Sjukskrivningar till följd av stress och utbrändhet ökar bland arbetstagare. Ökningen är störst bland lärare. För att tydliggöra arbetsgivares ansvar gällande psykosocial arbetsmiljö trädde den 31/3 2016 en ny arbetsmiljöföreskrift, AFS 2015:4 i kraft. Trots detta fortsätter sjukskrivningar till följd av stress och utbrändhet bland lärare öka. Givet ovanstående är studiens syfte att undersöka vilka förutsättningar skolledare som arbetar i svenska grund- och gymnasieskolor upplever att de har för att arbeta förebyggande mot stress och utbrändhet. Vidare är syftet att undersöka huruvida skolledarna upplever att det föreligger någon skillnad i hur de arbetar förebyggande nu jämfört med hur de arbetade innan AFS 2015:4 trädde i kraft. Ovanstående analyseras för att, om möjligt hitta en förklaring till varför sjukskrivningar bland lärare fortsätter öka trots att AFS 2015:4 trätt i kraft och varit gällande i fyra år.Syftet uppfylls genom en intervjustudie där skolledare i grund- och gymnasieskolor intervjuas om vilka förutsättningar de upplever att de har för att bedriva förebyggande arbete, samt huruvida de upplever att skillnader i arbetssätt mellan ”nu och då” föreligger. En innehållsanalys görs av intervjuerna utifrån ett analysverktyg bestående av implementeringsteori i form av Lundquists (2001) förstå, kunna, vilja samt Job Demand-resourses-theory (Bakker & Demerouti 2017).Studiens slutsats är att skolledare visar god förståelse kring hur förebyggande arbete ska bedrivas, samt vilja att utföra det samma. Dock upplever skolledarna att de saknar tillräckliga ekonomiska resurser för att kunna bedriva ett fullgott förebyggande arbete mot stress och utbrändhet. Vidare framgår att skolledarna upplever att inga större skillnader föreligger i hur de arbetar nu kontra innan AFS 2015:4 trädde i kraft. En möjlig förklaring till att sjukskrivningar bland lärare ökar är att skolledarna saknar vissa ekonomiska resurser för att kunna arbeta förebyggande. Ytterligare en möjlig förklaring är att AFS 2015:4 inte är tillräcklig för att skapa förutsättningar för att ett fullgott förebyggande arbete ska kunna bedrivas. / Sick leave due to stress and burnout is increasing among workers. The increase is greatest among teachers. To clarify employers' responsibilities regarding the psychosocial work environment, on 31 March 2016, a new work environment regulation, AFS 2015: 4, came into force. Despite this, sick leave due to stress and burnout among teachers continues to increase. Given the above, the purpose of this study is to investigate how school leaders who work in Swedish primary and secondary schools describes the conditions to work preventively against stress and burnout. Furthermore, the purpose is to investigate if the school leaders interviewed feel that there is any difference in how they work preventively now compared to how they worked before AFS 2015: 4 came into force. The above is analyzed to, if possible, find an explanation for why sick leave among teachers continues to increase even though AFS 2015: 4 came into force and has been valid for four years.The purpose is fulfilled through an interview study where school leaders in primary and secondary schools are interviewed about what conditions they feel they have to conduct preventive work, and whether they feel that there are differences in working methods between "now and then". The interviews are analyzed based on an analysis tool consisting of implementation theory in the form of Lundquist's (2001) förstå, kunna, vilja (understanding, ability, will) and Job Demand resources theory (Bakker & Demerouti 2017) which are combined.The study concludes that school leaders show a good understanding of how preventive work should be conducted, as well as a willingness to perform the same. However, school leaders feel that they lack sufficient financial resources to be able to conduct adequate prevention work against stress and burnout. Furthermore, it appears that school leaders feel that there are no major differences in how they work now versus before AFS 2015: 4 came into force. One possible explanation for the increase in sick leave among teachers is that school leaders lack certain financial resources to be able to work preventively. Another possible explanation is that AFS 2015: 4 is not sufficient to create the conditions for full preventive work to be carried out.

