Teenage mothers mostly live in poverty , lacks to

get prenatal care, gains less weight during pregnancy .

These all factors are associated with poor birth results.

Few adolescents from rural area perceived that their

community did not allowed them to become pregnant under

the age of 20 years. It is illegal according to their

community. (S Richter 2005)

Some teenagers perceived positively about teenage

pregnancy that they get become independent, receive love,

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attention and recognition. They able to maintain the good

relationships with their partners and they proved that

they are capable for having a child and become closer to

the family. Adolescent parents shows positive attitude

regarding teenage pregnancy that after having baby they

become strong, stopped all doing stupid things ,they more

grown up with growing baby, and developed more ability to

manage the time . Some adolescent had negative attitude

towards teenage pregnancy. They think that those teenage

mothers are unable to solve their problems and unable to

take care of herself and her baby also and they support

to abortion (Herman, 2008).

A perception of teenage mothers regarding teenage

pregnancy that they did not get any sex education by

their parents therefore they got pregnant. If they got

education regarding sex from their parents then this

mistake did not happened and they did not face these

problems (S Richter, 2005).

Teenage pregnancy can be prevented by high education

level. Some teenagers express their perception that we

need more information to prevent teenage pregnancy , they

need to know about the good contraceptive methods which

can prevent the teenage pregnancy and they want to know

about the diseases which are caused by teenage pregnancy;

these all information increase the knowledge of teenagers

and prevent the teenage pregnancy (kanku.T,2009).

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CHAPTER 3

METHODS AND PROCEDURES

This chapter is going to look at the methodology

that will be use to collect data on teenage pregnancy and

how the data will be analyzed.

RESEARCH DESIGN

The quantitative research method was chosen for the

study since quantitative research is a formal, objective,

and systematic process used to describe variables, verify

relationship between them, and study cause and effect

relationships between variables (Burns, Grove, & Gray

2015,510). Quantitative research summarizes data

collected from a sample, which is the target population

to which the results are applied. The study uses cross-

sectional descriptive model of the quantitative study.

The research intended to get the different attitude

of nursing students towards teenage pregnancy and

sexuality in University of Cagayan Valley. This design

was appropriate for this study since it involves

administering questionnaires to a sample of nursing

students to collect information about their attitude

towards teenage pregnancy and sexuality.

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The descriptive analysis will be done using

percentages, frequencies, and cross-tabulations.

Respondents of the study

The respondents of this study will be selected within

the University of Cagayan Valley. The target respondents

of this study are those from 3rd year nursing students.

Data about the respondents obtained will be considered

confidential, we will keep private all their identities.

The respondents are composed of 20 students from each

section. The table below shows the distribution of

respondents.

Table 1

Distribution of respondents

Respondents Population

Section A 20

Section B 20

Section C 20

Section D 20

total 80

Data Gathering Tool

The main research tool to be use in the study was a

survey questionnaire which is patterned from the study of

Emily King , (2009) entitled “Teenage Sex: A study of

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male and female teenager’s attitudes toward teen sex and

teen pregnancy.”

The first part of the questionnaire is the profile

of the respondents in terms of their Age,sex, civil

status, religion, parents highest educational attainment,

and parents occupation. The second part of the

questionnaire focuses on the attitude of nursing students

about teenage sexual activity and teenage pregnancy.

Data Gathering Procedure

Permission to conduct the study will be obtain from

the president of the university through the vice

president for academics noted by the college dean. After

the permission or approval of the said authority was

obtained, the questionnaire will be administer to the

respondents (nursing students).

The questionnaires for nursing students will be

administer and collect immediately as they will fill and

tally based on the focus of the study. For

confidentiality, the researcher will ensure that the

respondent’s names were not written.

Statistical Tools

The researcher will utilize the following

statistical tool to interpret and analyse the data to be

collected:
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The profile variables of the respondents will be

analyse through the use of the simple frequency counts

and percentage distribution.

The assessment of the respondent’s assessment on

their attitude towards teenage pregnancy and sexuality

among nursing students will be interpret and analyse

using the weighted mean grade and will be guided by the

scale below:

Numerical scale Descriptive scale

5 Strongly agree

4 Moderately agree

3 Neutral – neither agree or

disagree

2 Moderately disagree

1 Strongly disagree