Promotion of health in adolescence

PROMOTION OF HEALTH IN
ADOLESCENCE
Author:
Mª del Rosario Monter Ardanuy
Primary Care Nurse

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PROMOTION OF HEALTH IN ADOLESCENCE
Dª María Rosario MONTER ARDANUY, author of the work PROMOTION OF HEALTH IN
ADOLESCENCE.
With registration of intellectual property with the number
16/2018/5173, fecha 24 de julio de 2018
ISBN - 978-84-09-06617-9

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M.R. MONTER ARDANUY
Clarifications by the author
This objective deals with health education for adolescents which has been carried out
throughout my professional practice. It is more complex to guide the elderly in health
education since life habits have been consolidated over time. However, in the adolescent
population it is more useful to guide in health education because this is a time when it is
best assimilated and they are more open to receive information from the environment
and to learn healthy lifestyle habits.
On the other hand they are in a vital moment, where it is fundamental to learn the
concept of self-esteem and to work towards acquiring a good self image. In this way they
learn how to be able to take care of themselves and avoid the risks that may endanger
their physical and mental health.
It is important to adapt the teaching materials each year according to how society evolves
and also to the new fashions or drugs that may appear. It is not a question of prohibiting
certain behaviors but of making known the dangers and risks involved which are
detrimental for their health, so that they consciously and responsibly adopt an
appropriate attitude towards them.
The document provides all types of information for each slide as well as the reference of
the website where the contents of the texts or videos were obtained. In some cases it has
not been possible to obtain the references as the source data was inaccesible but I have
found it important and interesting to contribute them to clarify the topic. Visual images
greatly help the learning process. I would like to thank those people who have given me
these data on the web and have helped me in the development of this project.
Some slides may seem to incite incorrect attitudes and behaviour. I would like to make
clear that the fundamental intention is to prevent and understand the risks and dangers
that could cause damage to their health and their life and which in some cases could be
fatal.

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THANKS
Throughout these years I have counted on the help of many colleagues without whom
this project could not have been carried out.
This initiative began in the Health Centres of Manzanares and Soto del Real. The authors
at that time (Ana Sotillos and I) had the support of all professionals both at the beginning
and during the development of this project in the 2004-2005 academic year at the Sierra
de Guadarrama Institute in Soto del Real, where we gave our first educational talks for
teenagers. Therefore I would like to acknowledge all the support and help given to me by
these professionals in both centres.
Pilar Cabezón Blanco with whom I spent many hours working on the subject of self-
esteem for teenagers and who gave me both help and insight.
Gema Martínez González. She encouraged Ana Sotillos and I, giving us the opportunity to
make ourselves known in this field.
Carmen Jiménez Gómez. She helped me in the formation of the text in the chapter on
self esteem.
To the team of the Sierra de Guadarrama Institute of Soto del Real. They have always
shown interest in the area of adolescent health and have given me the opportunity to put
this project into practice.
Paz González Rodríguez, pediatrician. She gave a lot of information on the subject of
adolescence and gave encouragement to develop our work in health education.
Elena Martín de Castro, a nurse from the Research Department and María Luisa
Maquedano, a documentarist who has specialized in health sciences (both from the
University Hospital La Paz), for their help in the distribution of this document.
Julia López Puga who has supported me with the development of this project throughout
these years and Esther Frías who has taken part in the same.
I want to thank the very special collaboration of my good friend Milagros Lobete
Cardeñoso, who has always been by my side, helping me in the revision and the finalizing
of all my work.
My very special thanks to Maria José Fernández Rodríguez and Kate Mary Conroy for their
cooperation in translating this book into English, and therefore making it possible to
reach a wider audience.
María del Rosario Monter Ardanuy

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M.R. MONTER ARDANUY
INDEX
Content Page
1 - Educational project 8
1.1 - Introduction 9
1.2 - Analysis of the situation 9
1.3 – Project justification 11
1.4 - Goals 12
1.5 - Methodology 13
1.6 - Evaluation 16
1.7 - Bibliography 18
1.8 – Teacher group questionnaires 19
2. Education for health in self-esteem 24
2.1 Introduction 25
2.2 Justification 26
2.3 Goals 27
2.4 Methodology 27
2.5 – Content of the sessions 28
2.5.1 - 1º SESSION - Personal and emotional self-esteem - pdf
https://es.slideshare.net/CharoMonter/21-self-esteem-1
Explanatory text of the slides page - 83
2.5.2 - 2º SESSION - Self-esteem, self-concept and self-image – pdf
https://es.slideshare.net/CharoMonter/22-self-esteem-2-promotion-of-health-in-
adolescence
2.5.3 - 3º SESSION - Social influence on self-esteem - pdf
adolescence
2.5. 4 - 4º SESSION - New trends and challengers (influence on social
networks)- pdf
https://es.slideshare.net/CharoMonter/24-new-trends-and-challenges
2.6 – Schedule of sessions 30
2.7 - Evaluation 34
2.8 – Bibliography 35
2.9 – Questionnaires 37
3. Health education in behavioral disorders: eating disorders, alcohol and
drugs
41
3.1 Introduction 42
3.2 Justification 44
3.3 Goals 44
3.4 Methodology 45
3.5 – Content of the sessions 45
3.5.1 - 1º SESSION- Food and nutrition – pdf.

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https://es.slideshare.net/CharoMonter/31-food-nutrition-promotion-of-health-in-
adolescence
3.5.2 - 2º SESSION - Eating disorders- pdf
https://es.slideshare.net/CharoMonter/32-eatind-disorders-promotion-of-health-in-
adolescence
Explanatory text of the slides page -134
3.5.3 - 3º SESSION - Alterations of behavior (alcohol and drugs) – pdf
https://es.slideshare.net/CharoMonter/33-alterations-of-behaviour-promotion-of-
health-in-adolescence
3.5.4 - 4º SESSION - Toobacco, alcohol an druugs - pdf
https://es.slideshare.net/CharoMonter/34-tobacco-alcohol-and-drugs-promotion-
of-health-in-adolescence
3.6 – Schedule of sessions 47
3.7 – Evaluation 51
3.9 – Questionnaires. 54
3.9.1 – Food questionnaires 55
3.9.2 – Alcohol and drug questionnaires 62
4. Education for health in sexuality and affectivity (content development) 67
4.1 – Introduction 68
4.2 –Justification 68
4.3 - Goals 69
4.4- Methodology 68
4.5 Content of the sessions 70
4.5.1- 1º SESSION ESO- Physiology of sexuality and affectivity - pdf
https://es.slideshare.net/CharoMonter/41-physiology-of-sexuality-promotion-of-
4.5.2 - 2º SESSION ESO- Contraceptive methods and pregnancy - pdf
https://es.slideshare.net/CharoMonter/42-contraceptive-methods-promotion-of-
4.5.3 - 3º SESSION - Sexually transmitted diseases and pathologies. -
pdf
https://es.slideshare.net/CharoMonter/43-sexually-transmitted-diseases-promotion-
of-health-in-adolescence
4.6 - Schedule of sessions 71
4.7 – Evaluation 74
4.9 – Questionnaires 77
5 - - Guide to the contents of the PDF slides 81
5.1 Self esteem 82
Self esteem I 83

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M.R. MONTER ARDANUY
Self-esteem II Identity 92
Self-esteem: social influence 98
New fashions 116
5.2 Eating, alcohol and drug disorders 125
Food and nutrition 126
Eating disorders 134
Behavioral disorders: alcohol and other drugs 144
Tobacco, alcohol and drugs 151
5.3 Sexuality 166
Physiology of sexuality and affectivity 167
Contraceptive methods and pregnancy 179
Sexually transmitted diseases 188

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1
EDUCATIONAL PROJECT

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M.R. MONTER ARDANUY
1.EDUCATIONAL PROJECT
1.1 INTRODUCTION
Adolescence is a difficult stage in life which cannot be defined clearly, not even in
chronological terms. It is a critical time in life with rapid and profound changes in the
body, in the way of thinking, in emotions, in insecurities (anxiety about the future, and
about the great physical changes which will take place), of imbalances between
aspirations and opportunities in the affective field , sexual, academic and general
pressure from parents about careers and jobs, peer groups and the consumer society. All
this makes the adolescent particularly sensitive to health related problems.
Therefore, health professionals need to try and contribute to providing adolescents with
effective resources in order to enable them to face up to the inevitable risk situations
related to their bio-psycho-social development. They will encounter these in this period
of their lives and also in later stages.
This project of educational work, which is presented, seeks to provide the necessary tools
for health professionals, counsellors and educators so that adolescents can be made
aware of the reality and the environment that surrounds them. Hopefully it will enable
them to develop knowledge, values, skills and those capabilities which will allow them to
adapt their behavior to reality, improve self-care and acquire greater individual and social
competence so as to achieve self-fulfillment in all areas, both physical, psychological and
social.
1.2 ANALYSIS OF THE SITUATION
The young population of the Community of Madrid has been changing its habits with
respect to previous years, for example, according to the data of SIVFRENT-J (System of
surveillance of risk factors associated with non transmittable diseases in the young
population 2016) an increase is observed of almost 18% in physical inactivity by girls,
while in boys physical activity remains stable. The most frequently performed activities
are football for boys and dancing, jogging and basketball for girls.
A pattern of food consumption is maintained, with an excess of meat products and
pastries, a decrease in vegetable and fruit intake, and a consumption lower than that
which is recommended in terms of milk and dairy products. There is a higher intake of
salted snacks The difference in food intake between boys and girls is interesting since in
general the nutritional profile of the girls is slightly better: Their consumption of fruit and
vegetables is more frequent, as well as that of fish. The consumption of cookies and
pastries is lower.

