Serial-Multiple Mediation of Job Burnout and Fatigue in the Relationship Between Sickness Presenteeism and Productivity Loss in Nurses: A Multicenter Cross-Sectional Study

Background:In China, sickness presenteeism, job burnout, and fatigue are common among nurses during the COVID-19 pandemic. We propose the prevalence of sickness presenteeism can adversely affect nurses' physical and mental health, negatively impact their work productivity and quality, and pose a threat to patients' safety. Therefore, this study examines the mechanism of productivity loss caused by sickness presenteeism, fatigue, and job burnout.Objectives:To investigate the serial-multiple mediating effect of job burnout and fatigue in the relationship between sickness presenteeism and productivity loss among nurses.Methods:A multicenter cross-sectional survey was undertaken by administering an online questionnaire from December 2020 to May 2021. Stratified cluster sampling was used to include 3,491 nurses from 14 hospitals in Shandong Province, China. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Chalder Fatigue Scale, and Maslach Burnout Inventory. Data analyses were carried out using descriptive statistics, one-way analysis of variance, independent-samples t-test, Pearson correlation analysis, hierarchical regression, and bootstrapping method.Results:From the 3,491 nurses who volunteered in this online survey, only 2,968 valid questionnaires were returned. Sickness presenteeism exhibited a prevalence of 70.6% during the COVID-19 pandemic. The average score of health-related productivity loss was 15.05 ± 4.52, fatigue was 8.48 ± 3.40, and job burnout was 39.14 ± 19.64. Sickness presenteeism was positively associated with fatigue and job burnout while job burnout was positively associated with nurse fatigue. Sickness presenteeism, fatigue, and job burnout were also positively correlated with health-related productivity loss. Statistically significant paths via the single mediation of fatigue and job burnout were established. A statistically significant serial-multiple mediating effect of fatigue and job burnout on the association between sickness presenteeism and productivity loss accounted for 35.12% of the total effect size.Conclusions:There was a high incidence of sickness presenteeism and job burnout among Chinese nurses. High-frequency sickness presenteeism may result in increased productivity loss through the two mediating effects of fatigue and job burnout. Sickness presenteeism may increase fatigue, promote job burnout, and result in increased productivity loss among Chinese nurses during the COVID-19 pandemic.

Does Seasonal Influenza Related Hospital Occupancy Surge Impact Hospital Staff Sickness Presenteeism and Productivity Costs?

Background—The workload of public hospital staff is heightened during seasonal influenza surges in hospitals serving densely populated cities. Such work environments may subject staff to increased risk of sickness presenteeism. Presenteeism is detrimental to nurses’ health and may lead to downstream productivity loss, resulting in financial costs for hospital organizations. Aims—This study aims to quantify how seasonal influenza hospital occupancy surge impacts nurses’ sickness presenteeism and related productivity costs in high-intensity inpatient metropolitan hospitals. Methods—Full-time nurses in three Hong Kong acute-care hospitals were surveyed. Generalized estimating equations (GEE) was applied to account for clustering in small number of hospitals. Results—A total of 71.3% of nurses reported two or more presenteeism events last year. A 6.8% increase in hospital inpatient occupancy rate was associated with an increase of 19% (1.19, 95% CI: 1.06–1.34) in nurse presenteeism. Presenteeism productivity loss costs between nurses working healthy (USD1983) and worked sick (USD 2008) were not significantly different, while sick leave costs were highest (USD 2703). Conclusion—Presenteeism prevalence is high amongst acute-care hospital nurses and workload increase during influenza flu surge significantly heightened nurse sickness presenteeism. Annual presenteeism productivity loss costs in this study of USD 24,096 were one of the highest reported worldwide. Productivity loss was also considerably high regardless of nurses’ health states, pointing towards other potential risk factors at play. When scheduling nurses to tackle flu surge, managers may want to consider impaired productivity due to staff presenteeism. Further longitudinal research is essential in identifying management modifiable risk factors that impact nurse presenteeism and impairing downstream productivity loss.

COVID-19, Telecommuting, and (Virtual) Sickness Presenteeism: Working From Home While Ill During a Pandemic

This study explored (virtual) sickness presenteeism in the context of the COVID-19 pandemic. Using qualitative data from 505 members of the German working population, it investigates how working from home, which rapidly increased because of the COVID-19 outbreak, is perceived with regard to the pandemic. The study explored how this development affects the decision to show absence or presence in case of illness. More than 1,300 responses to different open-end questions by presenteeists and non-presenteeists were analyzed. The findings suggest that many previously identified reasons for deciding for or against presenteeism are still applicable. However, noteworthy differences with regard to both telecommuting and the pandemic occurred. Virtual sickness presenteeism seems to be strongly encouraged by the possibility to adjust working conditions at home. Additionally, COVID-19 has affected the perceptions of health at work. The study contributes to a more in-depth understanding of (virtual) sickness presenteeism during a global pandemic. Six propositions for future research are developed, and the importance of context for the consequences of virtual sickness presenteeism is discussed.

