Experiences of Multiple Risk Behaviors through Female Secondary School Student ’s Perception: A Qualitative Descriptive Study


  • Pimrat Thammaraksa Boromarajonani College of Nursing, Bangkok, Faculty of nursing, Praboromarajchanok Institute, Thailand
  • Arpaporn Powwattana Faculty of Public Health, Mahidol University, Bangkok, Thailand
  • Yutthana Meeklinhom Bangpleeratbamrung School, Samutprakan, Thailand
  • Surapon Boonlue Educational Communications and Technology, King Mongkut’s University of Technology Thonburi, , Bangkok, Thailand


female secondary school students, multiple risk behaviors, experiences, qualitative descriptive study


Introduction: The incidence rate of multiple risk behaviors (MRB) in Thai female adolescents have increased continuously. However, factors causing adolescent risk-taking behavior have highlighted only a single risk behavior, and lack of deep understanding the factors and experiences of multiple risk behaviors taking among Thai female adolescents. Research objectives: To study the experiences of multiple risk behaviors through female secondary school student’s perception. Research methodology: This study is qualitative descriptive study. Focus groups of 16 female secondary school students with multiple risk behaviors in Samut Prakan province. The data were analyzed by content analysis. Results: The findings indicated that 16 female secondary school students had engaged in MRB, ranging between two to eight risk behaviors. Most of them started their risk taking with alcohol drinking. After that, other types of risk-taking behaviors can be followed from a period of 1 week to 1 month. Situations that allowed female secondary school students engaging in MRB, such as party after the exam, camp, and having party at their friend’s house etc. Regarding, main causes of MRB, most of female secondary school students perceived that they lacked of self-confidence to control risky behaviors when their friends persuaded them because they felt afraid to refuse their friends, they also afraid their friends feel dissatisfaction, and afraid to not get along with friends. Female secondary school students had intentions to not avoided various risk-taking behaviors by did not avoid to have this risk when having a chance. Conclusions: Causes of MRB among female secondary school students include low perceived ability to control MRB and low intention to avoid MRB. Implications: The findings appoint the importance of developing a MRB prevention model for female adolescents that emphasizes to promoting the self-efficacy to control MRB and intention to avoid MRB. Nurses should understand the uniqueness of female adolescents and their needs in order to reduce risk opportunities.


Download data is not yet available.


1. Wichaidiz W, Macnale E, Sainham D, Autsanangkornchai S. Report of Thai society's alcohol consumption situation in the year 2017. Bangkok: Sahamitpattana Printing; 2019. (in Thai).

2. Autsanangkornchai S. Report on the results of the research project to surveillance about consumption of alcoholic beverages behavioral and health risk behavior of students in the junior secondary level in Thailand, Bangkok: Pimdee printing; 2008. (in Thai).

3. Bureau of Reproductive Health, Ministry of Public Health. Fact sheet 2020 teenage pregnancy in Thailand. C2021 [cited 2020 September]. Available from http://rh.anamai. moph.go.th/download/all_file/index/situation/Fact Sheet@62.pdf (in Thai).

4. National Statistical Office Thailand. Female adolescents are more likely to smoke. Bangkok: Bangkok block Printing; 2018. (in Thai).

5. Kengkanpanich T. Factors Influencing smoking behavior of female adolescents. Journal of Health
Education 2008;31(108):26-40. (in Thai).
6. Tobacco Control Research and Knowledge Management Center. Situation of consumer consumption control of tobacco country of Thailand in the year 2016. Bangkok: Chareondeemankong Printing; 2016. (in Thai).

7. Thammaraksa P, Powwattana A, Wannasuntad S, Tipkanjanaraykha K. Factors related to multiple risk behaviors among female secondary school students. Journal of Boromarajonani College of Nursing, Bangkok 2019;35(1):224-38. (in Thai).

8. Hair EC, Park MJ, Ling TJ, Moore KA. Risky behaviors in late adolescence: co-occurrence, predictors, and consequences. Journal of Adolescent Health 2009;45(3):253-61.

9. Powwattana A, Auemaneekul N, Lagampan S. Risk behaviors prevention in adolescence: concepts and management in multilevel approach. Bangkok: Protexts, 2017. (in Thai).

10. Teanchaithut C, Masingboon K, Wacharasin C. A Causal model of safe sex behaviors in female adolescents. Journal of Phrapokklao Nursing College 2016;27(2):78-94. (in Thai).

11. Ajzen I. The theory of planned behavior. Organ Behav Hum Dec. 1991;50:179-211.

12. Office of the Basic Education Commission. Education management information system. 2019[2019 Dec 17] Available from http://data.bopp-obec.info/emis/schooldata.(in Thai).

13. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2): 105-12. https://doi.org/10.1016/j.nedt.2003.10.001

14. Autsanangkornchai S, Sainham D, Jitpiboon W, Jinpon P, Chindech A, Jaroenrat S, Paileaklee S, Thaikra K. The fourth surveillance of alcohol, tobacco, substance use and health-risk behaviors among high school students in Thailand in 2018. Center for Alcohol studies, Prince of Songkla University; 2018. (in Thai).

15. Tipwareerom W, Powwattana A, Lapvongwatana P. The effectiveness of sexual risk behaviorprevention program for male adolescent in Phitsanulok province. Journal of Public Health Nursing 2013;27(1):31-45. (in Thai).

16. Areekul W, Hongsaholsee S, Treepatee S, Manaboriboon B, Areemit R, Prasertwit J, Inill S. Practical points in Adolescent Health Care. Bangkok, A-plus Print;2012. (in Thai).

17. Loke AY, Mak YW, Wu CST. The association of peer pressure and peer affiliation with the health risk behaviors of secondary school students in Hong Kong. Journal of Public Health. 2016;137:113-23. https://doi.org/10.1016/j. puhe.2016.02.024

18. Thammaraksa P, Powwattana A. Whether or not multiple risk behaviors in Thai adolescents is preventable? Journal of Boromarajonani College of Nursing, Bangkok 2018;34(2):173-88. (in Thai).



How to Cite

Thammaraksa P, Powwattana A, Meeklinhom Y, Boonlue S. Experiences of Multiple Risk Behaviors through Female Secondary School Student ’s Perception: A Qualitative Descriptive Study. JHNR [Internet]. 2021 Apr. 9 [cited 2022 Dec. 4];37(1):112-27. Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/248845



Research articles