Individer som ska tillbaka i arbete efter långtidssjukskrivning upplever att en hälsofrämjande kommunikation är en viktig och framgångsrik faktor i processen. Studien som har genomförts är en fallstudie där syftet var att undersöka hur arbetsmarknadskonsulenter och arbetshandledare arbetar med hälsofrämjande kommunikation för att få långtidssjukskrivna att återgå i arbete. För att besvara studiens frågeställning som framkom utifrån syftet har den salutogena teorin tillsammans med tidigare forskning tillämpats. En kvalitativ metod har tillämpats genom att tolv anställda intervjuats inom den mellansvenska kommunen och materialet som samlades in analyserades genom en tematisk analys. Av analysen framgick tre teman utifrån datainsamlingen, olika kommunikationsstilar, individanpassad kommunikation samt samtalsmetoder. Resultatet påvisar att arbetsmarknadskonsulenterna samt arbetshandledarna tillämpar flertalet tillvägagångssätt i kommunikationen för att öka deltagandet för långtidssjukskrivna. För att öka deltagandet tillämpar de en hälsofrämjande kommunikationen främst genom att engagera, stötta och vägleda deltagarna genom att bemöta varje individ utifrån deras specifika situation. Ämnet är tidigare relativt outforskat och därmed är det av intresse att undersöka detta vidare vid framtida studier. / Individuals who are going back to work after long-term sick leave experience that health promoting communication is an important and vital factor in the process. The study that has been conducted is a case study where the purpose was to investigate how labor market consultants and work supervisors work with health-promoting communication to get those on long-term sick leave to return to work. In order to answer the question of the study that emerged from the purpose, the salutogenic theory together with previous research has been applied. A qualitative method has been applied by interviewing 12 employees within the central Swedish municipality and the collected material was analyzed through a thematic analysis. The analysis revealed three themes based on the data collection, different communication styles, individualized communication and conversation methods. The results show that the labor market consultants and the supervisors apply the majority of approaches in communication to increase participation for those on long-term sick leave. To increase participation, they apply a health-promoting communication primarily by engaging, supporting and guiding the participants by responding to each individual based on their specific situation. The subject is previously relatively unexplored and thus it is of interest to investigate this further in future studies.

Submitted in fulfilllment of the requirements for the Masters in Nursing degree, Durban University of Technology, 2014. / Introduction Work-related musculoskeletal disorders are the most commonly reported work-related illnesses impacting on the quality of life of nurses. Absenteeism, work restriction, loss of income and disability are related outcomes. Nurses are at a higher risk of work-related musculoskeletal disorders (WMSD) compared to other healthcare professionals because of the nature of their duties. Problem statement The relationship between work-related musculoskeletal disorders, absenteeism and visits to the staff clinic by nurses has not been established in South Africa. Purpose The purpose of this study was to determine the prevalence of WMSD in nurses and its relationship to absenteeism and visits to the staff clinic by nurses in a selected eThekwini District hospital. Research method A cross-sectional quantitative descriptive survey was conducted in two stages namely the prospective cross-sectional survey of nurses and the retrospective review of records. A random sample of 231 nurses was selected, proportionally, from all nursing ranks and invited to fill in the self-administered musculoskeletal questionnaire. Results The lifetime prevalence of WMSD in nurses in this study was 77% with the twelve months prevalence of 67% and the seven days prevalence of 43%. The prevalence of low back pain was higher (21% for twelve months and 47% for seven days) than that of other body regions with a higher tendency (65%) of WMSD affecting more than two body regions. Although the prevalence and patterns of WMSD was almost the same across all nursing ranks, nurses working in the Out Patients Department reported the highest prevalence (22%). There was no significant relationship between age, gender and smoking; however, a strong correlation between WMSD and participation in physical exercise, work task and workload was noted. No relationship could be established between WMSD and staff visits to the staff clinic as well as amount of sick leave taken. Conclusion This study showed that WMSD is high in the selected hospital. Nurses working in the Outpatients department reported the most WMSD; body parts affected was not related to age, gender, nurse rank or unit in which the nurse worked. There is a problem of under- reporting of WMSD. Nurses working in this hospital have an option of attending their private health service providers even following a WMSD. In these cases the staff clinic is unable to keep accurate statistics of WMSD, conduct reviews and proper management of the WMSD.

