Productividad laboral en pacientes con artritis reumatoide temprana / Work productivity in patients with early rheumatoid arthritis

Introducción: La artritis reumatoide tiene un importante impacto sobre la función física y la productividad laboral. Objetivo: Determinar la productividad laboral de los pacientes con artritis reumatoide temprana identificando su relación con variables sociodemográficas y clínicas. Método: Se realizó un estudio observacional descriptivo de corte transversal en 53 pacientes atendidos en el Centro de Referencia de Enfermedades Reumáticas entre enero a diciembre de 2019. Para evaluar la productividad laboral se utilizó el cuestionario WPAI-AR. Resultados: Predominaron los pacientes entre los 35-55 años de edad (60,4 por ciento), el sexo femenino (60,4 por ciento). La productividad laboral medida a través de WPAI-AR reportó durante los últimos 7 días una media de 4,64 horas laborales perdidas, secundaria a la artritis reumatoide, con un porciento de pérdida por ausentismo del 16,5 por ciento y presentismo del 59,6 por ciento. Conclusiones: El mayor porciento de afectación de la productividad laboral le correspondió al presentismo. Se encontró asociación entre la pérdida de productividad laboral y la actividad clínica, la discapacidad funcional y la calidad de vida relacionada con la salud(AU)

Introduction: rheumatoid arthritis has been reported to have a significant impact on physical function and work productivity. Objectives: To determine the labor productivity of patient's diagnosis with early rheumatoid arthritis and to identify its possible relationship with sociodemographic and clinical variables. Methods: A cross-sectional descriptive observational study was carried out in 53 patients treated at the Reference Center for Rheumatic Diseases between January to December 2019. To evaluate labor productivity, the WPAIR AR questionnaire was used. Results: patients between 35-55 years of age predominated 60.4 percent, the female sex 60.4 percent. Labor productivity measured by WPAI AR reported during the last 7 days an average of 4.64 working hours lost, secondary to early rheumatoid arthritis, with a percentage of loss due to absenteeism of 16.5 percent and presenteeism of 59.6 percent. Conclusion: Conclusion: the highest percentage of affectation of labor productivity corresponded to labor presenteeism. Loss of work productivity was significantly associated with clinical activity, functional capacity, and health-related quality of lifepor ciento(AU)

Síndrome amotivacional en consumidores crónicos de marihuana. Una revisión narrativa para la aproximación al concepto / Amotivational syndrome in chronic marijuana users. A narrative review to approach the concept

Introducción: Durante los últimos sesenta años se ha construido evidencia sobre los efectos adversos relacionados con el consumo crónico de cannabis. Los problemas de memoria y concentración, el riesgo de esquizofrenia en sujetos predispuestos y el síndrome amotivacional han sido referenciados. Con los primeros al parecer no hay muchas dudas, pero en relación con el último, existe controversia. Objetivo: revisar la evidencia científica existente sobre el síndrome amotivacional. Material y Métodos: La revisión se realizó mediante una búsqueda en bases de datos académicas, se tomaron en cuenta las publicaciones que estuvieran relacionadas con trastornos mentales relacionados con el consumo crónico de marihuana en los que se hacía referencia al síndrome amotivacional que cumplieran con criterios de calidad de los artículos apegados a estándares internacionales. Desarrollo: Se incluyó un total de 31 artículos, de los cuales 16 incluían la definición de síndrome amotivacional. Una vez integradas todas las fuentes, se determinó organizar la evidencia encontrada en 15 factores: apatía; desinterés; pasividad; indiferencia; demora en la realización de tareas; pereza; presentismo; desgano para actividades prolongadas que requieran atención o tenacidad; abandono del cuidado personal; desinterés sexual; disminución de los reflejos; autoeficacia disminuida; deterioro de las habilidades comunicativas; retraimiento social y afecto no alterado. Conclusiones: A partir de los hallazgos, se sugiere que el síndrome amotivacional es una constelación de síntomas y/o signos relacionados, lo que podría constituir una morbilidad propia del consumo crónico de cannabis, se espera que en el futuro se desarrollen investigaciones que prueben o rechacen su existencia(AU)