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18.6% of the boys and 37.0% of the girls considered that they were overweight or obese.
29.7% of young people said they had tried some type of diet in the last 12 months, and
19.4% had carried out some diets for losing weight. The girls tried these diets
approximately 2 and a half time more frequently than boys (28.1% and 11.3%
respectively). The proportion of young people who made attempts to lose weight
increased by 74.3% in boys and slightly decreased in girls by 1%.
2.8% of the boys and 13.1% of the girls answered affirmatively to one or more of these
three indicators (3.0% of the total of women responded to two and 1.1% to the three).
Specifically, during the last year, 9.7% of the girls had not ingested any type of food in 24
hours at any time, 4.9% had been vomiting to lose weight, and 3.6% had used diuretics,
laxatives or slimming pills with the same purpose.
15.2% of young people were overweight and 2.4% were obese, this was twice as frequent
in men as in women. This evolution has increased in recent years, especially in the case of
women.
Overall, 18.1% reported smoking more or less regularly, 68.3% never smoked and 13.6%
were ex-smokers. Of the total of young people, 6.9% indicated smoking daily and 4.8%
smoking once a week, which gives a figure of 11.7% of habitual smokers. The proportion
of young people who indicated smoking daily, at present, was higher in women (8.3%)
than in men (5.6%) and the prevalence increased rapidly with age: 6.5% 16-year-olds
smoked daily compared to 4.1% of those who were 15 years old.
52.2% of young people had consumed some type of alcoholic beverage in the 30 days
prior to the interview and 7.8% (8.9% of boys and 6.6% of girls) had ingested alcohol 6 or
more days prior to the interview. The average consumption of alcoholic beverages in this
population meant an intake of 52.9 cc of alcohol each week (52.9 cc / per week in boys
and 53.0 cc /per week in girls). An increase in consumption was observed with age, with
40.0 cc of weekly consumption in adolescents of 15 years of age and 51.2 cc /per week in
those of 16 years of age. The drink that contributed the greater part of alcohol
consumption was the mixed drink, which represented 58.0%.
The excessive consumption of alcohol on the same occasion (adaptation of the Anglo-
Saxon "binge drinking"), defined in this study as the consumption of 60cc or more of
alcohol (for example 6 beers) in a short period of time (one afternoon or one night), is
very important in this age due to its relationship with acute effects such as alcohol
poisoning, traffic accidents and violence. 31.0% of the interviewees reported having made
some excessive consumption in the last 30 days, being slightly higher in women (31.6%)
than in men (30.5%), and more frequent in young people 16 years of age (29.0%) than in
those of 15 years of age (25.6%).

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M.R. MONTER ARDANUY
39.5% said they had been intoxicated sometime in the last 12 months and 19.8% in the
last 30 days. Finally, In the last 30 days 17.1% of the young people had travelled in a
vehicle whose driver was under the influence of alcohol.
The drug most frequently consumed, with a greater difference over the rest, continued to
be hashish. Referring to its consumption, during the last 12 months 10.9% of young
people consumed hashish and sometime in the last 30 days of 5.7% consumed. The
second most frequently consumed substance was tranquilizers without prescription, with
a consumption in the last 12 months in 2.6% of young people. The least consumed drug
was heroin and volatile substances, with a 0.2% prevalence in both cases.
Regarding sexual acitivity 27.7% of young people had had penetrative sex (29% of boys
and 26.4% of girls). In the 16-year-old, this percentage was 14.8% compared to 15.7% in
the 15-year-old.
80.2% used the condom during the last sexual intercourse. 14.1% used ineffective
contraceptive methods basically because no method was used at all other than coitus
interruptus or the Ogino method. Others replied that they did not know for sure which
method they had used.
Over the last 10 to 15 years, information on healthy habits for young people has been
progressively incorporated into the educational centres particularly when dealing with
the consumption of tobacco, alcohol and illegal trade drugs and sex education. This
training is incorporated voluntarily. It should be included in the teaching curriculum of
primary and secondary schools, taught by health personnel and/or tutors.
1.3 PROJECT JUSTIFICATION
The health education project for adolescents was born from the need detected by the
health centre professionals, having observed the frequency with which young people
arrive to the emergency room with alcohol poisoning, unwanted pregnancies and for a
consultation about eating disorders.
It is evident that the situation detected in the work zone by the teachers of the
educational centre and health professionals becomes crucial to work in this field.
Adolescents need specific actions aimed at facilitating their development and social
integration. This intervention must be done from within and together with their reference
group to be better accepted and achieve a better result. Individualized education in
adolescents has some drawbacks compared with the effectiveness of group education.
This project aims to support the demand of parents and educators in the formation of
health habits and personal development in adolescents. They intervene jointly: family,

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educational centre, and other agents existing within the community, whose educational
power is imbued and modified by the influence of the peer group, the media, etc.
Education for health must be included in the project of the educational centres. The
collaboration of the health team is necessary given the characteristics of the training in
health knowledge for teachers and their availability according to the programme. The
joint analysis (health team and teaching team) in the needs of adolescents, justifies the
direct intervention of the health team in the teaching centres.
The presence of the professional nurse in the educational centre is essential to provide
health education progressively in all year groups depending on the area and population,
in addition to being able to carry out health interventions.
1.4 GOALS
General purpose:
Provide adolescents with the greatest number of available resources and skills that
enable them to take better care of themselves and to achieve greater personal and social
competence, creating healthy habits for life
Specific objectives:
Knowledge areas:
• The adolescent will know the factors related to some basic personal health care
(food, body hygiene, physical activity and other),and to evaluate their behaviour
and develop alternatives to enhance this care. This objective will be evaluated
through the questionnaires of general habits that can be administered and the
group work covered in class.
• The adolescent will know the risks of any negative health habit that endangers
their life (alcohol, tobacco, drugs and new fads influenced by social networks.).
• The adolescent will know the influence of sexuality on health, develop knowledge
about contraception, sexually transmitted diseases and alternatives for the
prevention of risks. This objective will be evaluated through brainstorming and
group activities that will be carried out in class.
Area of attitudes:
• Raise awareness among adolescents of the importance of dialogue, reflecting and
planning healthy activities adapted to their stage of life. This objective will be
evaluated through the expression of ideas and opinions of young people on the
topics addressed in class.

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M.R. MONTER ARDANUY
Skills area:
• The adolescent will learn to develop critical thinking which will allow him/her to
analyse the world around and to adapt his/her lifestyle in a healthier way. This
objective will be evaluated through the observation of group work developed in
the classroom and the expression of ideas and opinions in open debates.
• He/she will develop the analytical capacity to identify the danger that is entailed
in physical and psychosocial health issues and to keep up to date on the various
fads that appear on social networks. This objective will be evaluated through the
discussions of images and videos that will be screened in class and that
correspond to fashions that young people are already aware of.
• Provide effective resources for adolescents to be able to face the inevitable risk
situations which are going to be related to their physical, personal and
psychosexual development. This objective will be evaluated through observation
in the performance of group tasks, role play and brainstorming.
1.5 METHODOLOGY
The methodology is presented in a global manner for the entire teaching project, as well
as being specified in each area in order to maintain the individuality of each of the
educational topics addressed.
Target population
Pupils of Compulsory Secondary Education.
Number of students
Approximately 30 students per classroom. In the case of existing more than one
classroom for each level of ESO, the training will be done in each individual classroom.
Inclusion criteria
The inclusion of adolescents in health education groups will be carried out voluntarily in
tutoring classes, maintaining these criteria:
 Age between 12 and 17
 Belonging to the Institute
Exclusion criteria
That the adolescent refuses to participate in this type of intervention because of cultural
and / or religious beliefs.

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METHODOLOGICAL DEVELOPMENT:
Information sessions:
 The Health Centres related to the work zone of the Institute together with the
reference nurse (if any) in the educational centre.
 Information and presentation to the school’s educational team for their support
and collaboration.
 Written Information to the parents’ association and the teaching team so that
they are introduced to the project. These sessions will be held one per level of
year group.
Sessions with students
With the students, there will be 3 sessions of 60 minutes per class in each year group
adapting to the tutorials, with the exception of 4th year, which only has 2 sessions, these
sessions should not be more than 2 or 3 weeks apart.
Educational techniques to be used:
- Classroom research techniques: repertory grid, brainstorm.
- Visual techniques: participation in lessons, colloquial talks.
- Analysis techniques: image analysis, text analysis, discussion.
- Skill development techniques.
- Role-play.
NECESSARY RESOURCES
Human Resources:
Teaching staff: counsellors and tutors of the Educational Centre. The tutors of these
classes will be present in the development of the educational sessions and will be
collaborative in the discussions
The work of the teaching staff is fundamental to the continuity of the contents addressed
in each of the tutorials held during the school year.
Health professionals from the Health Centre.
Material resources:
- Classroom or multipurpose room.
- Computer and cannon for projection of the didactic content for the work in the
classrooms.
Sheets of paper for classroom work, colored pens white boards? and coloured
markers.
- Sheets of paper to write letters, envelopes and stamps.
- Photocopier and printer
- DVD discs to store information and pen drives.
- Questionnaires.

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M.R. MONTER ARDANUY
LIST OF CONTENTS BY COURSE:
 1º COURSE
- Personal and emotional self-esteem
Explanatory text of the slides page – 82
- Food and nutrition
adolescence
- Physiology of sexuality and affectivity
https://es.slideshare.net/CharoMonter/41-physiology-of-sexuality-promotion-of-health-in-
adolescence
 2. ºCOURSE
- Self-esteem, self-concept and self-image
adolescence
- Eating disorders
adolescence
- Contraceptive methods and pregnancy
https://es.slideshare.net/CharoMonter/42-contraceptive-methods-promotion-of-health-
in-adolescence
 3. º COURSE
- Social influence on self-esteem
adolescence
- Alterations of conduct (alcohol and drugs)
https://es.slideshare.net/CharoMonter/33-alterations-of-behaviour-promotion-of-health-
in-adolescence
- Sexually transmitted diseases and pathologies.
- https://es.slideshare.net/CharoMonter/43-sexually-transmitted-diseases-promotion-of-

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 4º COURSE
- New fashions and dangers for health (influence of social networks).
- Tobacco, alcohol and drugs
https://es.slideshare.net/CharoMonter/34-tobacco-alcohol-and-drugs-promotion-of-
In points 2, 3 and 4, the complete programmes of each teaching unit are presented
throughout the four years of health education to adolescents in educational centres
The information of the content of each slide of the pdf is provided in point 5 separately,
as in the previous sections, by teaching units, as it is referenced throughout the project.
The contents would have to be adapted periodically, according to the evolution of
society.
This material has 14 years of experience and has been applied in Soto del Real Institute.
The involvement of the teaching staff is of vital importance in the continuity of the
contents addressed in class. It is also necessary to involve the parents of the adolescents
in order to continue the development of the contents within the family environment.
Each year it is advisable to review the new adolescent fads in order to keep the topics
covered up to date.
1.6 EVALUATION
There will be three levels of evaluation of the sessions and the project itself:
Structure:
Students will be assessed through a questionnaire about the adequacy of the number of
sessions, the characteristics of the class where education for health is taught and the
proposals for improvement for future sessions.
Process:
In the same questionnaire provided to the students, their opinion regarding the contents
and visual demonstrations given and the importance they give to other topics of interest
will be evaluated and included in successive years .
Results:

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M.R. MONTER ARDANUY
Changes in lifestyle and the students’ knowledge of health education will be assessed by
the questionnaire given at the end of this module.
In the first place, it is necessary to determine what the students already know previously
about the subjects that will be taught over four years.
In the first year groupo secondary school before starting the different topics (or teaching
units), the questionnaires of: self-esteem, eating disorders and sexuality will be given out.
It is from the third year when the evaluation of the acquired knowledge is assessed. The
questionnaire is passed at the end of the complete cycle of each subject. In this year
group we evaluate: sexuality and eating disorders.
The unit of alcohol and other drugs also begins in this year group. The questionnaire on
habits and knowledge in these topics will be carried out at the end.
In the fourth year group at the end of the training, (all units) the evaluation will be carried
out on the acquired knowledge and habits in self-esteem, alcohol and other drugs, as well
as the final evaluation of the student on what has been taught and the teaching staff.

