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J Educ Health Promot. 2019 Sep 30;8:176. doi: 10.4103/jehp.jehp_381_18. eCollection 2019.

Knowledge, attitudes, and coping strategies regarding pubertal changes among adolescent girls: Risks and compliances for health promotion in puberty.

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Department of Community Health, Alborz Medical Science University, Karaj, Iran.
School of Nursing, University of Connecticut, Storrs, CT, USA.
School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran.



Adolescent girls experience physical, psychological, and social changes during puberty. Lack of sufficient information, skills, and readiness to overcome this stressful situation make them vulnerable. The present study aims to assess the level of knowledge, attitude, and strategy used for coping with puberty crises of female secondary school students in Karaj, Iran.


Five-hundred and seventy female secondary school students from Karaj, Iran participated in this cross-sectional study. Knowledge, attitudes, and coping strategies of adolescents about puberty were evaluated using various questionnaires. The obtained data were analyzed using Chi-square, Fisher's exact, Kruskal-Wallis, Mann-Whitney, and Spearman tests.


The average age of participants was 15.28 ± 1.58 years old. About 85.1% of the participants had high knowledge about puberty and 66.7% had a good attitude toward it. Nearly, 54.2% of the girls used the avoidance-oriented coping strategy. There was no significant relationship between knowledge and attitude regarding selective strategies to cope with stressful situations in puberty.


According to the results, continuous training in secondary schools is necessary to improve adolescents' knowledge and attitudes toward puberty. Moreover, more training is required to change the dominant avoidance-oriented coping strategy to a task-oriented approach, especially at the first-grade level in secondary school.


Adolescent; attitude; coping strategy; girl; knowledge; puberty

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