Introduction: Over the past sixty years, evidence for the adverse effects of chronic cannabis use has been demonstrated. Memory and concentration problems, the risk of schizophrenia in predisposed subjects, and amotivational syndrome have been referenced. There is not much doubt in relation to the first effect mentioned, but there is controversy around the last. Objective: To review the existing scientific evidence for the amotivational syndrome. Material and Methods: The review was conducted through academic database searching. The publications related to mental disorders associated with the chronic marijuana use, which referred to amotivational syndrome that fulfilled the criteria for articles attached to international standards, were taken into account. Results: A total of 31 articles were included. Of them, 16 presented the definition of amotivational syndrome. Once all the sources were integrated, the evidence found in 15 factors was organized. These factors included: apathy; disinterest; passivity; indifference; delay to perform tasks; sloth; presentism; reluctance to do prolonged activities that require attention or tenacity; abandonment of personal care; sexual disinterest; decreased reflexes; decreased self-efficacy; impairment in communication skills; social withdrawal, and unaltered affection. Conclusions: Based on these findings, we suggest that the amotivational syndrome is a constellation of symptoms and / or related signs which could constitute a typical morbidity caused by chronic cannabis use, so we expect that future research will be developed to demonstrate or discard their existence(AU)

Using qualitative methods for a conceptual analysis of measures of health status and presenteeism prior to a mapping study.

OBJECTIVES: The inclusion of productivity in economic evaluations is a contentious issue. Methods are currently being developed to assess how it may feasibly be included for specific interventions, such as workplace interventions (WPIs), where productivity is a key outcome. Mapping (also called cross-walking or prediction modelling) may offer a solution. Prior to producing a mapping algorithm, it is recommended that the conceptual validity between 'source' and 'target' measures be understood first. This study aimed to understand the conceptual validity of two existing measures of health status (EQ-5D; SF-6D) and presenteeism to inform the potential for a subsequent mapping algorithm. METHODS: A purposive sample of individuals who were currently working and had either rheumatoid arthritis (RA), ankylosing spondylitis (AS) or psoriatic arthritis (PsA). Individuals were recruited through support groups. Semi-structured telephone interviews were conducted until data saturation (no new emerging themes) was reached. Deductive and inductive framework analysis methods were used to identify key aspects of the conditions (themes) that impact on presenteeism (working at reduced levels of health). RESULTS: Twenty-two (RA = 10; AS = 9; PsA = 3) employed individuals were interviewed. Deductive analysis identified evidence which confirmed the domains included in the EQ-5D and SF-6D capture those key aspects of RA, AS and PsA that increase presenteeism. Inductive analysis identified an additional theme; mental clarity, not captured by the EQ-5D or SF-6D, was also found to have a direct impact on presenteeism. CONCLUSIONS: The results of the study indicate conceptual validity of both health status measures to predict presenteeism. The next step is to develop a mapping algorithm for presenteeism.

What is Number of Days in Number of Times? Associations Between, and Responsiveness of, Two Sickness Presenteeism Measures.

OBJECTIVE: To examine the associations between sickness presenteeism (SP) reported as number of days with SP reported as number of times and to evaluate their responsiveness. METHODS: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health, and registered sick leave. Both SP constructs were measured several times to examine responsiveness. RESULTS: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seems to be more sensitive than number of days in detecting changes after rehabilitation. CONCLUSIONS: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seems to be more responsive.

Presenteeism in multiprofessional team workers in the Adult Intensive Care Unit.