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1.7 - BIBLIOGRAPHY
1. Bandura, A. (1995). En la rectificación ecumenismo conceptual. En JE Maddux
(Ed.), La auto-eficacia, adaptación y ajuste: teoría, investigación y aplicación (pp.
347-375). Nueva York: Plenum.
2. Bandura, A. (1997). La auto-eficacia y el comportamiento de la salud. En A. Baum,
S. Newman, J. Wien auto-eficacia, adaptación y ajuste: teoría, investigación y
aplicación (pp. 347-375). an, R. West, McManus & C. (Eds.), Cambridge manual de
la psicología, la salud y la medicina (pp. 160-162). Cambridge: Cambridge
University Press.
3. Díez-Gañán L. Hábitos de salud en la población juvenil de la Comunidad de Madrid
2013. Resultados del Sistema de Vigilancia de Factores de Riesgo asociados a
Enfermedades No Transmisibles en población juvenil (SIVFRENT-J). Año 2013.
Boletín Epidemiológico de la Comunidad de Madrid.
4. Epstein, S. (1981): Revisión del concepto de sí mismo. Lecturas de psicología de la
personalidad. Madrid. Alianza.
5. Merino Godoy MA. La Educación para la Salud en la escuela. NureInvestigación
[revista en Internet] 2004 noviembre. [Acceso 2 septiembre 2009]. Disponible en:
http://www.nureinvestigacion.es/tesis_detalle.cfm?ID_TESINA=1&FilaInicio=1
6. Organización Panamericana de la Salud. División de Promoción y Protección de la
Salud. Programa de Salud Familiar y Población. Unidad Técnica de Adolescencia.
Enfoque de habilidades para la vida para un desarrollo saludable en niños y
adolescentes. Washington DC: Organización Panamericana de la Salud, 2001.
7. Rodríguez Rigual M. Necesidad de creación de unidades de adolescencia. An
Pediatr 2003; 58 (2): 104-6.
8. Serra – Sutton V, Rajmil L, Berra S, Herdman M, Aymerich A, Ferrer M et al.
Fiabilidad y validez del cuestinario de salud y calidad de vida para adolescentes
Vecú et Santé Percue de l´Adolescent (VSP-A). Aten Primaria. 2006; 37 (4): 203-8.
9. Sistema de Vigilancia de Factores de Riesgo Asociados a Enfermedades No
Transmisibles en Población Juvenil (SIVFRENT-J). Año 2016

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M.R. MONTER ARDANUY
1.8 – APPENDIX
EVALUATION QUESTIONNAIRE TO THE TEACHING GROUP
Below are several general evaluation questionnaires (not by topic) so that
the teacher can choose the one that best suits their needs.
EVALUATION QUESTIONNAIRE – 1 (evaluation at the end of each session)
EVALUATION QUESTIONNAIRE – 2 – General evaluation on the different subjects
taught and teaching: to apply at the end of each year on the topics taught

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EVALUATION QUESTIONNAIRE – 1 (evaluation at the end of each session)
It is important that you complete this survey in order to improve in the following sessions.
The information is confidential, as you will not see your name on the questionnaire
Course ID
Date: Age: Sex: Ο Female
Ο Male
To fill in the questionnaire, put an X where you consider.
1. In relation to the following aspects related to today's session, what do you think?
1-Very bad 2-Bad 3-Tolerable 4-Good 5-Very good
Room
Schedule
Duration
Audiovisual material
Support material
Practical demonstrations
2. Have the exhibitions been clear?
Ο None whatsoever
Ο Very little
Ο Quite a bit
Ο A lot
3. Have they work out your participation well?
Ο None whatsoever
Ο Very little
Ο Quite a bit
Ο A lot
4. In general, what do you think of the workshop?
Ο Very good
Ο Good
Ο Not so good
Ο Bad
Ο Very bad
3. Do you think your knowledge about the subject has increased?
Ο None whatsoever
Ο Very little
Ο Quite a bit

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M.R. MONTER ARDANUY
Ο A lot
4. Do you think there is a topic that should have been given in greater depth?
Ο YES Ο NO Ο I DO NOT KNOW
If yes, would you mind telling us which one?
5. Contribute your suggestions that you think would improve this workshop
Thank you very much for your cooperation

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ASSESSMENT QUESTIONNAIRE No. 2 – (Perform at the end of four year)
It is important that you complete this survey in order to improve in the following sessions.
The information is confidential, as you will not see your name on the questionnaire
Course ID
Date: Age: ______ Sex: Ο Female Ο Male
To fill in the questionnaire, put an X where you consider.
1. In general, what do you think about the course?
1. Ο Very good
2. Ο Good
3. Ο Not so good
4. Ο Bad
5. Ο Very bad
2. Has your knowledge about self-esteem increased?
1. Ο None whatsoever
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
3. Has your knowledge about behavior disorders increased?
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
4. Has your knowledge about alcohol and drugs increased?
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
5. Has your knowledge about sexuality increased?
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
In relation to the teachers of the workshops:
6. Have they used a clear language?

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M.R. MONTER ARDANUY
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
7. Have they favored your participation?
2. Ο Very little
3. Ο Quite a bit
4. Ο A lot
8. The quality of their interventions has been in your opinion...
1. Ο Very good
2. Ο Good
3. Ο Not so good
4. Ο Bad
9. What aspects did you like the most?
10.What things did you not like?
11.What other issues would you like to be treated?
Thank you very much for collaborating

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2
EDUCATION FOR HEALTH: IN
SELF-ESTEEM

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M.R. MONTER ARDANUY
2. EDUCATION FOR HEALTH IN SELF-ESTEEM
2.1 INTRODUCTION
Clemens talks about self-esteem, as an effective part of self-concept. It is an important
starting point for the positive development of human relationships, learning, creativity
and personal responsibility
Self-esteem has an important presence in such areas as emotional control, creativity and
personal relationships among others.
Bandura explains that self-efficacy is the appreciation of the capabilities that each one of
us has. While self-esteem is the general feeling of how valuable one is as a whole,
referring to the appreciation of being, self-efficiency focuses on the belief of having the
ability to succeed.
Self-efficiency has consistently shown to be a factor of great importance when facing
difficulty. It can motivate the adoption of behaviours that promote general health or stop
harmful behaviours.
The concept of self-efficiency, introduced by Bandura in 1997, represents a core aspect in
cognitive social theory. According to this theory, human motivation and behaviour are
regulated by thought and three types of expectations would be involved:
 Expectations of the situation, in which the consequences are produced by
environmental events independent of personal action.
 Expectations of result, which refers to the belief that a type of behaviour will
produce certain results.
 Expectations of self-efficiency, which refers to the belief that a person has the
ability to perform the necessary actions to obtain the desired results
Wylie defined how behaviour is influenced not only by the past and by present
experiences, but by the meanings that each individual attributes to their perception of
these experiences.
Self-efficacy has been adapted to psychology and nursing as an important indicator of
health behaviour.

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2.2 JUSTIFICATION
From birth and throughout the different stages of life, people experience different
situations, activities and life events that produce positive feelings, satisfaction and
wellbeing along with others that produce negative feelings, tension, stress and
discomfort.
These processes of life building and life development occur in constant interaction with
the environment in which they live. They are not only shaped by age but are conditioned
by the social structure and cultural aspects of each society and the actual historical
moment.
The training in physical and emotional self-care, is one of the most efficient interventions
for the promotion of health and well-being, to prevent health problems and diseases as
well as to train, develop and deepen skills and resources so as to be able to face the
challenges of life and prepare in advance, for whatever may occur.
That is why it is considered positive for nursing professionals to carry out educational and
assistance interventions with the people concerned, so that they stimulate the
perceptions of self-efficacy towards their health condition or illness, in the psychosocial
aspects of cognitive or psychological theories, such as motivation and learning in relation
to health behaviours.
The relationship of theory with nursing practice is also connected to providing the
achievement of behavioral changes.
The increasing incidence in our adolescent children of the consumption of toxins in their
social relations (especially alcohol, tobacco and drugs), the imbalance in nutrition
(obesity, anorexia - bulimia) and the increasingly early onset of relationships sexual, have
resulted in an increase in our consultations and emergency services, problems related to:
 Consumption of alcohol, drugs, violence, traffic accidents, etc.
 Anorexia - bulimia and obesity.
 Excessive importance of the physical aspect, as a way to improve social relations.
Thus appear obsessions for thinness and / or exaggerate the muscles.
 Requests for "post-coital contraception", even in 13 years old girls, with unwanted
pregnancies.
 Concern on the part of parents and educators of problems in coexistence and
relationships with adolescents.
The Coordinator of the UNESCO Chair of Youth, María Esmeralda Correa Cortez
indicated that for adolescents it is easier to exercise violence in a common space
such as social networks.
"The type of violence that is exercised in social networks among adolescents’ ranges
from teasing for physical appearance to women, even for poor grades in the case of
men," she said. She said that there is even a line to evaluate the schoolmates, "the

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M.R. MONTER ARDANUY
boys create virtual communities where they qualify the ugliest, the most beautiful,
the dumbest, the smartest and then put the link in social networks, so that all
others realize, enter and mock"
2.3 GOALS
General purpose
- Create in the adolescent the need to identify, develop and maintain their self-
esteem through the knowledge of their own resources.
Specific objectives
Knowledge area:
- The adolescent will know the concept of self-esteem, self-image and self-concept.
- The adolescent will know the influence of the media on self-image and self-
esteem.
Attitudes area:
- The adolescent will be able to critically analyze the influence of the media on the
acquisition of habits that affect self-esteem and self-image.
Skills area:
- He will learn to identify the dangers of social networks and their influence on the
acquisition of fashions dangerous to health.
- He will acquire the necessary skills to detect and handle situations of violence.
Resources
Human resources:
- Teachers and education counselors of the Institute.
- Health and socio-health professionals.
Material resources:
- Multiple use room.
- Computer and cannon for projection of the didactic content that is worked in the
classrooms.
- Sheets for classroom work, colored pens, slate and colored markers.
- Sheets to write letters, envelopes and stamps.
- Photocopier, printer and ink for copies and jobs.
- DVD discs, to store information.
- Pendrive to pass information among the participants.
- Questionnaires

