Presenteeism refers to the behavior of people who turn up for work despite complaints of ill health that should prompt rest and absence from work. The high incidence of presenteeism in the nurse population has been extensively investigated using self-reported methods to explore its effects on individual outcomes. However, few studies have examined nurse presenteeism using an “other's” perspective to verify self-reported information. Our aim in this study was to evaluate the prevalence, consequences, and causes of presenteeism in Chinese nurses from the perspectives of nurses and chief nurses. A sample of 481 nurses and 282 chief nurses from five hospitals in Henan Province, China, took part in this cross-sectional study. Participants completed the Sickness Presenteeism Questionnaire, Social Productivity Loss Questionnaire, and Causes of Nurse Presenteeism Questionnaire. The human capital method was used to estimate the monetary loss because of nurse presenteeism. We found that 94.25 and 82.08% of nurses experienced presenteeism in the past 6 months from the perspective of nurses and chief nurses, respectively. The annual monetary loss was estimated to be ¥4.38 billion and ¥2.88 billion based on the presenteeism reports from nurses and chief nurses, respectively. Workload, leave system, and conscientiousness are the main reasons for nurse presenteeism, and financial need is another important reason that is likely overlooked by chief nurses. This study provides a foundation for future research by presenting new knowledge about the prevalence, consequences, and causes of presenteeism in Chinese nurses. The findings emphasize the need for nursing managers and nursing departments to establish policy systems around paid sick leave, workload, and communication with managers to reduce nurse presenteeism and the subsequent socio-economic financial losses.

Presenteeism refers to attending work when one is ill, which not only leads to a decline in the physical and mental health of employees but also negatively impacts organizational productivity and increases an organization's extra costs. Therefore, to explore the antecedents and outcomes of nurses' presenteeism behavior and the acting mechanism among the variables, a sample of 330 nurses from China were investigated with the Sickness Presenteeism Questionnaire, Job Insecurity Scale, Perceived Supervisor Support Scale, and Emotional Exhaustion Scale. The results indicated that (1) job insecurity had a significantly predictive effect on nurses' presenteeism behavior; (2) nurses' presenteeism partially mediated the relationship between job insecurity and emotional exhaustion; and (3) supervisor support moderated the relationship between nurses' presenteeism behavior and emotional exhaustion; i.e., the higher the level of supervisor support, the weaker the positive relationship between nurses' presenteeism behavior and emotional exhaustion. The findings provide theoretical guidance and an empirical basis for prevention and intervention strategies concerning nurses' presenteeism behavior.

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.