Propensity for presenteeism and sickness absenteeism in nurses working with older adults

Abstract

Introduction: Presenteeism is usually defined as attending for work whilst ill and contrasts with sickness absenteeism, where individuals do not attend work when ill. Whilst sickness absenteeism is often health promoting, presenteeism has been linked with lost productivity, increased sickness absence, and can be costly for organisations. Findings that presenteeism was highly prevalent in healthcare workers led to several studies that analysed the predictors of presenteeism frequency in this sector. Very few studies however, have studied the reasons why some healthcare workers exhibit presenteeism more frequently than sickness absenteeism and vice versa.

Aim: To investigate the correlates of propensity for presenteeism (engaging in presenteeism more frequently than sickness absenteeism) and propensity for sickness absenteeism (engaging in sickness absenteeism more frequently than presenteeism) in a sample of ward-based nurses working with older adults in Malta.

Methods: Multinomial logistic regression was used to determine the correlates of propensity for presenteeism and propensity for sickness absenteeism in a cross-sectional survey of ward based nurses working with older adults in Malta (n = 270). The investigated predictors were informed by an earlier qualitative study and included: illness perceptions during participants’ last episodes of presenteeism and sickness absenteeism; work engagement; adjustment latitude; replaceability; work demands; co-worker support; supervisor support; workplace relationships; the Big Five personality factors; work attendance attitude; general health; emotional exhaustion; and demographic information.

Results: Compared to those with a propensity for sickness absenteeism, those with a propensity for presenteeism were significantly more likely to have: attributed the cause of their illnesses during presenteeism to organisational factors; held expectations that had they stayed home during their last presenteeism episode it would not have benefitted their illness; reported lower levels of workability during their last presenteeism episode; reported greater levels of work demands. Compared to those who reported equal presenteeism and sickness absenteeism, those with a propensity for presenteeism were more likely to have: reported greater emotional representations during sickness absenteeism; and greater levels of work engagement. Compared to those who reported equal presenteeism and sickness absenteeism, those with a propensity for absenteeism were more likely to have: attributed their illness to a non-organisational cause; held expectations that staying home during their last presenteeism episode would have benefitted their illness; reported lower levels of work demands. Discussion: In this sample, propensity for presenteeism was influenced by work demands and illness attributed to organisational factors, as opposed to non-organisational factors. Furthermore, propensity for presenteeism was linked with both poorer levels of occupational health and with positive attitudes towards work. The findings indicate that workplace interventions which reduce exposure to organisational causative factors and make work demands more manageable might lead to reductions in presenteeism frequency. Study limitations, are that findings might not apply to nurses working in areas other than the care of older adults, or to similar nursing populations in other countries. Large-scale replications in other healthcare contexts are needed.