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2.4 METHODOLOGY
Target population: Students of Compulsory Secondary Education with ages between
12 and 17.
Number of students: An average of 25 to 30 students per classroom.
Number of sessions: One session per course and classroom, from January to April of
the school year.
Inclusion criteria
The inclusion of adolescents in health education groups will be carried out voluntarily
maintaining these criteria:
 Age between 12 and 17.
 Belonging to the Institute.
Exclusion criteria
Providing that both the parents or guardians and the adolescent refuse to participate in
this type of intervention, it is by the type of beliefs (cultural, political, religious, etc.).
Time: 60 minutes each session. There will be 1 session per course and classroom, from
January to April of the school year.
- Research techniques in the classroom: Repertory grid, brainstorm.
- Exhibition techniques: Participated lesson, talk colloquium.
- Analysis techniques: Image analysis, text analysis, discussion.
- Role-playing, practice of relaxation technique.
2.5 CONTENT OF THE SESSIONS
In each session the link of the corresponding pdf topic appears
In the first session with the students, the following will be done:
- Presentation of teachers.
- Presentation of content of the sessions.
- Realization of the questionnaire.
2.2.1 – First session of self-esteem –
Emotional and personal self-esteem:
The set of features and variations that characterize a person.
Feeling of positive or negative assessment of oneself.

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M.R. MONTER ARDANUY
Control emotions without putting our health at risk.
Learn from your experiences to change your way of life.
2.2.2 – Second session of self-esteem – 2. SESSION
Self-esteem, self-concept and self-image:
Know the external influences that may endanger health: fashions, excessive
sports, unnecessary physical risks, alcohol, and drugs. Like following the trend of
unreal models, the denial of our body as it is, follow diets and aggressive
treatments and everything that puts health at risk.
Consequences of high and low self-esteem.
Encourage communication for a good relationship that helps us understand
different points of view and feel the support that will help them strengthen their
health, both physical and mental.
Know how they have to face the pressure of peer groups.
adolescence
2.2.3 – Third session of self-esteem – 3. SESSION
Social influence of self-esteem:
Learn to manage the social messages that can influence and determine our
behavior.
To know, accept and integrate in the environment that is lived, without causing a
risk to our physical, mental and personal development.
Understand the different existing cultures and fashions that may harm our health
adolescence
2.2.4 – Fourth self-esteem session – 4º SESSION
New fashions and dangers for health (influence of social networks):
Learn to identify how new social fashions influence the formation and
modification of self-esteem.
Identify the importance of controlling the effect of social networks on our lifestyle.
Know the importance of interpersonal relationships in the acquisition of habits
and lifestyles that can be harmful to health.

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2.6 CHRONOGRAMS OF SESSIONS
1st SESSION: EMOTIONAL AND PERSONAL SELF-ESTEEM
Educational
objectives
Contents Technique Group Time Resources Evaluation
Identify
knowledge about
self-esteem
Presentation of the teaching
team and program.
Previous questionnaire
Expository
Participatory
GG 10’ Computer Pre-test
analysis and
evaluation.
Identify the
preconceptions of
the group about
self-esteem.
Feelings of valuation of
oneself.
Consequences of high / low
self-esteem.
Changes in adolescence.
Expository
Participatory
GG 20´ Computer
Canon
Video
Board
Flipcharts
Power point
guide
Analysis of the
task and free
contributions.
Identify the
preconceptions of
the group about
the SELF.
Definition of the SELF.
The conception that a person
has of his own personality.
Expository
Participatory
GG 20 Computer
Canon
Video
Board
Flipcharts
Power point
guide
Analysis of the
task and free
contributions.
Synthesis Summary, return and closure. Expository
Participatory
GG 5` Board
Flipcharts
Analysis of the
task and free
contributions.

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M.R. MONTER ARDANUY
2nd SESSION: SELF-ESTEEM, SELF-CONCEPT AND SELF-IMAGE
Educational
objectives
Remember the previous
session.
Analysis and summary of the
previous session.
Presentation of the sessions
and their objectives.
Exhibition and
summary
GG 5´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis of
the
contributions.
The student must
identify the different
concepts
Self-esteem
Self-efficacy
Self-concept
Expository
Participatory
GG 10´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis of
the
contributions.
The student must
identify the influence of
the environment on the
development of his
personality.
Influence of family and social
models in the formation of the
SELF. The formation as a
decisive element in the
conformation of the
personality.
Expository
Participatory
Role playing
Dramatization
GG 20 Computer
Presentation
Canon
Flipcharts
Power Point
Guide
Observation
and analysis of
the
contributions.
The student must
identify the social
influences on health
Positive and negative influences
of the social environment.
Preconceptions and types of
friendship. Management of
conflicting situations. Values:
solidarity, sincerity and labels.
Expository
Participatory
Brainstorming
GG 15´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis of
the
contributions.
Synthesis Summary, return and closure. Closing roll GG 5´ Flipcharts
Markers
Observation
and analysis of
the
contributions.

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3rd SESSION: SOCIAL INFLUENCE IN THE SELF-IMAGE
Objetivos
educativos
Remember the
previous session
Summary analysis of
the previous session.
Exhibition and
summary.
GG 5´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis of
the
contributions.
The student must
identify the different
cultures.
You will learn the
different
characteristics of
societies.
Expository
Participatory
GG 10´ Computer
Canon
Board
Flipcharts
Power Point
Guide
Observation
and analysis of
the
contributions.
The student must
identify the changes
of fashions along the
history.
Exhibition of the
evolution of fashions
throughout history and
different cultures.
Expository
Participatory
GG 10´ Computer
Canon
Board
Flipcharts
Power Point
Guide
Observation
and analysis of
the
contributions.
The student must
learn to look for his
own identity
Exhibition about the
sale of images and
myths about
consumerism in
society.
Expository
Participatory
GG 15´ Computer
Canon
Flipcharts
Observation
and analysis of
the
contributions.
Synthesis of self-
esteem I and II
Conclusions
Exhibition-summary of
the sessions.
Expository
Participatory
GG 10´ Computer
Canon
Flipcharts
Conclusion,
analysis and
contribution.

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M.R. MONTER ARDANUY
4th SESSION - NEW FASHIONS, DANGERS TO HEALTH (INFLUENCE OF SOCIAL
NETWORKS)
Educational
objectives
Review the self-
esteem
knowledge of
previous sessions.
Presentation of the
teaching team and
program.
Realization of
questionnaire.
Expository
Participatory
GG 10´ Computer Pre-test analysis
and evaluation.
Identify the
influence of social
media on self-
esteem.
Social impact in new
fashions that harm
health (influence and
dangers of social
networks).
Expository
Participatory
GG 20´ Computer
Canon
Board
Flipcharts
Power Point
Guide
Analysis of the
task and free
contributions.
Analyze the
impact of social
media with more
influence for you.
Resources and skills
that enable them to
take better care of
themselves and respect
for their health and
identity.
Participatory GG 20´ Computer
Canon
Board
Flipcharts
Power Point
Guide
Analysis of the
task and free
contributions.
Evaluation Evaluation survey Expository
Participatory
GG 5´ Surveys
Pens
Observation
and analysis of
the
contributions.
Synthesis. Summary, return and
closure.
Expository
Participatory
GG 10´ Flipcharts
Board
Analysis of the
task and free
contributions.

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2.7 EVALUATION
Structure:
Students will be assessed through a questionnaire the adequacy of the number of
sessions, the characteristics of the classroom where education for health is taught and
the proposals for improvement for future sessions.
Process:
In the same questionnaire provided to the students, the opinion regarding the
contents and exhibitions given and the importance they give to other topics of interest to
be included in successive years will be evaluated.
The possibility of administering a questionnaire to parents to evaluate the project
and the new topics of interest is also contemplated.
Results:
At all times, the possibility is offered to educators to provide questionnaires of
healthy lifestyle and health knowledge in order to evaluate changes before and after the
sessions.

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M.R. MONTER ARDANUY
2.8 BIBLIOGRAPHY
1. Armero Pedreira p, Bernardino Cuesta B, Bonet de Luna C. Acoso escolar. Rev Pediatr
Aten Primaria vol.13 no.52 Madrid oct.-dic. 2011. Disponible en:
http://dx.doi.org/10.4321/S1139-76322011000600016
2. Bandura, A. (1995). En la rectificación ecumenismo conceptual. En JE Maddux (Ed.), La
auto-eficacia, adaptación y ajuste: teoría, investigación y aplicación (pp. 347-375).
Nueva York: Plenum.
3. Bandura, A. (1997). La auto-eficacia y el comportamiento de la salud. En A. Baum, S.
Newman, J. Wien auto-eficacia, adaptación y ajuste: teoría, investigación y aplicación
(pp. 347-375). an, R. West, McManus & C. (Eds.), Cambridge manual de la psicología,
la salud y la medicina (pp. 160-162). Cambridge: Cambridge University Press.
4. Cha C, Nock M. Emotional intelligence is a protective factor for suicidal behavior. J Am
Acad Child Adolesc Psychiatry. 2009;48(4):422-30.
5. Clemes, H. Bean, R. & Clark, A. (1994) Cómo desarrollar la autoestima en niños y adolescentes.
Madrid, Debate.
6. Denegri Coria M, Opazo Pino C, Martínez Toro G. Aprendizaje cooperativo y desarrollo
del autoconcepto en estudiantes chilenos. Rev Ped. 2007;28 (81):1-18.
7. Estévez López E, Martínez Ferrer B, Musitu Ochoa G. La autoestima en adolescentes
agresores y víctimas en la escuela: La perspectiva multidimensional. Intervención
Psicosocial. 2006;15(2):223-32.
8. Kear M. Concept analysis of self-efficacy. Graduate Research in Nursing [Internet]. 2000.
Available from: http:// graduateresearch.com/Kear.htm
9. Luego Arjona P, Orts Cortés MI, Arcángel Caparrós- González R, Arroyo Rubio OI.
Comportamiento sexual, prácticas de riesgo y anticoncepción en jóvenes
universitarios de Alicante. Enferm Clin. 2007;17 (2):85-9.
10. Mesa Gallardo MI, Barella Balboa JL, Cobeña Manzorro M. Comportamiento sexuales
y uso de preservativos en adolescentes de nuestro entorno. Aten Primaria.
2004;33(7): 374-80.
11. Mytton J, DiGuiseppi C, Gough D, Taylor R, Logan S. Programas escolares de
prevención secundaria de la violencia (Revisión Cochrane traducida). En: La Biblioteca
Cochrane Plus, 2008 Número 4. Oxford: Update Software Ltd. Disponible en:
http://www.update-software.com. (Traducida de The Cochrane Library, 2008 Issue 3.
Chichester, UK: John Wiley & Sons, Ltd.).
12. Oñate Cantero A, Piñuel, Zabal I. Informe Cisneros X. Violencia y acoso escolar en
España. Instituto de Innovación educativa y desarrollo directivo [Internet]. 2007.

