Female Adolescents’ Sexual Reproductive Self-Care Scale

This 74 item scale evaluates female adolescents’ reproductive and sexual self-care behaviors in seven dimensions.


Geographies Tested: Iran

Populations Included: Female

Age Range: Adolescents


Adolescents and Family Interaction

1. Because my parents support me, I can talk to them
2. Because I trust my parents, I can talk to them
3. Having a close relationship with my father is a reason that I can talk to them easily
4. My father/mother’s behavior with me is such that I feel that they are always like my friend and beside me, not in front of me
5. My father/ mother welcome that I raise my issue with them
6. I feel that the family values me and my conversations
7. My family members give me more attention and emotions to prevent my natural affection towards the opposite sex
8. All my needs (both materialistic and spiritual) are met within the family
9. When I want to make a decision, parents make clear to me the positive and negative aspects (possible consequences) of each decision
10. I talk to my mother and the issues of puberty and menstruation, such as the cause of menstruation, how to care for myself, the problem I m having in this area
11. In social relationships, I adhere to the family framework
12. I usually share my outsources communication with a family member
13. I take care of my parents defined frameworks, for example, about how to treat and interact with others such as friends, relatives, opposite sex, clothes, perks, and allowed places.
14. On the issue related to interacting with the opposite sex, such as the suggestion of friendship on the part of the boy, I speak about the dangers of the friendship relationship with the boy with mother or father
15. I inform my parents about the time I go and the areas I go to
16. I am allowed to go with those friends that my parents know them and their families
17. I have independence in my decisions

Response Options:
Never- 0
Rarely – 1
Sometimes – 2
Often – 3
Always - 4

The perception of female adolescents of premarital sexual relationships

18. I do not accept sexual relationships, because I suspect that having such a good relationship can prevent a good life in the future
19. I do not accept sexual relationships, because I fear that this request will be repeated, and I am abused
20. Engaging in a friendship with the opposite sex or having sexual relationships with hum causes me to be defamed and it’s a disgrace for my family
21. Having sexual relationships creates dangers (such as unwanted pregnancy, loss of virginity, STDs, etc.) for my physical health
22. I think that having sexual relationships with a boyfriend is a sin
23. Sexual relationships between the girl and boy should be done after marriage
24. Making sexual relationships on the pretext of marriage in the future deception
25. I have friends who have been damaged due to sexual relationships with the opposite sex, and I do not want to harm my friends
26. The friendship relationship with the boy even with sexual relationships is unstable
27. In the context of friendship with the opposite sex, I have a certain limit and do not go further
28. My parents are sensitive to any kind of my relationship with the opposite sex, and I will be questioned
29. I do not accept the suggestion of having sexual relationship with the boyfriend
30. Having friendship relationship with a boy should be postponed when I get older and intend to get married

Response Options:
I completely disagree - 0
I disagree - 1
I object to some extent - 2
I agree to some extent - 3
I agree - 4
I totally agree - 5

Enabling factors for sexual and reproductive self-care

31. The availability of special centers for teenagers helps with reproductive and sexual health self-care
32. Providing the opportunity to receive sexual and reproductive health services from the appropriate person with a good attitude will make me more capable for reproductive and sexual health self-care
33. Access to healthcare services such as visits to a gynecologists or midwife, a phycologist, and a nutritionist, etc. enhances my ability for reproductive and sexual health self-care
34. Having books and programs for the education for reproductive and sexual health in schools helps me to empower myself for reproductive and sexual health self-care
35. Life skills educations (stating no answer, critical thinking, creative thinking, managing thoughts and feelings, and interacting with others…) empowers me for reproductive and sexual health self-care
36. Educational programs about ethical and religious considerations about gender issues make me more capable of reproductive and sexual health self-care
37. The existence of coherent educational programs in the school about issues of fertility and sexual health (puberty and menstruation, relationships with the opposite sex, etc.) makes me more capable of reproductive and sexual health self-care
38. Receiving education about sex at home and from parents helps me become empowered for reproductive and sexual health self-care

Response Options:
I completely disagree - 0
I disagree - 1
I object to some extent - 2
I agree to some extent - 3
I agree - 4
I totally agree - 5