OBJECTIVE: To analyze the occurrence of presenteeism in multiprofessional team workers of an Adult Intensive Care Unit, relating it to sociodemographic and labor characteristics. METHOD: It is an analytical cross-sectional qualitative study, which used a questionnaire for sociodemographic data collection, and Stanford Presenteeism Scale(SPS-6) to assess presenteeism. RESULTS: There was predominance of women (75.9%), nursing workers (66.7%), mean age of 39.81 years, and 6 to 10 years (31.6%) of experience in the labor market. Regarding presenteeism, 48.7% presented work impairment and 31.8% presentedperformance and completion of tasks altered by this phenomenon. CONCLUSION: Expressive numbers of general presenteeism were identified, with results indicating impairment in completing work. When connecting presenteeism to sociodemographic and labor characteristics, the variables sex, dependent children and absence from work presented values with statistical significance among the studied workers.

Presenteeism in multiprofessional team workers in the Adult Intensive Care Unit / Presentismo en trabajadores del equipo multiprofesional de Unidad de Terapia Intensiva Adulta / Presenteísmo em trabalhadores da equipe multiprofissional de Unidade de Terapia Intensiva Adulta

ABSTRACT Objective: To analyze the occurrence of presenteeism in multiprofessional team workers of an Adult Intensive Care Unit, relating it to sociodemographic and labor characteristics. Method: It is an analytical cross-sectional qualitative study, which used a questionnaire for sociodemographic data collection, and Stanford Presenteeism Scale(SPS-6) to assess presenteeism. Results: There was predominance of women (75.9%), nursing workers (66.7%), mean age of 39.81 years, and 6 to 10 years (31.6%) of experience in the labor market. Regarding presenteeism, 48.7% presented work impairment and 31.8% presentedperformance and completion of tasks altered by this phenomenon. Conclusion: Expressive numbers of general presenteeism were identified, with results indicating impairment in completing work. When connecting presenteeism to sociodemographic and labor characteristics, the variables sex, dependent children and absence from work presented values with statistical significance among the studied workers.

RESUMEN Objetivo: Analizar la ocurrencia del presentismo en trabajadores del equipo multiprofesional de una Unidad de Terapia Intensiva Adulta y relacionar con las características sociodemográficas y laborales. Método: Estudio analítico, transversal y cuantitativo, que utilizó para la recolección de datos un cuestionario para la obtención de los datos sociodemográficos y la Stanford Presenteeism Scale SPS-6 para evaluar el presentismo. Resultados: La mayoría fue de mujeres (75,9%), trabajadoras de enfermería (66,7%), con una media de edad de 39,81 años y con 6 a 10 años (31,6%) de trabajo. Acerca del presentismo, el 48,7% presentó compromiso en el trabajo, y el 31,8% tuvo la realización y finalización de las tareas alteradas por este fenómeno. Conclusión: Se identificaron números expresivos de presentismo general, con resultados que indican compromiso en la finalización del trabajo. Al relacionar el presentismo con las características sociodemográficas y laborales, las variables género, tener hijos dependientes y haber se alejado del trabajo presentar on valores consignificación estadística entre los trabajadores estudiados.

RESUMO Objetivo: Analisar a ocorrência do presenteísmo em trabalhadores da equipe multiprofissional de uma Unidade de Terapia Intensiva Adulta e relacionar com as características sociodemográficas e laborais. Método: Estudo analítico, transversal e quantitativo, que utilizou para a coleta de dados um questionário para a obtenção dos dados sociodemográficos e a Stanford Presenteeism Scale SPS-6 para avaliar o presenteísmo. Resultados: Predominaram mulheres (75,9%), trabalhadoras de enfermagem (66,7%), com média de idade de 39,81 anos e com 6 a 10 anos (31,6%) de trabalho. Quanto ao presenteísmo, 48,7% apresentaram comprometimento no trabalho e 31,8% tiveram a realização e finalização das tarefas alteradas por este fenômeno. Conclusão: Foram identificados números expressivos de presenteísmo geral, com resultados que indicam comprometimento na finalização do trabalho. Relacionando o presenteísmo com as características sociodemográficas e laborais, as variáveis sexo, ter filhos dependentes e ter-se afastado do trabalho apresentaram valores com significância estatística entre os trabalhadores estudados.