Vårt intresse för äldreomsorgen och psykisk ohälsa i samhället grundar idén till denna uppsats. Uppsatsen riktar sig till sjukfrånvaron och vilka faktorer som är hälsofrämjande på en arbetsplats inom äldreomsorgen. För att få fram ett rikt resultat valde vi etnografi och semistrukturerade intervjuer som forskningsmetoder. Urvalet gjordes efter att statistik jämfördes på olika enheter inom äldreomsorgen i den aktuella kommunen. Vi genomförde observationer, enligt etnografisk metod, samt intervjuer på den valda enheten. Vi har valt att använda nya begrepp, osjuk och ofrisk eftersom de förklarar gråzonen mellan att vara sjuk och frisk och begreppen kan vara en del i att öka förståelsen för sjukfrånvaron inom äldreomsorgen. Studien visar att den mest betydande friskfaktorn på vår valda arbetsplats är trivsel i arbetsgruppen, samhörighet, teamkänsla samt de nya rutiner som införts angående sjukanmälan. Ledarskap som tidigare forskning visar är en stor bidragande del till sjukfrånvaro på en arbetsplats, visade sig inte vara lika betydelsefull som vi först trodde efter vår analys av vår studies resultat. / The idea for this bachelor thesis was founded by our interest in elderly care and psychiatric illness in the community. This paper addresses absenteeism and the factors that are health promoting in the workplace in elderly care. To obtain representative results, ethnography and semi-structured interviews were selected as research methods. The selection was made after we compered the statistics from different units within elderly care in the municipality. We made observations based on ethnographic methods and semi-structured interviews within the selected unit. We have chosen to introduce two new terms, ”unsick” and ”unhealthy”, because they both explain the grey area between being sick and being healthy and can be used for increasing the understanding of absenteeism in elderly care. The study shows that the most significant health determinants was appreciation of the work group, solidarity, team spirit along with new routines regarding reported sickness. Leadership, that previous research shows is a major contributing part of absenteeism in the workplace, proved in this study, not to be as significant as above mentioned factors.

Bakgrund Celiaki är en autoimmun sjukdom som ger inflammation i tunntarmsslemhinnan vid intag av gluten. Symtom hos vuxna kan vara diffusa och därför svåra att koppla till celiaki. I Sverige är genomsnittstiden från första symtom till celiakidiagnos ungefär 10 år och det finns luckor i kunskapen om vilka konsekvenser fördröjningen till diagnos ger. Syfte Studiens syfte är att överblicka hur fördröjd diagnos av celiaki hos vuxna påverkar samhällets resurser, hur dessa individer upplever att symptomen påverkat deras sociala liv före och efter diagnos, samt om diagnostiken behöver effektiviseras. Metod I Sverige, september 2012, skickades en Internetbaserad enkät ut till 4337 medlemmar i Svenska Celiakiförbundet varav 611 kvarstod efter bortfall. Enkätens fokus var främst sjukfrånvaro, vårdkontakter och social påverkan p.g.a. symtom av celiaki. Enkäterna analyserades i SPSS (v.20.0) med p<0,05. Resultat Efter diagnos sjönk både sjukfrånvaro och vårdkontakter. Deltagarna undvek också sociala aktiviteter i mindre utsträckning och majoriteten upplevde förbättrad livskvalité. En stor del (39 %, n=238) uppgav att de fått diagnos först 10 år eller mer efter symtomdebut, varav majoriteten var äldre. Det var framför allt de som uppgav en fördröjning på fyra år eller mer från första symtom till diagnos som upplevde att deras livskvalité förbättrades av diagnosen. Slutsats Det är viktigt att celiakidiagnos ställs tidigt för att bespara kostnader som annars kommer av sjukfrånvaro och vårdkonsumtion, samt minska den negativa påverkan av symtom på det sociala livet och livskvalitén. Då mer än hälften av deltagarna i studien haft symtom i minst 5 år innan diagnos anser vi att åtgärder måste sättas in. Tidigare diagnos kräver antingen screening av befolkningen eller nya vårdplaner där diffusa symtom av celiaki uppmärksammas mer. Mer studier behövs för att avgöra vilken åtgärd som är mest hållbar. / Background Coeliac disease is an autoimmune disease where gluten causes inflammation in the mucosa of the small intestine. Symptoms in adults may be vague and therefore difficult to associate with coeliac disease. In Sweden, the average delay from first symptom to diagnosis is about 10 years. There are gaps in the knowledge of the consequences of a delayed diagnose. Objective The purpose of this study is to review the effect of the delay of coeliac diagnosis among adults on society’s resources, how the symptoms may have affected these individuals social life and the need of improved diagnosis. Method In Sweden, September 2012, an online questionnaire was distributed to 4,337 members of the Swedish Coeliac Society of which 611 was included in the study. The survey focus