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Parcialmente disponible en: http://www.fapacne.com/publicaciones/acoso-
escolar/acoso-escolar.pdf
13. Ortega R. Agresividad injustificada, bullying y violencia escolar. Madrid: Alianza
Editorial; 2010.
14. Wylie, R.C. The s'elf concept. Lincoln: University of Nebraska Press, 1961.

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M.R. MONTER ARDANUY
2.9 SELF-ESTEEM QUESTIONNAIRES
Below are several evaluation questionnaires on adolescent self-esteem so
that the teacher can choose the one that best suits their needs.
QUESTIONNAIRE 1
Bibliographic reference: Self-esteem assessment questionnaire for secondary school students.
Available in:
http://roble.pntic.mec.es/~agarci19/Orientainterviene/Cuestautoestima/secundaria.htm
Consulted on August 26, 2015.
QUESTIONNAIRE 2
Self-esteem assessment questionnaire for high school students.
High School Annexed to Normal No. 1 of Toluca.
Isidro Fabela Norte No. 601, Colonia Doctores, Toluca, Edo. Méx. C.P.50090

- 38 -
QUESTIONNAIRE 1
Self-esteem assessment questionnaire for high school students
ID: Course:
Age: Sex: Date:
Then you will find a series of sentences in which statements are made related to your way
of being and feeling. After reading each sentence, circle the answer option (1, 2, 3, or 4)
that that best expresses your degree of agreement.
1= strongly agree.
2= partly agree.
3= partly disagree.
4= strongly disagree
1. I do many wrong things 1 2 3 4
2. Often the teacher tells me off for no reason. 1 2 3 4
3. I sometimes get angry 4 3 2 1
4. All in all, I feel satisfied with myself. 4 3 2 1
5. I am a handsome boy / girl 4 3 2 1
6. My parents are happy with my grades. 4 3 2 1
7. I like all the people I know. 4 3 2 1
8. My parents demand too much in my studies. 1 2 3 4
9. I get nervous when we have an exam. 1 2 3 4
10. I think I'm a smart kid. 4 3 2 1
11. Sometimes I feel like saying swearwords. 4 3 2 1
12. I think I have a good number of good qualities. 4 3 2 1
13. I'm good at math and calculations. 4 3 2 1
14. I would like to change some parts of my body. 1 2 3 4
15. I think I have an attractive build 4 3 2 1
16. Many of my classmates say that I am clumsy for
studies.
1 2 3 4
17. I get nervous when the teacher asks me 1 2 3 4
18. I am inclined to think that I am a failure in everything 1 2 3 4
19. I usually forget what I learn. 1 2 3 4

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M.R. MONTER ARDANUY
QUESTIONNAIRE 2- THEME: SELF-ESTEEM IN ADOLESCENCE
ID: Date:
Course: Group: sex:
Objective: To know the opinion of adolescents to establish bases that serve us to issue a
criterion on the subject and thus be able to reach a conclusion.
- Read carefully underlining only one option.
- Do not leave answers unanswered.
1.- Do you think you know what is necessary on the subject of self-esteem?
A) yes
B) no
C) a little
2.- Do you think it is beneficial for self-esteem not to love you?
A) yes
B) no
C) a little
3.- Of the following options, which one has made you feel depressed at some time?
A) teasing from your classmates
B) finishing a love relationship
C) a scolding from your parents
4.- In which of the following social relationships is your self-esteem more reflected?
A) engagement
B) your family
C) friendship
D) fellowship
5.- Which of the following substances have you ingested to get along with your friends?
A) alcohol
B) tobacco
C) drug
D) none
6.- Do you think that a person will commit suicide because of their level of self-esteem?
A) yes
B) no
C) sometimes
7.- In some occasion those who claim to be your friends have let you solve only one problem in
which you needed their support?
A) yes
B) no
C) always
D) sometimes
8.- Do you think that a close person can help another to raise or lower their self-esteem?

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A) yes
B) no
C) sometimes
9.- How is the relationship you have with your family?
A) good
B) bad
C) regular
10.- When your parents fight, do their problems affect your self-esteem?
A) yes
B) no
C) sometimes
11.- Have you had a long-term emotional crisis related to the death of a relative, a reprimand
from your parents or another similar problem?
A) yes
B) no
C) sometimes
12.- What kind of people make you feel bad through comments?
A) colleagues
B) teachers
C) family
D) none of the above
13.- Do you think your life makes sense?
A) yes
B) no
C) a little
14.- Do sentimental relationships affect you when they come to an end?
A) yes
B) no
C) sometimes
15.- What concept do you have of yourself (describe yourself physically, morally and
psychologically, involving your personality and way of thinking)?
Observations:

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M.R. MONTER ARDANUY
THANK YOU FOR CONTRIBUTING IN THE ELABORATION OF THIS INVESTIGATION.
3
EDUCATION FOR HEALTH IN
ALTERATIONS OF CONDUCT:
DISORDERS OF FOOD, ALCOHOL AND
DRUGS

- 42 -
3. ALTERATIONS OF CONDUCT: disorders of food, alcohol
and drugs
3.1 INTRODUCTION
In adolescence there is a significant increase in nutritional needs related to the
acceleration of growth. These nutritional needs are more related to the biological age
than to the chronological one, since they go parallel to the growth rates and to the
changes that occur in the body composition, with differences according to sex.
These changes significantly affect the body image, so important for them in this stage.
Many teenagers feel pressured and dissatisfied with their body image. The established
beauty canons respond to patterns of extreme thinness. This concern for their figure and
the desire to go in search of that ideal model, sometimes encourages them to initiate
inappropriate behaviors, without taking into account the possible consequences
Since adolescence is a stage of life in which the lifestyle that will last until adulthood is
configured, it becomes a privileged period to develop healthy eating, hygiene and
exercise behaviors, (depending on personal characteristics and of environmental factors),
avoiding disorders that may occur in the immediate future or already in adulthood, such
as: eating disorders, diseases such as diabetes, hypercholesterolemia, hypertension
(HBP), insomnia, anxiety states, stress, lack of attention, back pain, tooth decay, etc.
One of the most popular risk behaviors is the diet to lose weight, which together with
other processes to lose weight no less dangerous has been linked to the genesis of eating
disorders.
Research on the subject has multiple methodological deficiencies, so it is not unusual to
find prevalence from 23% to 80%. In purgative anorexia and bulimia there is more
impulsivity, sensitivity and emotional instability, and lower self-esteem. As for the
presence of personality disorders, different figures are also reported (21-77%).
A study in American adolescents found that 30% of girls had been teased and joked about
their physical appearance by peers, 28.7% by family members and 14.6% by peers and
family. If to the predisposition of the pubertal change and the environmental pressure
add negative comments, it is logical that the affected adolescents present a high body
dissatisfaction, low self-esteem, considerable depressive symptoms and suicidal thoughts.
Eating disorders and body cult are spreading in our society alarmingly, is a new epidemic
characterized by the obsession of the search for the perfect body. Beyond the already
known and disclosed anorexia (mannorexia in men), bulimia and new forms appear such
as vigorexia, diambulemia, orthorexia or Gourmet syndrome, pregorexia and dunkorexia.
In addition, the age of starting in the consumption of tobacco in our country is between
11 and 13 years old. Recalling that smoking is the leading cause of preventable death in

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M.R. MONTER ARDANUY
our country we can get an idea of the magnitude of the problem when consumption is at
such early ages.
On the other hand, drug use is part of a social phenomenon that especially affects
adolescents. The prevalence of its use and abuse in the adolescent stage and youth are
high. Given the availability of these adolescents have to learn to live with drugs and make
the decision to either consume or abstain them. The process of socialization that marks
this stage, the relationship with family and friends, the institute and the influence of the
media is important in this. The perception of risk together with leisure and free time are
elements to consider in order to understand the problem.
The head of the Clinical Toxicology Unit of the General Hospital of Valencia, Benjamín
Climent, has warned of the danger of new forms of alcohol consumption that have been
detected in adolescents seeking to achieve rapid alcohol intoxication through the ocular,
vaginal or anal.
These are practices known as "eyeballing", which consists of the direct application of
alcohol on the ocular mucosa, and the "tampodka" or "tampax on the rocks", tampons
impregnated with alcohol, usually vodka, which are applied to the vagina or the anus, for
which a very fast absorption takes place and also avoids that the breath smells of alcohol.
There is also the "oxy-shots", which arrived in Spain in the summer of 2011, and which
allows alcohol consumption in nebulization devices along with oxygen, as in
bronchodilator treatments, which allows a greater absorption surface and speed of
action, by avoiding the liver filter.
According to the latest UN report, the consumption of new drugs of abuse has more than
200 million addicts. The most commonly used drug continues to be cannabis and its
derivatives, followed by amphetamines, cocaine, ecstasy, heroin and opium derivatives;
and this list is joined by other drugs that are being used more every day and serve as a
bridge for sexual relations, such as inhalants and designer drugs or synthesis.
It is estimated that the value of all drugs of abuse, commercialized retail, is about 400
billion dollars and is, after arms trafficking, the illegal business that generates more
money in the world.
This economic aspect has notably influenced the appearance of new drugs such as the
cannibal drug or the drug Krokodril whose effects are very damaging to health, causing
death even in the short term.
3.2 - JUSTIFICATION
In these new pathologies increasingly widespread and that begin to emerge increasingly,
we focus on studying the socio-cultural component in which it has its origin. The growing
obsession with the cult of the body influenced by the sociocultural factors of the time and
causes the emergence of new eating disorders that pose a challenge for the nursing staff.
The study and research of these disorders by nursing professionals give us the ability to
act dynamically and effectively in this type of pathologies.

