Background

Teenage girls who enter puberty begin to experience many physical, physiological and psychological changes. One of these changes is complaints during menstruation when entering the menstrual period. Teenage girls often experience problems that often arise, and the most experienced by Teenage Girls is dysmenorrhea.

Menstruation is one of the primary signs that a woman has entered the age of puberty. Menstrual disorders that women often face are quite a lot, including Pre-Menstruation Syndrome (PMS), amenorrhea, polimenorrhea, and oligomenorrhea, and one of them is dysmenorrhea.

This dysmenorrhea causes pain in the lower abdomen, which radiates to the lower back and the legs. Dysmenorrhea usually occurs two to three years after menarche. Pain begins to arise shortly before or during menstruation. Dysmenorrhea is one of the most common gynecological disorders in teenage girls. The signs and symptoms of dysmenorrhea have very varied physical symptoms [1]. Dysmenorrhea is not dangerous to health, but if left untreated, it can cause pain and discomfort that can interfere with teenage activities, both daily activities and activities at school. Dysmenorrhea has a high impact on women's lives, resulting in restriction of daily activities, lower academic performance in teenagers, and poor sleep quality; and harms mood, causing anxiety and depression [2]. The occurrence of dysmenorrhea in the world is substantial. On average, almost more than 50% of women experience it. In the UK, a study found that 10% of school teenagers every 1-3 days each month experience dysmenorrhea. Primary dysmenorrhea is expected; more than 50% of women experience it, of which 15% experience severe pain. Usually, primary dysmenorrhea occurs in teenagers about 2-3 years after the first menstruation. Based on data released by WHO, it was found that 1,769,425 people (90%) of women who experienced dysmenorrhea, 10-15% of them experienced severe dysmenorrhea. These results are supported by the results of studies in various countries, which are very surprising. Primary dysmenorrhea in each country is reported in more than 50%, and 14.8% of women experience severe dysmenorrhea. A study conducted in India found a prevalence of severe dysmenorrhea of ​​73.83% [1].

In Indonesia, around 45-95% of women of reproductive age experience dysmenorrhea [3]. The occurrence of dysmenorrhea in Indonesia is around 64.25%, 54.89% identified as primary dysmenorrhea and 9.36% as secondary dysmenorrhea. Primary dysmenorrhea is experienced by 60-75% of teenagers, with three-quarters of these teenagers experiencing mild to severe pain and a quarter experiencing severe pain [1].

According to the Bali Provincial Health Office, dysmenorrhea in 2014 was 48.05%. According to Setianingsih's research, by providing effleurage massage to decrease the dysmenorrhea pain scale, the average value before being given effleurage massage was 4.65. After being given an effleurage massage, it was 1.81. With this, there is a decrease in the intensity of dysmenorrhea pain by 2.84 points.

Overcoming dysmenorrhea complaints is by non-pharmacological pain management is safer because it does not cause side effects such as drugs because non-pharmacological therapy is a physiological process. There are several ways to treat primary dysmenorrhea pain, pharmacologically and non-pharmacologically, using warm compresses and effleurage massage.

Handling non-pharmacological primary dysmenorrhea with a combination of warm compresses and massage effleurage is given counseling to Teenage Girls using media in the form of videos. A video is a form of technology for recording, capturing, processing and transmitting and rearranging moving images. Counseling with video media aims to make counseling more interesting so that Teenage Girls better understand the message conveyed regarding the non-pharmacological treatment of primary dysmenorrhea. In addition, video media is easier to carry everywhere, can be stored for a long time, and is more informative and exciting.