was mainly sick leave, health care contacts and social impacts due to symptoms of coeliac disease. The questionnaires were analyzed in SPSS (v.20.0) with p<0,05. Results Both sick leave and health care contacts decreased after diagnosis. The participants also avoided social activities to a lower extent and the majority experienced an improved quality of life. A large proportion (39%, n=238) reported that diagnosis delayed at least 10 years from the onset of symptoms, the majority of whom were older than the average. It was mainly those who reported a long delay from first symptom to diagnosis who experienced an improvement in quality of life due to diagnosis. Conclusion Early diagnosis is important in order to reduce costs that would otherwise derive from health care consumption and sick leave. Early diagnosis would also reduce the negative impact of symptoms on social life and quality of life. Since the majority of the participants reported a delay of at least 5 years from onset of symptoms to diagnosis, we believe that it is necessary to take action. In order to diagnose individuals with coeliac disease at an earlier stage it is necessary to apply effective methods such as screening or new care plans with more attention on vague symptoms. To determine which method is most sustainable, more studies needs to be done.

American businesses have confronted a changing world economy marked by increasing competition , technological innovation, and instability. Many more women have entered the labor force. Many families' caregiving needs are now being met by family members who also are holding down jobs. This, in turn, has fueled the rising need among employees for workplace policies that enable them to meet the often competing demands of job and home. In 1993, Congress passed the Family and Medical Leave Act (FMLA of the Act) to provide a national policy that supports families in their efforts to strike a workable balance between the competing demands of the workplace and the home. The objective of this study is to examine the amount of FMLA lost time at one particular company in order to determine a demographic and job characteristic profile of employees who take time away from their jobs for reasons that are protected by the Act.

O estudo das faltas e licenças médicas pode tornar-se referencial privilegiado para observar-se a conjuntura na qual se edificam as diretrizes e os produtos que se constituirão nas ações educativas para jovens e crianças que dependem da Secretaria da Educação do Estado de São Paulo. Para medir o absenteísmo no trabalho relacionado a motivos de saúde optou-se em descrever a magnitude média das taxas de faltas e de licenças médicas do magistério e do pessoal de apoio, segundo as 91 diretorias de ensino de todo o Estado de São Paulo, entre maio de 2008 e julho de 2009 e comparar as proporções de faltas e de licenças entre as funções do magistério e de apoio, segundo coordenadorias de ensino. Trata-se de um estudo ecológico que utilizou em sua construção, dados secundários, coletados a partir de registros oficiais. Verificou-se que a região periférica da metrópole paulistana foi a que apresentou um número superior de ausências, em detrimento do interior e da capital, que tiveram registradas médias aproximadas. As licenças médicas, contudo, têm, principalmente no interior, significativa elevação. Este trabalho pôde registrar que aproximadamente 20 por cento da força de trabalho contratada esteve ausente durante o período letivo observado, sendo o tempo fator importante para a predição do afastamento das pessoas do trabalho. Identifica-se que, em janeiro, quase não há afastamentos por motivo de saúde e que ocorre aumento progressivo ao longo do semestre estudado. Em junho/julho, inverte-se essa tendência, que se modifica novamente em agosto, o que sugere um padrão de repetição (ciclo). Nítida é a elevação de ausências por motivo de saúde no período definido como letivo / The study of absences and sick leave can become privileged reference point for observing the situation in which the guidelines are built and the products that will serve on the educational activities for adolescents and children who depend on the Bureau of Education of the State of São Paulo. Measuring absenteeism in work related to medical reasons was decided to describe the magnitude of the average rates of absenteeism and medical leave from teaching and support staff, according to the 91 boards of education throughout the State of São Paulo between May 2008 and July 2009 and compare the proportion of absences and licenses among the functions of teaching and support, according to coordinators of education. This is one ecological study that used in its construction, the secondary data collected from official records. It was found that the peripheral region of the metropolis was the one with a higher number of absences at the expense of the interior and the capital, who had recorded approximate average. Sick leave, however, have mainly within, a significant increase. This work could report that approximately 20 per cent of the workforce employed was absent during the school year observed, the time factor is important for predicting the removal of people from work. We found that in January, there was almost no leaves due to health reasons and that it had increased progressively throughout the semester studied. In June / July, that trend reversed itself, which was modified again in August, which suggested a pattern of repetition (cycle). Sharp was the elevation of absences due to health reasons in the period defined as academic