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Health education in which the nursing professionals have a prominent role, is once again
an essential work tool that will allow us adequate prevention to prevent the spread of
this new epidemic.
In addition, the influence of audiovisual media (advertising, television, cinema, etc.) in
adolescence is an important issue to address in the acquisition and development of
health risk behaviors such as: eating disorders, anorexia, bodybuilding, alcohol
consumption, drugs, self-harm, etc.
It is therefore essential to provide adolescents with the skills and tools necessary to
critically analyze the impact on their development and health that has the acquisition of
certain behaviors such as disorders of eating behavior and drug / alcohol consumption
and the influence that the media have on them.
3.3 GOALS
General purpose
- Provide adolescents with the information, resources and skills necessary to take
control and responsibility for their health, knowing the impact that the media
have on the acquisition of harmful behaviours for health.
Specific objectives
Knowledge area:
- The adolescent will know what a balanced diet is and will know how to adapt it to
their nutritional needs.
- He will know the negative effects of alcohol and drugs that are harmful to his
physical and psychosocial health.
- The adolescent will identify the symptoms and signs of the main eating disorders.
Attitudes area:
- The teenager will analyze the influence of the news that appears in the press
about fashions and food.
- He will analyze the consequences and effects produced by alcohol and drugs.
Skills area:
- He will learn to identify the dangers of social networks and their influence on the
acquisition of fashions and fads which are dangerous to their health.
- The adolescent will demonstrate the ability to identify foods that are harmful to
health as well as foods that promote healthy growth and development.
- He will learn to develop healthier leisure alternatives in contrast to the
consumption of alcohol and drugs.

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M.R. MONTER ARDANUY
3.4 METHODOLOGY
Target population: ESO students.
the school year.
- Research techniques in the classroom: repertory grid, brainstorm.
- Exhibition techniques: Participated lesson, talk colloquium.
Resources
Human resources:
- Teachers and counselors of education in the Institute
- Health and socio-health professionals
Material resources:
classrooms.
- DVD discs to store information.
- Pen drive to pass information among the participants.
- Questionnaires
3.5 - CONTENT OF THE SESSIONS
3.5.1– First session of behavior disorders (eating disorders, alcohol and
drugs) – 1º SESSION
Food - nutrition:
- Know which foods and healthy lifestyle habits adapt to our way of life.
- Know the most harmful foods for health.
- Know the eating disorders and their consequences.
adolescence

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3.5.2 – Second session of behavior disorders (eating disorders, alcohol and
drugs) – 2 º SESSION
Eating disorders:
- Learn to respect our body, as an important part of our personal development, for
good health.
- Social influence on eating disorders.
- Eating disorders (anorexia, bulimia, vigorexia, etc).
- Work the images and myths.
adolescence
3.5.3 – Third session of behavior disorders (eating disorders, alcohol and
drugs) – 3 º SESSION
Behavioral alterations (tobacco, alcohol and drugs):
- Know the different types of drugs and their effects.
- Know the effect of tobacco on health.
- Know the effect of alcohol on health.
https://es.slideshare.net/CharoMonter/33-alterations-of-behaviour-promotion-of-
3.5.4– Tocacco, alcohol and drugs– 4º SESSION
Tobacco, alcohol and drugs:
- Know the effect of drug addiction on people's lives.
- Identify the danger of social networks in the acquisition of new fashions.
- Relate the concept of self-esteem with the acquisition of new fashions.
https://es.slideshare.net/CharoMonter/34-tobacco-alcohol-and-drugs-promotion-of-

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M.R. MONTER ARDANUY
3.6 – CHRONOGRAMS
1st SESSION: FOOD AND NUTRITION
Educational
objectives
Identify food
knowledge
Presentation of the
session and its
objectives.
Questionnaire
Exhibition and
analysis in the
classroom.
GG 10’
5´
Computer
Presentation
Canon
Flipcharts
Observation
and analysis
of the
contributions.
The student must
identify the right
foods for a
balanced diet
Food Pyramid
Distribution of food
Importance of
breakfast
Expository
Participatory
Brainstorming
GG 10´ Flipcharts
Markers
Computer
Canon
Presentation
Power Point
Guide
Observation
and analysis
of the
contributions.
The student must
know the different
foods harmful to
health.
Influence of
audiovisual media on
foods that can alter
health.
Expository
Participatory
Brainstorming
GG 10´ Flipcharts
Markers
Computer
Canon
Presentation
Power Point
Guide
Observation
and analysis
of the
contributions.
Synthesis Summary, return and
closure.
Expository
Participatory
GG 5` Food pyramid
brochure

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2nd SESSION: FOOD DISORDERS
Educational
objectives
Identify eating
disorders
Presentation of the
session and its
objectives.
Summary of the
previous session
Exhibition and
analysis in the
classroom
GG 10´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis
of
contributions.
The student must
know the disorders
in the inadequate
feeding.
Anorexia, bulimia,
vigorexia, etc.
Expository
Participatory
Brainstorming
GG 20´ Computer
Presentation
Canon
Flipcharts
Power Point
Guide
Observation
and analysis
of
contributions
The student must
identify the social
influence that
fashions exert.
Anorexia, bulimia,
vigorexia, etc.
Team work GG 10´ Presentation
Canon
Power Point
Guide
Participatory
GG 5´ Surveys
Pens
Observation
and analysis
of
contributions
Synthesis Summary, return
and closure.
Expository
Participatory
GG 10 Brochure
Healthy dish

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M.R. MONTER ARDANUY
3rd SESSION: ALTERATIONS OF CONDUCT (ALCOHOL AND DRUGS)
Educational
objectives
Identify the new
concepts of eating
disorders
Presentation of the
session and its
objectives.
Summary of
previous session
Exhibition and
analysis in the
classroom
GG 10´ Computer
Presentation
Canon
Flipcharts
Observation
and analysis
of
contributions.
the student must
know the impact of
social networks
Behaviors that
harm health such
as alcohol, tobacco
and other drugs.
Expository
Participatory
Brainstorming
GG 20´ Computer
Presentation
Canon
Sheets
Pens
Flipchart
Observation
and analysis
of
contributions
the student must
analyze the social
influence of drugs on
health
They will work the
behaviors that
society marks in
health
Team work GP 10´ Sheets
Pens
Flipchart
Observation
and analysis
of
contributions
and closure.
Expository
Participatory
GG 10´ Brochure
Healthy dish

- 50 -
4th SESSION: ALCOHOL AND DRUGS
Educational
objectives
New fashions that
harm health
Presentation of the
session and its
objectives.
Summary of previous
session
Exhibition and
analysis in the
classroom
GG 10´ Computer
Presentation
Canon
Flipcharts
Observation and
analysis of
contributions.
The student must
know the danger of
social networks in
the acquisition of
new fashions.
Social networks that
encourage aggressive
fashions with alcohol,
synthetic drugs, etc.
Expository
Participatory
Brainstorming
GG 20´ Computer
Presentation
Canon
Sheets
Pens
Flipchart
Observation and
analysis of
contributions
He must identify the
concept of health
with the acquisition
of new fashions.
They will work on the
impact of the new
fashions.
Team work GP 10´
Participatory
GG 5´ Surveys
Pens
Observation and
analysis of
contributions
Synthesis Summary, return and
closure.
Expository
Participatory
GG 10´ Brochure
Healthy dish

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M.R. MONTER ARDANUY
3.7 - EVALUATION
Structure:
Process:
contents and exhibitions given and the importance they give to other topics of interest
to be included in successive years will be evaluated.
The possibility of administering a questionnaire to parents to evaluate the project and
the new topics of interest is also contemplated.
Results:
sessions.

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3.8 - BIBLIOGRAPHY
1. American College Health Association. National College Health Assessment:
Reference group data report fall 2008. Baltimore: American College Health
Association; 2008.
2. Anderson DA. Martens MP. Cimini M P. Do female college students who purge
report greater alcohol use and negative alcohol-related consequences? Int J Eating
Disorders. 2005;37:65-8.
3. Cremeens J, Burke S, Vail-Smith K. East Carolina University, Greenville, Restriction
of Calories Prior to Alcohol Consumption among College Freshman. NC Scheduled
for AAHE RCB Poster Session - Professional. Convention Center: Exhibit Hall NA
Poster Area. 2010.
4. Garcés Trulleque EM. Intervención familiar en trastornos de la conducta
alimentaria. Revista Agathos. Atención Socio Sanitaria y Bienestar. 2012;2(2).
5. García Armesto S. El efecto del acoso en la salud de los escolares. (Informes de
Gestión Clínica y Sanitaria Cochran. En: En la Biblioteca Cochrane Plus.
Disponible:http://212.169.42.7/newgenClibPlus/ASP/logina.asp?product=CLIBPLU
S&username=_USERNAME_&group=2660&server=UpdateUK&authcode=2611754
740972013&country=ES&guest=_GUEST_&SearchFor=_searchfor_
6. García HH, González AE, Gilma RH. Diagnóstico, tratamiento y control de la
cisticercosis por Tenia solium. Curr Op Infect Dis 2003, 16:411-19.
7. García Iriarte A, Arrondo de Esteban M, Guillén Grima F, Aguinaga Ontoso I.
Trastornos de la conducta alimentaria en una población adolescentes de un
instituto de enseñanza secundaria. Enferm Clin. 2006;16(2):77-83.
8. González-Juárez C, Pérez-Pérez E, Martín Cabrera B, Mitja Pau I, Roy de Pablo R,
Vázquez de la Torre Escalera P. Detección de adolescentes en riesgo de presentar
trastornos de la alimentación. Aten.Primaria. 2007;39(4):189-94..
9. Jáuregui Lobera I, Rivas Fernández M, Montaña González MT, Morales Millán MT.
Influencia de los estereotipos en la percepción de la obesidad. Nutr Hosp.
2008;23(4):319-25.
10. Jáuregui Lobera I, Santiago Fernández MJ, Estébanez Humanes S. Trastornos de la
conducta alimentaria y la personalidad. Atención Primaria 2009;41(4):201-6.
11. Julie Hasken BS, CHES1. Diabulimia y la función del personal de Salud Escolar.
2010. DOI: 10.1111/j.1746-1561. 00529.x (2010).
12. Kaiser LL, Allen L; American Dietetic Association. Position of the American Dietetic
Association: Nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet
Assoc. 2008;108:553-61.