Sickness Presenteeism Among the Swedish Self-Employed During the Covid-19 Pandemic

The present study analyzed the impact of business operations, work and family circumstances, and well-being on the risk of sickness presenteeism for Swedish self-employed workers during the Covid-19 pandemic. It is of great importance to investigate the impact of the pandemic on the self-employed and their enterprises because they are seen as key drivers of economic growth and constitute an expanding group in many countries. Data were obtained from 845 self-employed workers by a web-based survey including questions about background information, work and family circumstances, well-being, sickness presenteeism, and questions about the pandemic. Results were that around 40% of the self-employed introduced new products, processes, and marketing methods, and just over 50% attempted to get new customers during the pandemic. Nearly half of the self-employed people reported that they lost contracts, and 22% judged the risk of bankruptcy to be quite or highly likely. Regression analyses showed that the more the self-employed reported impact on business indicators, increased work hours, a higher level of work-family conflict, and a lower level of mental well-being, the higher the risk of sickness presenteeism. The most common reasons given by the participants for sickness presenteeism during the pandemic were “nobody else can carry out my responsibilities,” “I can't afford to take sick leave” and “I enjoy my work.” Conclusions are that a critical event such as the pandemic probably adds to an already high workload for the self-employed. Impact on business operations such as developing new products/services and marketing, risk of bankruptcy and increased work hours seems to be important factors for explaining sickness presenteeism among the self-employed. Theoretical contributions from the study suggest that critical events such as the Covid-19 pandemic should be considered as an important environmental factor when studying sickness presenteeism among self-employed.

Treatment interruption is a risk factor for sickness presenteeism: a large-scale cross-sectional study during the COVID-19 pandemic

ObjectiveThis study examined the relationship between interruption to routine medical care during the coronavirus disease 2019 pandemic and sickness presenteeism in Japan.MethodsAn internet monitor questionnaire was conducted. Data from 27,036 people were analyzed. Interruption to medical care was defined based on the response “I have not been able to go to the hospital or receive treatment as scheduled.” The number of sickness presenteeism days in the past 30 days was employed as the primary outcome. A zero-inflated negative binomial model was used for analysis.ResultsThe incidence rate ratio was significantly higher among workers who experienced interrupted medical care (2.26; 95% confidence interval: 2.03–2.52) than those who did not require routine medical care.ConclusionsThis study suggests the importance of continuing necessary treatment during a pandemic to prevent presenteeism.

A cross-sectional study of socioeconomic status and sickness presenteeism in Japanese workers during the COVID-19 pandemic

Background: We examined the relationship between socioeconomic and health status, and lifestyle habits and sickness presenteeism among Japanese workers during the COVID-19 epidemic. Methods: A cross-sectional study using Internet monitors was conducted in December, 2020 in Japan. Of 33,302 survey participants, we analysed 27,036 (13,814 males and 13,222 females) who reported experience with sickness presenteeism. Results: The OR of sickness presenteeism associated with unmarried versus married status was 1.15. Respective figures for other variables were 1.11 for manual laboring work compared to desk work; 1.79 and 2.29 for loss of employment at the time the pandemic began and continuation of unemployment compared to maintaining employment during the pandemic; and 3.34 for a feeling of financial instability compared to stability. Conclusion: The issue of sickness presenteeism has been highlighted by COVID-19.

Development and Validity of the Nurse Presenteeism Questionnaire

This study aimed to develop and test the reliability and validity of a multi-item nurses’ presenteeism behaviour questionnaire. Study 1 administered the Nurse Presenteeism Questionnaire (NPQ) to 250 Chinese nurses. Study 2, surveyed 650 nurses with the NPQ, the Sickness Presenteeism Questionnaire, the Stanford Presenteeism Scale, the General Health Questionnaire, and the Emotional Exhaustion Scale using convenience sampling. After item analysis, the subjects were randomly divided into two groups to verify the questionnaire structure. Study 1 revealed the nurses’ core symptoms when they go to work with illness, and the NPQ with 11 items was developed. Study 2’s item analysis revealed that 11 NPQ items had good discrimination (t = 22.67∼36.11, p < 0.01) and high homogeneity. Besides, the scale had good reliability (Cronbach’s = 0.93) and external criterion validity (r = 0.24∼0.84, p < 0.01). Thus, the NPQ can be used to measure presenteeism behaviour in nursing.