LETTER TO APPLY TO RESPONDENT

Dear Sirs, I am the undersigned:

Name : Dwi Inas Sari
NIM : 20140320007
Adress : Kos Yesifa, Tlogo RT 6 Tamantirto Kasihan Bantul D.I
Yogyakarta

Student of Nursing Study Program (PSIK) University of Muhammadiyah

Yogyakarta who is doing research with title: “NURSING UMY STUDENT
PERCEPTION ABOUT SEX EDUCATION”
I ask the participants to be willing to be respondents in this study. This study
aims to see the perception of students about sex education. You will fill out a
questionnaire containing the questions and this research will not have a negative
impact on you as well as any confidentiality of the watchdog. Therefore the researcher
requests the partisipant availability to sign this agreement if they are willing to be
respondents.
Upon Attention and availability of parents of students to be respondents, the
researchers say thank you.
Yogyakarta, 2018
researcher
 5

APPROVAL SHEETS BEING A RESPONDENT

I the undersigned hereby declare that I am willing to participate in a study

conducted by a student of nursing sciences UMY year 2014/2015 under the title
"NURSING UMY STUDENT PERCEPTION ABOUT SEX EDUCATION".
I know that the information I provide is very useful for the development of science.
Thus the statement of consent to be respondents from me hopefully can be used as
necessary.

Yogyakarta, 2018
Participant

( )
 QUESTIONNAIRE
"NURSING UMY STUDENT PERCEPTION ABOUT SEX EDUCATION"
I. Profile
1. Name (initials):
2. Age :
3. Gender :
4. Major :
5. Have you ever received education or information about sex?
a. Yes b. No
6. If yes, from the source of information you get?
......
II. Instuctions
a. Read the questions carefully and examine them before you answer the questions.
b. This questionnaire has no effect on your academic value.
c. To smooth the research, please fill in the answers according to your knowledge,
no need to ask a friend. Answer honestly what it is.
d. Your confidentiality will remain our guard.
1. Have you ever been told about the changes that occur during puberty.
For example: in a girl's breast enlargement and a boy's enlarged voice?
a. Yes, who told you?..................................................
b. No
2. Have you ever had basic information about sexual issues. For example:
body processes such as the process of pregnancy and birth?
a. Yes, where/who told you?...........................................
b. No
3. Have you ever received information about the reproductive organs and
their functions. For example: the vagina serves as the outlet of
menstruation and the penis in addition to the urinary tract also functions
as the outlet of sperm.
a. Yes, where/who told you?.........................................
b. No
4. Have you ever been informed of what is allowed and should not be done
in public. For example: should not wear minimal / thin clothes when
outside the home?
a. Yes, where/who told you?............................................
b. No
5. Can sex education prevent free sex?
a. Yes, what the reason?.........................................................................
b. No
6. Do you think sex education should be known by every teenager?
a. Yes, what the reason?.............................................................................
b. No
7. Do your parents always advise you in hanging out with the opposite
sex?
a. Yes
b. No
8. Do you limit yourself to socializing with the opposite sex?
a. Yes, what the reason?...........................................................................
b. No
 9. Have you ever attended a seminar on reproductive health?
a. Yes, what the topic?..........................................................................
b. No
10. Has your teacher ever explained about the dangers of abortion
(abortion)?
a. Yes, specify the danger of abortion!.......................................................
b. No
11. Have you ever received information about venereal disease?
a. Yes, where/who told you?...........................................
b. No
12. Have your parents ever explained about the dangers of free sex?
a. Yes, pecify the danger!............................................................
b. No

Source: Modified from the results of research Fitriani with the title "Relationship Sex
Education with Sexual Behavior in adolescents at SMK PRAYATNA-1 Medan Year 2011".