Factors of occurrence and improvement methods of presenteeism attributed to diabetes: A systematic review.

OBJECTIVE: A systematic review was performed to study factors of occurrence and improvement methods of presenteeism attributed to diabetes. METHODS: We set 2 clinical questions; (a) how comorbidities and complications of diabetes induce presenteeism and (b) what interventions or conditions effectively improve presenteeism. Then, we conducted a comprehensive search with MEDLINE/PubMed and Scopus databases and extracted those that met the clinical questions. RESULTS: Eighteen papers studied occurrence of presenteeism by comorbidities and complications of diabetes. Most studies were cross-sectional and had a low quality of evidence. However, the associations of hypoglycemia, diabetic neuropathy, and mood disorders with presenteeism were relatively well studied. The papers that discussed effective interventions or conditions for improving presenteeism were very limited. CONCLUSIONS: Our review suggests that presenteeism attributed to diabetes is mainly caused by hypoglycemia, diabetic neuropathy, and mood disorders. There are very limited evidences, but available information suggests that improving glycemic control, adjusting treatment regimen by evaluating the impact on work, providing psychological support, and developing suitable work accommodations may effectively reduce presenteeism.

Work addiction and presenteeism: The buffering role of managerial support.

The current study examined the mediating effect of presenteeism and moderating effect of managerial support in the relation between workaholism and work-family conflict. A sample of 1065 white-collar employees from an Italian company filled in an online survey and hypotheses were tested using a bootstrapping procedure. Results showed that presenteeism mediated the association between workaholism and work-family conflict. Moreover, the mediating effect of presenteeism was moderated by managerial support: for employees reporting lower levels of support workaholism was stronger related to presenteeism than for those experiencing higher support. Presenteeism, in turn, was related to greater levels of work-family conflict. The present study sheds light into the protective role played by managerial support in preventing workaholic employees from forcing themselves to attend work also when feeling sick. Accordingly, early intervention aimed at buffering the negative association between workaholism and work-family conflict should focus on training managers to develop supportive leadership skills.

Single item presenteeism question: Reliability and validity of Persian version in participants with low back pain.

BACKGROUND: Single item presenteeism question (SIPQ) is a rating scale to assess the impact of low back pain (LBP) on presenteeism. OBJECTIVE: To translate the SIPQ into Persian language (SIPQ-P) and evaluate the reliability and validity of the SIPQ-P in participants with LBP. METHODS: In the first stage, the English SIPQ was translated into Persian language in a cross-sectional design following standard forward-backward approach with expert panel review and pilot testing. In the second stage with a prospective cohort design, 100 participants with LBP (84 male and 16 female, mean age±SD: 33.9±11.2 years) participated. Participants were asked to answer the SIPQ-P and rate their LBP from 0 to 10 according to the numerical pain rating scale (NPRS) for concurrent criterion validity. To evaluate the convergent construct validity of SIPQ, participants completed Persian Functional Rating Index (PFRI). For the divergent validity, the Spearman's correlation test was used to evaluate the association between the SIPQ-P and education. For the test-retest reliability, 50 participants answered the SIPQ-P after 7 days. Fifty healthy participants (mean age±SD: 24.24±8.07 years) answered the SIPQ-P for evaluating discriminant validity. RESULTS: There was a significant difference between the SIPQ-P score of participants and the healthy participants (p <  0.001). The concurrent criterion validity was demonstrated by a significant correlation between the SIPQ-P and pain NPRS (Spearman's rho = 0.46, p <  0.001). The Spearman correlation coefficient showed a significant correlation between the SIPQ-P scores and the Persian FRI (r = 0.56, p <  0.001). There was no correlation between the SIPQ-P score and the education level (r = -0.001, p = 0.99). The ICCagreement was 0.77 indicating a very good test-retest reliability. CONCLUSIONS: This study showed that the Persian version of SIPQ is a reliable and valid scale to assess the effect of LBP on presenteeism in Persian speakers with LBP.