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M.R. MONTER ARDANUY
13. Malinauskas BM, Aeby VG,Carpenter-Aeby T, Barber-Heidal K. A survey of energy
drink consumption patterns among college students. Nutrition Journal. 2007;6:35.
doi:10.1186/1475-2891-6-35.
14. Malinauskas B M, Aeby V G;, OvertonR F, Carpenter-Aeby T,Barber-Heidal K. A
survey of energy drink consumption patterns among college students. Nutrition
Journal 2007, 6:35 doi: 10.1186/1475-2891-6-35.
15. Mathieu J. ¿Qué es la pregorexia?. J Am Dietet Assoc. 2009: 976-9.
16. Mathieu J. What es diabulimia?. J Am Dietet Assoc. 2008;108:769-70.
17. Miller K. Energy drinks, RACE and problem behaviors among college students. J
Adolesc Health 2008;43 (5):490-7.
18. Miller K. Wired: energy drinks, jock identity, masculine norms, and risk taking. J
Am Coll Health. 2008;56(5):481-9.
19. Mytton J, DiGuiseppi C, Gough D, Taylor R, Logan S. Programas escolares de
prevención secundaria de la violencia (Revisión Cochrane traducida). En: La
Biblioteca Cochrane Plus, 2008 Número 4. Oxford: Update Software Ltd.
Disponible en: http://www.update-software.com. (Traducida de The Cochrane
Library, 2008 Issue 3. Chichester, UK: John Wiley & Sons, Ltd.).
20. Organización Mudnial de la Salud. Teniasis. Disponible en
http://www.who.int/mediacentre/factsheets/fs376/es/ Consultado el 19 de
agosto de 2016.
21. Pardo Lozano R, Álvarez García Y, Barral Tafalla D, Farré Albaladejo M. Cafeína: un
nutriente, un fármaco, o una droga de abuso. 2007. Adicciones 2007; 19 (3):225-
38.
22. Poulisis J. Los nuevos tratornos alimentarios: alcohorexia, vigorexia, diabulimia,
pregorexia, orthorexia. Buenos Aires; Paidós; 2011.
23. Rosebloom T, Rooij S, Painter R. The Dutch famine and its long-term consequences
for adult health. Early Hum Dev. 2006;82:485-91.
24. Roussos A, Franchello A, Flax Marcó F, De Leo M, Larocca T, Barbeito S, Rochaix A,
Jacobez S, Alculumbre R. Bebidas energizantes y su consumo en
adolescentes. Pediatría y Nutrición. 2009;10(2):124-9.
25. Toro J. Trastornos del comportamiento alimentario en adolescentes. Humanitas.
2009;38.
26. Toscani O. La anorexia y los procedimientos publicitarios. Pensar la Publicidad.
2007; 1(2):9-12

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3.9 QUESTIONNAIRES

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M.R. MONTER ARDANUY
3.9.1 FOOD QUESTIONNAIRES
Next, an evaluation questionnaire on nutrition is offered so that the
teacher can administer it to the students and evaluate their results.
QUESTIONNAIRE 1
PRELIMINARY ADAPTATION OF THE STUNKARD AND MESSICK FOOD QUESTIONNAIRE
(THREE FACTOR EATING QUESTIONNAIRE, TFEQ) WITH A SPANISH UNIVERSITY
SPECIMEN1
David Sánchez-Carracedo2, Rosa María Raich i Escursell, Universitat Autònoma de Barcelona
Mercé Figueras Piqueras, ADES Gabinet Psicològic, Barcelona
Joan Torras Clarasó y Marisol Mora Giral, Universitat Autònoma de Barcelona (España)

- 56 -
QUESTIONNAIRE 1 - FOOD QUESTIONNAIRE
Course ID
Date: Age: Sex: Ο Female Ο Male
PART I
1. When I smell a "sizzling" steak or see a juicy piece of meat, I find it very difficult to refrain
from eating, even if I have finished making a meal.
True False
2. Usually I eat too much in social situations, like parties and "picnics".
True False
3. I am usually so hungry that I eat food more than three times a day.
True False
4. When I have consumed my calorie quota, I am fine as to not eat more.
True False
5. Dieting is too hard for me because I get too hungry.
True False
6. I eat small portions deliberately as a method to control my weight.
True False
7. Sometimes there are things that taste so good that I continue to eat even when I am no
longer hungry.
True False
8. Since I am often hungry, I sometimes wish that as I eat, an expert would tell me that I have
had enough or that I can eat something else.
True False
9. When I feel anxious, I find myself eating.
True False
10*. Life is too short to worry about diet.
True False
11. Since my weight goes up and down, I have been reducing diets more than once.

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M.R. MONTER ARDANUY
True False
12. I often feel so hungry that I have to eat something else.
True False
13. When I'm with someone who is eating a lot, I usually do it too.
True False
14. I have a pretty good idea of the number of calories in common foods.
True False
15. Sometimes when I start eating it seems like I cannot stop.
True False
16*. It is not difficult for me to leave something on the plate.
True False
17. At certain times of the day, I get hungry because I have become accustomed to eating then.
True False
18. While I'm on a diet, if I eat meals that are not allowed, I consciously eat less during a period
of time to compensate.
True False
19. Being with someone who is eating often makes me hungry enough to eat too.
True False
20. When I feel sad, I often overdo eating.
True False
21*. I enjoy too much eating to spoil it by counting calories or watching my weight.
True False
22. When I see a real delicacy, often I have to eat immediately.
True False
23. I often stop eating when I'm not really full as a conscious means of limiting the amount of
food I eat.
True False
24. I get so hungry that my stomach often looks like a bottomless pit.
True False

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25*. My weight has hardly changed in the last ten years.
True False
26. I am always so hungry that it is hard for me to stop eating before I finish the meal on the
plate.
True False
27. When I feel lonely, I console myself by eating.
True False
28. Consciously I repress myself in the meals so as not to gain weight.
True False
29. Sometimes I get very hungry at the end of the afternoon or at night.
True False
30*. I eat everything I want and when I want.
True False
31*. Even without thinking, eating takes me a lot of time.
True False
32. I calculate calories as a conscious means of controlling weight.
True False
33. I do not eat some foods because they make me fat.
True False
34. I'm always hungry enough to eat at any time.
True False
35. I pay close attention to the changes in my figure.
True False
36. When I am on a diet, if I eat food that is not allowed, I often leave it (splurge) and eat other
high-calorie foods.
True False

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M.R. MONTER ARDANUY
PART II
Instructions
Please answer the following questions surrounding the number above the answer that you
consider appropriate for your case.
37. How often do you diet in a conscious effort to control your weight?
1 2 3 4
Rarely Sometimes Usually Always
38. Would a 2 kg weight fluctuation affect your way of living life?
1 2 3 4
Nothing Slightly Moderately Very much
39. How often do you feel hungry?
1 2 3 4
Sometimes Often Almost always Between meals
40. Do you have guilt feelings about eating a lot to help you control your intake?
1 2 3 4
Never Rarely Often Always
41. How hard would it be for you to stop eating at mid-dinner and not eat for the next four
hours?
1 2 3 4
Easy Slightly easy Moderately very
difficult
Difficult
42. How conscious are you of what you are eating?
1 2 3 4
Never Slightly Moderately Extremely

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43. How often do you avoid stocking up on tempting meals?
1 2 3 4
Hardly ever Rarely Habitually Almost always
44. How likely are you to buy low-calorie foods?
1 2 3 4
I'm not prone Lightly Moderately Very prone
45. Do you eat sensibly in front of others and leave (splurge) alone?
1 2 3 4
Never Rarely Often Always
46. How likely are you to eat slowly to reduce the amount of food you eat?
1 2 3 4
47*. How often do you skip desserts because you're not hungrier?
1 2 3 4
Hardly ever Rarely At least, once a week Almost every day
48. How likely are you to eat less deliberately when you want?
1 2 3 4

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M.R. MONTER ARDANUY
49. Do you still eat a lot even if you're not hungry?
1 2 3 4
Never Rarely Sometimes At least, once a week
50. On a scale of 0 to 5, where 0 means no restriction on intake (eat everything you want,
whenever you want) and 5 total restriction (constant limitation of intake and never give up),
what number would you give to yourself?
0: Eat everything you want when you want
1: Usually eat everything you want, when you want
2: Often eat everything you want, when you want
3: Limit intake often, but often also surrender
4: Usually limit the intake, rarely surrender
5: Consistently limit intake, never give up
51. To what extent does this phrase describe your eating behavior? «I start to diet in the
morning, but due to the amount of things that happen during the day, at night I give up and eat
what I want, promising to restart the diet tomorrow».

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3.9.2 - QUESTIONNAIRES ON
ALCOHOL AND DRUGS
Below are several evaluation questionnaires on alcohol and drug use so
that the teacher can choose the one that best suits their needs
QUESTIONNAIRE 1
The AUDIT is a questionnaire developed by the WHO based on an international study of a
representative sample of patients who attended health centers in different countries. It is a
Lickert scale that consists of 10 questions that will allow us to discriminate between risk
consumption (8 points in men, 6 in women), harmful use (between 8 / 6-20 points) and
dependence (more than 20 points). Instrument validated in our country.
QUESTIONNAIRE 2
Consumption of tobacco, alcohol and other drugs in adolescents (Alcal.
Cornide M, et al.)