Introdução - Os trabalhadores no Brasil geralmente retornam ao trabalho nas mesmas condições que geraram seus afastamentos. No ano de 2012 os professores foram o terceiro grupo profissional que mais se afastou e retornou ao trabalho (RT) em readaptação funcional, entre os servidores públicos da rede municipal de São Paulo. Transtornos mentais e comportamentais (TMC) foram um dos diagnósticos mais frequentes. Objetivos - Conhecer e analisar os processos de afastamentos por TMC e RT entre os professores da rede pública municipal de SP. Métodos - Estudo qualitativo, de caráter exploratório, realizado por meio de entrevistas individuais centradas no problema, em linha de narrativa oral e grupos focais. Participaram 20 professores ativos e readaptados, com histórico de licenças médicas por TMC e RT. A análise dos dados envolveu transcrição, codificação aberta, axial e seletiva. Resultados - As categorias temáticas discutidas foram: a) afastamentos do trabalho por TMC; b) RT; c) estratégias para o cuidado da saúde e permanência no trabalho; d) período de afastamento até o retorno ao trabalho; e) preconceitos no trabalho; f) perícia médica; g) autonomia dos professores em modificações das condições e organização do trabalho. Os participantes foram na maioria mulheres, principais responsáveis pela renda familiar e com longa jornada de trabalho. Foram relatadas situações caracterizadas pela falta de autonomia. As negociações no âmbito do RT ocorreram preferencialmente com os professores readaptados, de maneira dependente da equipe gestora da escola e sem direcionamento às modificações dos fatores que colaboraram com os afastamentos. Professores ativos e readaptados significaram de modo distinto afastamento e RT. O contexto de trabalho na educação foi causa referida para o adoecimento. Aspectos de gestão do trabalho na escola foram associados tanto ao afastamento quanto ao RT, que ocorreram na sua maioria, em condições desfavoráveis ao trabalho e à saúde. Conclusões - São complexas as relações entre os aspectos envolvidos nos processos de afastamento por TMC e RT entre os professores participantes. Discutir retorno ao trabalho exige abordar os motivos dos afastamentos. Tanto politicas públicas e macroestruturas, quanto as micropolíticas foram determinantes do adoecimento, afastamento e processo de RT entre os participantes. Ações de prevenção do adoecimento mental e dos afastamentos e promoção da saúde devem integrar um projeto multi-institucional que garanta vigilância em saúde do trabalhador, capacitações voltadas ao processo de afastamento e RT e participação dos professores / Introduction - Workers in Brazil usually return to work under the same conditions that led to their sick leave. In 2012 teachers were the third professional group with more sick leave and return to work (RT) in functional readaptation, among public servants of the city of São Paulo. One of the most frequent diagnoses was mental and behavioral disorders (MBD). Objectives - To investigate and analyze the processes of sick leave by MBD and RT among teachers from São Paulo public municipal system. Methods - Qualitative study, of exploratory approach, conducted through individual interviews focused on the issue in oral narrative line and focus groups. Twenty active and readaptation functional teachers participated, with a history of sick leave due MBD and RT. The data analysis involved transcription, encoding open, axial and selective. Results - The themes discussed were: a) sick leave due MBD; b) RT c) strategies for health care and remain in work; d) period off work on sick leave; e) prejudices at work; f) medical expertise; g) autonomy of teachers in changing the conditions and organization at work. Participants were mostly women, sole breadwinner and long working hours. Situations characterized by lack of autonomy were reported. Negotiations within the RT preferentially occurred with readaptation functional teachers, in dependant way of the management team of the school and without targeting alteration of the factors that collaborated with the sick leave. Active and readaptation functional teachers meant sick leave and RT differently. The work context in education was concerned referred to the illness. Work management aspects at school were both associated with the sick leave on the RT, which occurred mostly in unfavorable working and health conditions. Conclusions - Relationships among aspects are complex when involved in the process of sick leave due TMC and RT among participants. Discussing return to work requires addressing the reasons for the sick leave. Both public policy and macro structures as the micro were determinants of illness, sick leave and RT process 8 among participants. Actions to prevent MBD and sick leave, and health promotion should integrate a multi-institutional project to ensure worker health surveillance, qualification aimed at the sick leave and RT process and participation of teachers