A warm compress is a compress carried out using hot bladders wrapped in cloth, namely by conduction, where there is a transfer of heat from the bladder into the body so that it will cause dilation of blood vessels. There will be a decrease in muscle tension so that the menstrual pain felt will decrease or disappear. Warm compresses are very effective in reducing the pain of dysmenorrhea because it does not require a lot of money, a long time, or heavy physical work. Warm compress therapy has been proven based on the results of Dahlan's research. It was found that 56% of respondents had mild pain levels after warm compress therapy, whereas previously, respondents experienced severe and moderate pain. This indicated a decrease in pain levels after warm compress therapy. In addition, based on the research of Nida and Sari [4], it was found that there was a decrease in the pain scale in teenage girls who experienced dysmenorrhea. Massage Effleurage is a stroke that is done using the palms of the hands and fingers at the same time. Effleurage can be done with one or both hands or arms in several body areas. Based on a preliminary study conducted on October 15, 2021, from 15 samples of Teenage Girls at the State High School 2 Amlapura, 86.7% of Teenage Girls were suffering from dysmenorrhea. As many as 69.2% used pharmacological methods to treat pain by taking medicine in stalls containing analgesics, and 46.2% of people used non-pharmaceutical methods. Logically, namely by exercising, drinking herbal medicine, and resting. In addition, Teenage Girls at Senior High School 2 Amlapura do not yet know that warm compresses and effleurage massage are complementary therapies to treat dysmenorrhea pain.

Based on this background, researchers were interested in researching "the effectiveness of the administration of warm compress and effleurage massages videos on the knowledge of teenage girls about primary dysmenorrhea management."

The research used in this research was comparative analytic with a pre-experimental design using one group pre-test and post-test design, namely observations were carried out twice before and after the experiment. The sample in this study were all teenagers who were female students who experienced dysmenorrhea at Senior High School 2 Amlapura and who met the inclusion criteria, totaling 42 samples. The sampling method in this study was the purposive sampling technique. Data was collected by administrating pre-test and post-test questionnaires containing questionnaires to determine knowledge about the treatment of primary dysmenorrhea pain in teenage girls and videos containing explanations about warm compresses and massage effleurage. The statistical test used in this study was the Wilcoxon test because the data were not normally distributed with p < 0.05. This research has received a research ethic letter from the Research Ethics Commission at the Denpasar Health Ministry Poltekkes Number: LB.02.03/EA/KEPK/0114/2022 on April 4, 2022.

Based on Table 1, it can be seen that the number of respondents aged 15-16 years was the same as the number of respondents aged 17-18 years, each of which was 21 respondents (50.0%), and most of the respondents never received information about handling primary dysmenorrhea pain with a combination of warm compresses and massage effleurage that was 31 respondents (73.8%)

Teenage Girls' Knowledge About Primary Dysmenorrhea Pain Management before Videos administration at Senior High School 2 Amlapura

Based on the result, the knowledge of teenage girls about the treatment of primary dysmenorrhea before video administration, it was found that the minimum value was 25, the maximum value was 100, the mean was 79, the median was 83, the mode was 75, and the standard deviation was 18.613.

Table 1: Distribution of Respondents' Characteristics in Senior High School 2 Amlapura

Teenage Girls' Knowledge About Primary Dysmenorrhea Pain Management After Administrating Video at Senior High School 2 Amlapura

The result indicated that after administrating videos, all 42 respondents (100%) had a minimum score of 83, a maximum value of 100, a mean of 95, a median and a mode of 100 with a standard deviation of 6.497.

Differences in Knowledge of Teenage Girls about Treatment of Primary Dysmenorrhea Before and After Counseling with Video Media

Statistic indicates the results of the Wilcoxon test with a significance value of 0.000 (p<0.05). Thus, it was concluded that there was a significant difference in knowledge scores between before, namely a median of 83 with a standard deviation of 18.613 and a median of 100 with a standard deviation of 6.497. The results of the research data analysis showed that the significance level of the p-value in the Wilcoxon test was 0.000. Because the p-value <0.05, it could be concluded that there was an effect of administrating video massage effleurage and warm compresses on the knowledge of teenage girls about managing primary dysmenorrhea pain in Senior High School 2 Amlapura.

Teenage Knowledge Before Counseling Administrating Videos of Warm Compress and Massage Efflurage

Before being given education with video media, some teenage girls had knowledge in handling dysmenorrhea with non-pharmacological methods, the minimum score was 25, the maximum value was 100, the mean was 79, the median was 83, the mode was 75 with a standard deviation of 18.613; hence, teenagers with dysmenorrhea experience a decrease. learning activities and decreased achievement.