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M.R. MONTER ARDANUY
QUESTIONNAIRE 1
Identification test of alcohol consumption disorders AUDIT
Course: ID: Date:
Age: Sex:
The information is confidential.
Be sincere in your answers.
1. How often do you consume any alcoholic beverage?
(0) Never (Skip to questions 9-10)
(1) One or less times a month
(2) 2 to 4 times a month
(3) 2 to 3 times a week
(4) 4 or more times a week
2. How many alcoholic drinks do you usually make on a day of normal consumption?
(0) 1 or 2
(1) 3 or 4
(2) 5 or 6
(3) 7, 8 or 9
(3) 10 or more
3. How often do you drink 6 or more alcoholic drinks in a single day?
(0) Never
(1) Less than once a month
(2) Monthly
(3) Weekly
(4) Daily or almost daily
4. How often last year was unable to stop drinking once you had started?
(0) Never
(2) Monthly
(3) Weekly
5. How often during last year could you not do what was expected of you because you had
drunk?
(0) Never
(2) Monthly
(3) Weekly

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6. How often during last year have you needed to drink on an empty stomach to recover after
drinking a lot the day before?
(0) Never
(2) Monthly
(3) Weekly
7. How often during last year have you had remorse or feelings of guilt after drinking?
(0) Never
(2) Monthly
(3) Weekly
8. How often during last year have you been unable to remember what happened the night
before because you had been drinking?
(0) Never
(2) Monthly
(3) Weekly
9. Have you or someone else been hurt because you had drunk?
(0) No
(2) Yes, but not during last year
(4) Yes, last year
10. Has any family member, friend, doctor or health professional been concerned about your
drinking or have you been suggested to stop drinking?
(0) No
(2) Yes, but not during last year
(4) Yes, last year

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M.R. MONTER ARDANUY
QUESTIONNAIRE 2
Consumption of tobacco, alcohol and other drugs.
This questionnaire is completely anonymous, answer what you know even if it is
approximately
1. List No. - ID
2. Sex
(1) Male
(2) Female
3. Course
4. Do you smoke?
(1) No
(2) Weekends
(3) To 10/ day
(4) From 10 to 20/day
(5) More than 20/day
5. Age at which you started smoking, if you smoke.
6. Do you drink alcoholic beverages?
(1) No
(2) Rarely
(3) Sometimes
(4) Often
(5) Daily
7. Age when you remember that you took your first glass of an alcoholic beverage.
8. Do you consider drug use dangerous?
(1) Yes
(2) Quite a bit
(3) Sometimes
(4) Nothing
9. Have you ever tried any of these products?

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1. Never 2. Once or twice 3. Often
Joints
Design drugs: Ecstasy, MDA ...
Amphetamines
Tranquilizers or sleeping pills
Cocaine
Heroin
Others: which?
10. Do you have a family member or friend who is a drug addict?
(1) Brother
(2) Father
(3) Mother
(4) Distant family
(5) Friend
11. Do you have a family member or friend with problems with alcohol?
(1) Brother
(2) Father
(3) Mother
(4) Distant family
(5) Friend

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M.R. MONTER ARDANUY
4. SEXUALITY

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4. SEXUALITY
4.1 INTRODUCTION
In 1975, the WHO already said that everyone has the right to receive sexual information
and to consider that sexual relations serve for pleasure, in addition to serving for
procreation.
The "postmodern" definition of sexual health by WHO comes in 2002, already in the new
century:
"Sexual health is a state of physical, emotional, mental and social well-being related to
sexuality; it is not merely the absence of disease, dysfunction or discomfort. Sexual health
requires a positive and respectful approach to sexuality and sexual relations, as well as
the possibility of obtaining pleasure and safe sexual experiences, free from coercion,
discrimination and violence. For sexual health to be achieved and maintained, the sexual
rights of all people must be respected, protected and satisfied. "
Although the definition of the WHO does not need to clarify much more, we will adapt it
in this chapter, to the objective of our programme, which is the adolescent, with the
unique characteristics that their life stage gives them and that make them vulnerable and
privileged recipients of sexual information since it begins a new phase in their sexuality
(although we maintain as a premise that sexuality accompanies the individual from birth
to death).
4.2- JUSTIFICATION
Sexual and reproductive health in our area is going through an important process of
change in relation to social transformations and scientific and technological advances
produced in recent decades. Among the main trends to be highlighted in this process,
which we observe from our daily work in the nursing consultation, we can highlight the
following, according to the data obtained by the National Survey of Sexual Health 2009
MSPS - CIS: study nº 2780:
Increased precocity at the beginning of sexual relations. The first act of sexual
intercourse, in both boys and girls in the age range of 15 to 16 is 58.1% to 59.8%.
The rate of pregnancies in the adolescent population. In Spain, it is 3.6% similar to the
European Union average, which is 3.8%. Currently there are around 20,000 pregnancies in
children under 20, of which 39% end in a voluntary interruption of pregnancy (IVE). This
percentage in Madrid exceeds 50%. More than 30% of the sexually active adolescent
population never uses any contraceptive method, and those who use it take around a
year and a half to adopt an effective method after starting coital relationships. These data
indicate the current risk of adolescents in relation to their patterns of sexual behavior.
It emphasizes that the most used method for the prevention of pregnancies by the young
population in their first sexual relation is the male condom. Followed by this, the pill is

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M.R. MONTER ARDANUY
used by younger girls in 5.9% of the cases and by 12.1% in those between 18 and 24 years
old.
The transmission of HIV by heterosexual relationships has increased in recent years, being
the cause of infection in 34% of affected women, compared to 16% of infected men.
Associated above all with promiscuity, infections due to syphilis and gonorrhea reached in
2010 the highest level in the last eight years, to the point of increasing in that period to
almost 300% and gonococcal infections almost to 135%.
These data are part of the report on 'Diseases of mandatory declaration' (EDO) published
by the Carlos III Health Institute in 2013.
4.3 GOALS
General purpose
- To ensure that adolescents develop and maintain healthy and responsible sexual
health through knowledge of their own resources and skills while preventing STDs
and unwanted pregnancies, promoting the free and responsible decision of their
sexuality.
Specific objectives
Knowledge area:
- Learn to know and discover their body.
- Getting teens to know the different types of contraceptive methods.
- Know the STIs and the consequences of unwanted pregnancies.
Attitudes area:
- Learn to identify and manifest their emotions.
- Adolescents should identify the best contraceptive method for each situation.
Skills area:
- Getting teens to have skills when placing a condom.
4.4 METHODOLOGY
Target population: Students of Compulsory Secondary Education with ages between
12 and 17 years old.
the school year. The teacher can expand the number of sessions depending on the
tutoring time that the institute has for this topic.

- 70 -
- Research techniques in the classroom: Repertory grid, brainstorm.
- Exhibition techniques: Participated lesson, colloquium talks.
Resources
Human resources:
- Teachers and counselors of education in the Institute.
- Health and socio-health professionals.
Material resources:
classrooms.
- DVD discs, to store information.
- Pen drive to pass information among the participants.
- Questionnaires
4.5 CONTENT OF THE SESSIONS
4.1 – First session of sexuality – 1º SESSION
Physiology of sexuality and affectivity:
- Know the physiology of the reproductive system and hormonal changes.
- The importance of affectivity in relationships.
https://es.slideshare.net/CharoMonter/41-physiology-of-sexuality-promotion-of-health-in-
adolescence
4.2– Second session of sexuality – 2º SESSION
Contraceptive methods and pregnancy:
- Knowledge of contraceptive methods, their advantages and problems.
https://es.slideshare.net/CharoMonter/42-contraceptive-methods-promotion-of-health-
in-adolescence
4.3– Third session of sexuality - 3º SESSION
Sexually transmitted diseases and pathologies:
- Sexually transmitted diseases (general concepts).
- Prevention of sexually transmitted diseases.
- Influence of social networks in the acquisition of risk behaviors for sexuality.
https://es.slideshare.net/CharoMonter/43-sexually-transmitted-diseases-promotion-of-

- 71 -
M.R. MONTER ARDANUY
4.6 - CHRONOGRAMS
1st SESSION: PHYSIOLOGY OF SEXUALITY AND AFFECTIVITY
Educational
objectives
Sexuality and affectivity Presentation of
the session and
its objectives.
Questionnaire
Analysis in the
classroom.
Expository
GG 5´
5´
Computer
Presentation
Canon
Flipcharts
Observation and
analysis of the
contributions.
The student must identify
the changes produced in
himself and in others in
the last year.
The pubertal
changes: physical
and psychic.
Participatory
Brainstorming
GG 10´ Flipcharts
Markers
Computer
Canon
Presentation
Observation and
analysis of the
contributions.
the relationship of these
changes with gonadal and
hypothalamic
maturation.
Male and female
sexual organs.
Menstrual cycle.
Expository
Participatory
GG 10´ Flipcharts
Markers
Computer
Canon
Presentation
Observation and
analysis of the
contributions.
the appearance of new
sensations, feelings and
relationships.
The sexuality. Participatory
Brainstorming.
Expository
GG 15 Computer
Presentation
Flipcharts
Markers
Observation and
analysis of the
contributions.
and closure.
Expository
Participatory
GG 10´

- 72 -
2nd SESSION: CONTRACEPTIVE METHODS AND PREGNANCY
Educational
objectives
Contraceptive methods Greetings,
analysis and
summary of the
previous session.
Presentation of
the session and
its objectives.
Expository GG 5' Computer
Presentation
Canon
Flipcharts
Observation and
analysis of the
contributions.
Students should identify
methods to avoid
unwanted pregnancies
and existing STIs to
avoid unintended
consequences.
All contraceptive
methods.
Expository
Participatory
Brainstorming
GG 30´ Computer
Presentation
Canon
Sheets
Pens
Flipcharts
Power Point
Guide
Observation and
analysis of the
contributions.
Students must know the
male condom and its
correct use
Male condom
Indications.
Form of use.
Dramatization
by teachers.
Participatory
GG 10´ Male
condoms
Banana
Paper bin
Ring
Computer
Presentation
Observation and
analysis of the
contributions.
and closure.
GG 10 Brochure.
Summary
session.

- 73 -
M.R. MONTER ARDANUY
3rd SESSION: DISEASES OF SEXUAL TRANSMISSION AND PATHOLOGIES
Educational
objectives
Sexually transmitted
diseases
Greetings,
analysis and
summary of the
previous
session.
Presentation of
the session and
its objectives.
Expository GG 5´ Computer
Presentation
Observation and
analysis of the
contributions
Students must know the
risks of unprotected
relationships
Pregnancy
STI
Expository
Participatory
GG 10´ Computer
Presentation
Flipcharts
Markers
Observation and
analysis of the
contributions
Students must identify
the different sexually
transmitted diseases
Methods of
protection
Participatory
Brainstorming.
Expository
GG 10´ Computer
Presentation
Flipcharts
Markers
Power Point
Guide
Observation and
analysis of the
contributions.
The students must know
how to act before a
possible contagion.
Care and
sanitary
alternatives.
Dramatization
by teachers.
Participatory
GG 10´ Computer
Presentation
Flipcharts
Markers
Observation and
analysis of the
contributions.
Evaluation Evaluation
survey
Expository
Participatory
GG 5´ Surveys
Pens
Observation and
analysis of the
contributions.
Synthesis Return and
closing
GG 5´ Brochure.
Session
summary

- 74 -
4.7 – EVALUATION
Structure:
Process:
contents and exhibitions given and the importance they give to other topics of interest to
be included in successive years will be evaluated.
The possibility of administering a questionnaire to parents to evaluate the project and the
new topics of interest is also contemplated.
Results:
sessions.

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