A relação entre o trabalho e as condições de saúde ou doença do ser humano vem sendo estabelecida desde a antiguidade. Relação esta, entre o trabalho e o adoecimento, e também a saúde do indivíduo, que está diretamente ligada à saúde de uma população. Assim, a saúde ocupacional está diretamente relacionada ao bem estar, produtividade e qualidade de vida do trabalhador. Conceituando-se o absenteísmo como sendo a ausência crônica ao trabalho ou a outras obrigações, surge consequentemente o desdobramento em absenteísmo tipo I, ou seja, a falta ao trabalho por motivo de doença, ou o absenteísmo do tipo II, com a presença, porém com menor capacidade produtiva e falta de concentração. O absenteísmo com origem em patologias odontológicas tem sido relatado como sendo responsável por número de horas perdidas que refletem no prejuízo econômico de empresas tanto privadas, como públicas. Dado à escassez de investigações acerca do tema, propõe-se, com este estudo, um levantamento epidemiológico, com o intuito de se vislumbrar um panorama inequívoco da relação entre absenteísmo e doenças orofaciais de interesse da odontologia. Para tanto, optou-se por traçar o perfil do Absenteísmo na Administração Pública. A estratégia envolveu uma amostra de 340 prontuários funcionais de servidores públicos municipais de uma cidade do interior do Estado de São Paulo, Brasil, de um universo de 973 servidores ativos, que foi submetida a uma avaliação transversal retrospectiva de 11 anos e 5 meses, no período de janeiro de 2001 a maio de 2012, através da análise da História Médico-Odontológica Pregressa colhida dos atestados médicos e odontológicos juntados e justificantes de faltas ou afastamentos, documentos legais estes, comprovantes do motivo do absenteísmo. Os dados coletados foram submetidos a tratamento estatístico pertinente buscando fornecer subsídios para discussão e conclusão do trabalho, levantando questões a serem analisadas e posteriormente informadas à administração municipal, como sugestão para melhoria da qualidade de vida e saúde do servidor dentro do ambiente de trabalho, contribuindo para a redução do absenteísmo e aumento da produtividade, e consequente acréscimo na qualidade da prestação do serviço público. / The relationship between work and health conditions or disease of human beings has been established since antiquity. Such relationship between work and illness, and also the individual health, is directly linked to the health of a population. Thus, occupational health is directly related to the workers welfare, productivity and quality of life. Conceptualizing up absenteeism as the chronic absence from work or other obligations, this absenteeism could be split in type I, which is the absence from work due to illness, or type II, which is the presence, but with low productive capacity and lack of concentration. Absenteeism originating from dental diseases has been reported as being responsible for uncountable hours lost that reflect in economic damage to companies both private and public. Given the scarcity of research on the subject, it is proposed, in this study, an epidemiological survey, in order to discern a clear picture of the relationship between absenteeism and oral and facial diseases related to the dentistry interest. Therefore, we chose to profile the Absenteeism in Public Administration. The strategy involved a sample of 340 medical functional records of municipal civil servants at a city in the state of São Paulo, Brazil, from an universe of 973 active servers, which was subjected to a 11 years and 5 months cross-sectional retrospective comprising January 2001 to May 2012, through Medical and Dental History analysis harvested from dental and medical certificates about absences or non-working periods, being these legal documents the proof of the reason for absenteeism. The collected data were analyzed statistically relevant trying to provide subsidies for discussion and work completion, raising issues to be analyzed and subsequently reported to the municipal administration, as a suggestion for improving the quality of life and health of the server within the work environment, contributing to reduce absenteeism and increase productivity, and consequent increase in the quality of public service delivery.

