title: Students' school satisfaction as predictor of teachers' sickness absence: a prospective cohort study.
abstract: BACKGROUND
  Although health is an important determinant of sickness absence, social relationships at the workplace may also affect levels of sick leaves. This study examined whether students' self-assessed satisfaction with school predicted sickness absence among teachers in Finnish secondary schools.
  
  
  METHODS
  We measured school satisfaction of 17 033 students aged 14-16 years from 90 schools by a survey (the School Health Promotion Study) and aggregated school-specific scores of students' school satisfaction. For analysis, we linked these school-level data to records of sickness absence in the survey year and the following year among 2364 teachers working in the same schools (the 10-Town Study). For sickness absence longer than 9 days, we obtained diagnoses from national health registers.
  
  
  RESULTS
  Multilevel Poisson and logistic regression models adjusted for relevant baseline covariates showed a rate ratio of 1.2 [95% confidence interval (95% CI): 1.0-1.5] for long-term (>3 days) sickness absence among teachers working in schools with two lowest thirds of student satisfaction compared with teachers in schools with high student satisfaction. The corresponding odds ratio (OR) was higher for sickness absence with a psychiatric diagnosis (OR 1.9, 95% CI: 1.1-3.2), more specifically, neurotic and stress-related disorders (OR 2.6, 95% CI: 1.2-5.9). Students' school satisfaction was not associated with teachers' short-term (1-3 days) sick leaves.
  
  
  CONCLUSIONS
  These data suggest a link between social relationships at school, as indexed by students' school satisfaction, and teachers' sick leaves, with the strongest associations seen for absences with mental health diagnoses.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland. jenni.ervasti@ttl.fi
authors.forename: Jenni
authors.initials: J
authors.lastname: Ervasti
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Riikka
authors.initials: R
authors.lastname: Puusniekka
authors.forename: Pauliina
authors.initials: P
authors.lastname: Luopa
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Sakari
authors.initials: S
authors.lastname: Suominen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005178:Faculty / Q000706:statistics & numerical data*; D005387:Finland; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D009497:Neurotic Disorders / Q000453:epidemiology; D016017:Odds Ratio; D010549:Personal Satisfaction; D011446:Prospective Studies; D012574:Schools; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology; D013334:Students / Q000523:psychology*