Understanding and behaviors of female adolescents of the interaction with the opposite sex

39. Having a relationship with a boy is against my religious teachings
40. Because of my adherence to family principles, I refrain from having a relationship with a boy
41. I reject the suggestion of friendship with any boy
42. Having a relationship with a boy in a teenage period is fleeting and useless
43. I can control myself in not establishing a friendship relationship with a boy
44. It is normal to have a friendship with a boy in society*
45. I try to control my thoughts through various activities such as reading, painting, reading the Qur’an and religious words, helping the mother, expressing my interest in my sister or brother, sports, and even thinking about romance

Response Options:
I completely disagree - 0
I disagree - 1
I object to some extent - 2
I agree to some extent - 3
I agree - 4
I totally agree - 5

Parent-adolescent communication barriers

46. My parents think that a parenting dialog with a teenager about adolescence makes the teenager rude*
47. My mother does not want to talk about sex with me because of shame*
48. I do not talk with my mother/father about issues related to the opposite sex/puberty and menstrual cycle, so that our respect is preserved*
49. If I try to talk to my mother about sexual issues and fertility, I will only suspect her*
50. I am embarrassed to raise some issues with my parents*
51. I hide some issues, because of the fear of punishing or blaming parents*
52. My mother does not have enough information to ask questions about sexual and reproductive issues*

Response Options:
Never- 0
Rarely – 1
Sometimes – 2
Often – 3
Always - 4

Reproductive and sexual knowledge

53. Pain when urinating is a sign of STDs
54. Genital ulcers are a sign of STDs
55. Odorous and bloody genital secretions are the sign of STDs
56. Condoms are an effective way to protect against STDs such as AIDs, genital herpes and hepatitis
57. People with HIV always are thin, inferior and seem ill*
58. The probability of getting pregnant is greater if someone has a sexual intercourse in the midst of the menstrual cycle (about 7-10 days after menstruation)
59. Apart from HIV and AIDS, there are other illnesses that are transmitted through a sexual intercourse between men and women
60. People can find out whether they have HIV or not by giving a simple test
61. A teenage girl may also become pregnant at the first sexual relationship

Response Options:
Incorrect - 0
Correct - 1

Self-Care for Reproductive health and Menstruation

62. The normal menstrual cycle is from the onset of a menstrual cycle to the onset of the next menstrual period and it 21-35 days
63. I change my underwear daily
64. I use the iron pill periodically
65. If I cannot dry my underwear in the sun, I use a hot iron
66. I record the start and end of my menstruation on the calendar
67. I put my underwear under the sunlight to dry
68. If I have menstrual pain, I use methods such as keeping my belly warm, taking painkillers, or drinking liquid and herbs, relaxing or going to a doctor or midwife
69. I use iron-rich foods like meat and a variety of nuts
70. After each bowel movement I dry my genital area with toilet paper
71. In the menstrual period, I change my sanitary pad at intervals before it becomes completely wet
72. I can do menstrual care because I have known about it and I have been ready for it before menstruation
73. I pay attention to the amount of bleeding in my menstruation
74. I use water and soap to wash the underwear

Response Options:
Never - 0
Rarely – 1
Sometimes – 2
Often – 3
Always - 4

*Items are reverse scored

Scoring Procedures

Due to the diversity of the areas studied and the response scales chosen for each domain, a standardization method of 0-100 was used to better understand the scores and compare them in the dimensions. To convert scores of the dimensions and the entire questionnaire to a score of 0-100, the following conversion formula was used:

Adjusted score = (acquired raw score/maximum possible score) x 100

This formula allows for a score between 1 and 100 for each dimension. The total score of the questionnaire was measured using the calculation of the average of the total modified scores of the questionnaire.

Higher scores indicated a better condition for reproductive and sexual self-care.

Original Citation

Alimoradi, Z., Kariman, N., Ahmadi, F., Simbar, M., & AlaviMajd, H. (2019). Development and psychometric properties of the female adolescents' sexual reproductive self-care scale. International Journal of Adolescent Medicine and Health, 33(2).

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