Introdução - Os trabalhadores no Brasil geralmente retornam ao trabalho nas mesmas condições que geraram seus afastamentos. No ano de 2012 os professores foram o terceiro grupo profissional que mais se afastou e retornou ao trabalho (RT) em readaptação funcional, entre os servidores públicos da rede municipal de São Paulo. Transtornos mentais e comportamentais (TMC) foram um dos diagnósticos mais frequentes. Objetivos - Conhecer e analisar os processos de afastamentos por TMC e RT entre os professores da rede pública municipal de SP. Métodos - Estudo qualitativo, de caráter exploratório, realizado por meio de entrevistas individuais centradas no problema, em linha de narrativa oral e grupos focais. Participaram 20 professores ativos e readaptados, com histórico de licenças médicas por TMC e RT. A análise dos dados envolveu transcrição, codificação aberta, axial e seletiva. Resultados - As categorias temáticas discutidas foram: a) afastamentos do trabalho por TMC; b) RT; c) estratégias para o cuidado da saúde e permanência no trabalho; d) período de afastamento até o retorno ao trabalho; e) preconceitos no trabalho; f) perícia médica; g) autonomia dos professores em modificações das condições e organização do trabalho. Os participantes foram na maioria mulheres, principais responsáveis pela renda familiar e com longa jornada de trabalho. Foram relatadas situações caracterizadas pela falta de autonomia. As negociações no âmbito do RT ocorreram preferencialmente com os professores readaptados, de maneira dependente da equipe gestora da escola e sem direcionamento às modificações dos fatores que colaboraram com os afastamentos. Professores ativos e readaptados significaram de modo distinto afastamento e RT. O contexto de trabalho na educação foi causa referida para o adoecimento. Aspectos de gestão do trabalho na escola foram associados tanto ao afastamento quanto ao RT, que ocorreram na sua maioria, em condições desfavoráveis ao trabalho e à saúde. Conclusões - São complexas as relações entre os aspectos envolvidos nos processos de afastamento por TMC e RT entre os professores participantes. Discutir retorno ao trabalho exige abordar os motivos dos afastamentos. Tanto politicas públicas e macroestruturas, quanto as micropolíticas foram determinantes do adoecimento, afastamento e processo de RT entre os participantes. Ações de prevenção do adoecimento mental e dos afastamentos e promoção da saúde devem integrar um projeto multi-institucional que garanta vigilância em saúde do trabalhador, capacitações voltadas ao processo de afastamento e RT e participação dos professores / Introduction - Workers in Brazil usually return to work under the same conditions that led to their sick leave. In 2012 teachers were the third professional group with more sick leave and return to work (RT) in functional readaptation, among public servants of the city of São Paulo. One of the most frequent diagnoses was mental and behavioral disorders (MBD). Objectives - To investigate and analyze the processes of sick leave by MBD and RT among teachers from São Paulo public municipal system. Methods - Qualitative study, of exploratory approach, conducted through individual interviews focused on the issue in oral narrative line and focus groups. Twenty active and readaptation functional teachers participated, with a history of sick leave due MBD and RT. The data analysis involved transcription, encoding open, axial and selective. Results - The themes discussed were: a) sick leave due MBD; b) RT c) strategies for health care and remain in work; d) period off work on sick leave; e) prejudices at work; f) medical expertise; g) autonomy of teachers in changing the conditions and organization at work. Participants were mostly women, sole breadwinner and long working hours. Situations characterized by lack of autonomy were reported. Negotiations within the RT preferentially occurred with readaptation functional teachers, in dependant way of the management team of the school and without targeting alteration of the factors that collaborated with the sick leave. Active and readaptation functional teachers meant sick leave and RT differently. The work context in education was concerned referred to the illness. Work management aspects at school were both associated with the sick leave on the RT, which occurred mostly in unfavorable working and health conditions. Conclusions - Relationships among aspects are complex when involved in the process of sick leave due TMC and RT among participants. Discussing return to work requires addressing the reasons for the sick leave. Both public policy and macro structures as the micro were determinants of illness, sick leave and RT process 8 among participants. Actions to prevent MBD and sick leave, and health promotion should integrate a multi-institutional project to ensure worker health surveillance, qualification aimed at the sick leave and RT process and participation of teachers