Knowledge is the result of human sensing, or the result of someone knowing about objects through their senses (eyes, nose, ears, and so on). In this study, what was studied was the knowledge of teenage girls about the non-pharmacological treatment of primary dysmenorrhea. Knowledge is everything that is known to teenage girls based on sensory results about the non-pharmacological treatment of primary dysmenorrhea as measured by a questionnaire containing questions about the definition of dysmenorrhea, the causes of dysmenorrhea, how to treat primary dysmenorrhea, types of primary dysmenorrhea treatment, and the workings of each type of non-pharmacological treatment of primary dysmenorrhea through video education media.

A person can be influenced by exposure to information from various sources such as: mass media, the internet, parents, friends/ close friends, relatives/ family, teachers or health workers. Lack of information about treating dysmenorrhea with warm compresses will affect one's knowledge. This is supported by research by Karimah, which states that the lack of sources of information about something will affect one's knowledge. The more exposed to information, the knowledge of a person will increase. This is in accordance with the statement according to Long in Nursalam and Pariani that someone who gets information will increase the level of knowledge of something.

Knowledge of Respondents After Being Given Counseling About Vulva Hygiene

After receiving counseling about the combination of warm compresses and effleurage massage using video, all 42 respondents (100%) showed that some teenage girls had knowledge of managing dysmenorrhea with non-pharmacological methods, the minimum score was 85, the maximum value was 100, the mean was 95, the median and mode were 100 with a standard deviation of 6.497. Video education media was very effective in being used as a medium for disseminating information, helping to increase understanding and practitioners in handling teenage dysmenorrhea.

The knowledge of teenagers who experienced a significant increase from the questionnaire points and the presentation of the results of video media education was on the questions on the causes of dysmenorrhea, how to handle dysmenorrhea and work steps for treating primary dysmenorrhea.

Thus, it could be interpreted that information about the treatment of primary dysmenorrhea with warm compresses, and effleurage massage could be conveyed and accepted by respondents. This is in accordance with research conducted by Sugiarti, that there was an increase in respondents' knowledge during the pre-test from 75 (65-80) to 95 (90-100) at the post-test after being given an extension intervention with video media.

Differences in Knowledge Levels Before and After Administrating Warm Compress Videos and Massage Effleurage about Primary Dysmenorrhea Pain Management

The results of the research data analysis showed that the significance level of the p value in the Wilcoxon test was 0.000. Because the p-value <0.05, it can be concluded that there was an effect of administrating videos of massage effleurage and warm compresses on the knowledge of teenage girls about managing primary dysmenorrhea pain in Senior High School 2 Amlapura. This was in line with research conducted by Wongkor in Woloan Dua Village, Tomohon City, which stated that health education affects teenage girls' knowledge about the management of menstrual pain (Dysmenorrhea).

Notoatmodjo's statement that knowledge was the result of knowing that occurs after people had sensed through the five senses. This was related to Brown's statement regarding the function of health education that health education provides information or instructions regarding health behavior.

Sugiarti's statement [5] stated that health counseling is a health education activity carried out by spreading messages so that people who are given counseling become aware and know about a health issue, while the original meaning of counseling is the provision of information and information. One of the factors that could increase teenage knowledge is the source of information obtained through educational media such as video.

The results of this study were in line with the results of research [2], in community service, which states that there was a significant difference in the knowledge of private junior high school students in Mengwi District before and after being given counseling and group guidance. Other research also showed that most respondents had good knowledge about the impact of teenage pregnancy after being given video media at the Pertiwi Private High School Jambi City in 2018 [4].

Research states that the administration of booklets and videos increased teenage girls' knowledge about dysmenorrhea. This showed that video media could increase teenagers' enthusiasm to listen and understand more, which is very helpful in increasing knowledge [6].

Health education was all efforts made to have an influence on the target, either individual, group, or community, so that the target was able to behave as expected by the perpetrators of education or health promotion. The expected result was behavior to maintain and improve health. To achieve this goal, a form of promotion that could be done was through health education [7].

The use of interactive health education media in the form of videos or anime cartoons could increase understanding of educational materials of ASI was needed and very effectively used as a medium for disseminating information, helping to increase understanding and practitioners in increasing knowledge for teenagers [8].

The conclusion in this study is that there are differences in the level of knowledge of young women in the treatment of primary dysmenorrhea before and after being given counseling with video media. 

Acknowledgment

Thank you to the institution for administrating permission for the researchers to conduct research and the school that has supported this research.

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