Johansen Vegard
Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
BMJ Open. 2025 Jan 20;15(1):e072702. doi: 10.1136/bmjopen-2023-072702.
This paper investigated sickness presence (SP) among students in academic upper secondary schools (USS). The research question asked was: To what extent do the prevalence of SP and reasons for SP vary between school classes in USS in Norway?
A cross-sectional survey was done in the final year of USS. Multilevel modelling was used to estimate school class-level effects.
71 school classes from 13 Norwegian schools participated in the study in April 2018.
1955 students in academic education programmes were invited to participate in the survey, and 1511 completed it. The response rate was 77%. 58% of the respondents were female students.
The outcome measures were the number of SP incidents and reasons for practising SP in school. The analysis examined factors that influenced the prevalence of and reasons for SP.
54% of the students reported two or more incidents of SP. The primary reason for reporting SP was attendance pressure, including factors such as not wanting to exceed the absence limit (90%), concerns that high school absences could negatively affect grades (65%) or reduce chances of getting a job (61%). Some students reported positive reasons for SP, such as maintaining social connections (32%). Multilevel modelling indicated that the class-level effect on the prevalence of SP incidents and positive attendance reasons accounted for 5% of the variance. Some of the class-level effect was due to contextual factors (eg, student relations) and less was due to compositional factors (eg, gender distribution).
The study discovered significant variations in SP between school classes, suggesting that students' attitudes and behaviours towards SP can influence their peers. Moreover, attendance pressure factors for SP were more frequently reported than positive attendance factors.
本文调查了学术性高中学生的疾病缺勤情况（SP）。所提出的研究问题是：挪威学术性高中不同班级之间，疾病缺勤情况的发生率及原因有多大程度的差异？
在学术性高中最后一年进行了一项横断面调查。采用多水平模型来估计班级层面的影响。
2018年4月，来自挪威13所学校的71个班级参与了该研究。
邀请了1955名接受学术教育课程的学生参与调查，1511人完成了调查。回复率为77%。58%的受访者为女生。
观察指标为疾病缺勤事件的数量以及在学校出现疾病缺勤情况的原因。分析考察了影响疾病缺勤发生率及原因的因素。
54%的学生报告有两次或更多次疾病缺勤事件。报告疾病缺勤的主要原因是出勤压力，包括诸如不想超过缺勤上限（90%）、担心高中缺勤会对成绩产生负面影响（65%）或减少就业机会（61%）等因素。一些学生报告了疾病缺勤的积极原因，比如维持社交关系（32%）。多水平模型表明，班级层面因素对疾病缺勤事件发生率及积极出勤原因的影响占方差的5%。部分班级层面的影响归因于情境因素（如学生关系），较少归因于构成因素（如性别分布）。
该研究发现不同班级之间疾病缺勤情况存在显著差异，这表明学生对疾病缺勤的态度和行为会影响其同龄人。此外，报告的疾病缺勤出勤压力因素比积极出勤因素更常见。
