Objective: To explore the perceived causes of presenteeism in nurses on geriatric wards.Background: Presenteeism, defined as working when unwell, is associated with lost productivity and increased absenteeism. It is more commonly reported by employees in the healthcare sector than other sectors.Methods: An exploratory, qualitative study using semi-structured interviews, thematically analysed. Data collected via 18 recorded interviews with nurses working with patients on geriatric medical wards in Malta.Results: Four major themes emerged that related to nurses’ decisions to engage in presenteeism: illness perceptions, which included participants’ views and experiences of their own health complaints; attitudes to their employing organisation, co-workers and patients; organisational aspects such as culture and administrative arrangements; and personal reasons including illness behaviour preference and personal circumstances.Conclusions: Nurses’ decisions to attend work when unwell were reported as dependent upon four themes. Further studies are warranted to determine if findings are applicable to nurse populations other than those represented in this study.Implications: Workplace health promotion initiatives should target nurses’ management of their own health, particularly if they have chronic illnesses. Workplace policies and arrangements should be examined with a view to controlling presenteeism.

Background Presenteeism has been linked with lost productivity, impaired health and absence. Whilst much research has focused on types of diseases associated with presenteeism and absenteeism, there has been little investigation into the role of individuals’ illness perceptions in these episodes. Aims To assess how illness perceptions vary between presenteeism and absenteeism episodes. Methods A cross-sectional questionnaire was distributed to ward-based nurses working with older adults. Data on illness perceptions during presenteeism and absenteeism episodes were collected. Data were analysed via the Paired-Samples t-test, Wilcoxon test and McNemar test. Results Two hundred and seventy cases were analysed (88% response rate). Compared with presenteeism, illnesses during absenteeism were thought to affect lives more (P < 0.001), to have more serious symptoms (P < 0.001), to be more concerning (P = 0.003), more likely to be treated (P = 0.009), more infectious (P < 0.001) and perceived as more legitimate reasons for absenteeism (P < 0.001). Treatment was considered more effective during absenteeism (P < 0.001), whilst workability was better during presenteeism (P < 0.001). Presenteeism was perceived as harmful and absenteeism beneficial for illness. Individuals attended work when presenteeism was expected to be less harmful (P < 0.001) and avoided work when absenteeism was expected to be more beneficial for illness (P < 0.001). Conclusions Illness perceptions varied significantly between presenteeism and absenteeism episodes and should be included in models of illness behaviour. Findings also highlight that policy may influence illness behaviour and that nurses may attend work despite concerning levels of illness.

IntroductionPresenteeism is usually defined as attending for work while ill. It is linked with lost productivity and increased sickness absence, and can be costly to organisations. Studies suggest a high prevalence of presenteeism in the healthcare sector. Additionally European statistics suggest that presenteeism is particularly frequent in Malta (EU). A study was therefore conducted to investigate the correlates of presenteeism in a sample of nurses working within a geriatric ward setting in Malta.MethodsA cross-sectional survey (n=270) investigated the suggested predictors of presenteeism that had emerged in an earlier qualitative study. Hierarchical binary logistic regression was used to identify the correlates of presenteeism. Data was analysed using SPSS.ResultIndividuals who had engaged in presenteeism two or more times in the previous 12 months were more likely to have: engaged in sickness absenteeism frequently (OR 2.36, 95% CI: 1.02 to 5.94); felt emotional during their last presenteeism episode (OR 1.21, 95% CI: 1.07 to 1.37); felt that their last sickness absenteeism episode was good for their health (OR 1.72, 95% CI: 1.14 to 2.61); and felt presenteeism was necessary following recent sick leave (OR 1.45, 95% CI: 1.08 to 1.94). They were also less likely to have: reported a fracture (OR 0.06, 95% CI: 0.01 to 0.63) or gastric illness (OR 0.35, 95% CI: 0.15 to 0.82) during their last absenteeism episode; understood the illness that led to their last presenteeism episode (OR 0.80, 95% CI: 0.67 to 0.95); and to feel that they had managerial and peer support (OR 0.45, 95% CI: 0.26 to 0.91).DiscussionThe study highlights that presenteeism is linked to overall health, however perceptions of individual illnesses can also influence the frequency of this behaviour. The study also supports previous findings that work attitudes and organisational factors also play a role. Interventions that benefit nurses’ health and provide support at work may reduce the frequency of presenteeism.