Presentismo en profesionales sanitarios de los servicios de urgencias y emergencias / Presenteeism among emergency health care staff

Objetivo. Conocer la prevalencia de presentismo en las diferentes categorías profesionales del personal asistencial sanitario de los servicios de urgencias (SU) hospitalarios y extrahospitalarios del Servicio de Salud del Principado de Asturias, así como definir las características sociodemográficas y los factores laborales que se asocian con el mismo en las diferentes categorías profesionales. Método. Estudio descriptivo transversal llevado a cabo durante el último semestre del año 2014 y primero del 2015. Mediante cuestionario anónimo y voluntario se recogieron variables sociodemográficas y relacionadas con el trabajo, la percepción del trabajo como estresante y, de forma autoaplicada, la escala de presentismo Standford Presenteeism Scale-6 adaptada a población española. Resultados. Sobre 323 profesionales se observó una prevalencia de presentismo del 52,9%. Se comprobó la existencia de relación entre estrés y presentismo (p < 0,01), el presentismo en función del centro de trabajo (p = 0,004) y el hecho de tener personas dependientes al cargo (p = 0,034). También se encontró asociación con el estrés en personal médico (p = 0,049) y personal de enfermería con personas dependientes a su cargo (p = 0,016). Conclusiones. Existe una elevada prevalencia de presentismo en el personal sanitario de los SU del Principado de Asturias, hallándose relaciones estadísticamente significativas con múltiples variables (AU)

Objectives. To estimate the prevalence of presenteeism among different categories of hospital and pre-hospital emergency health care professionals in the Principality of Asturias, Spain, and to define the sociodemographic characteristics and workplace factors associated with presenteeism in all categories. Methods. Cross-sectional descriptive study carried out during the last half of 2014 and first half of 2015. A self-administered questionnaire was used to collecta data on sociodemographic and work-related variables and perception of work as stressful. The respondents, who answered voluntarily and anonymously, assessed themselves on the Stanford Presenteeism Scale-6 adapted for use in Spain. Results. The prevalence of presenteeism was 52.9% among the 323 respondents. Presenteeism was associated with stress (P<01), place of work (P=.004), and bearing responsibility for dependent persons (P=.034) in the group overall. The association between stress and presenteeism was clearly present in emergency physicians (P=.049) and in nurses with dependents under their care (P=.016). Conclusions. The prevalence of presenteeism is high among emergency staff in the Principality of Asturias. Presenteeism is associated with diverse factors (AU)

Presenteeism in academic employees-occupational and individual factors.

Background: There is growing evidence that presenteeism can be damaging for individuals and organizations. It is, therefore, important to identify the prevalence of working while sick in different working environments and the factors that contribute to such behaviour. Aims: To examine the prevalence of self-reported presenteeism in academic staff working in UK universities and colleges and the extent to which job demands, control, support and work engagement are risk factors. Methods: Scales from the Health and Safety Executive Management Standards Indicator Tool were used to measure job demands, control and support from managers and co-workers. Work engagement was assessed using a validated measure and the frequency of self-reported presenteeism was measured. The effects of demands, control, support and engagement on presenteeism were examined with ordinal regression analysis. Results: The study sample comprised 6874 people working in academic roles in UK colleges and universities (59% female). Most respondents (88%) reported working while sick at least sometimes. The risk factors for presenteeism were job demands, control, support from managers and work engagement. Conclusions: The findings of this study indicate that presenteeism is commonplace in UK colleges and universities. Some of the features of the job that might encourage employees to work while sick are highlighted, whereas engagement in work was an additional risk factor.

Associations between perceived leadership and presenteeism in an industrial population.

Background: Presenteeism has received increasing attention in occupational health research but the evidence for its association with perceived leadership is scant. Aims: To assess the association of perceived leadership and presenteeism among industrial workers. Methods: Survey responses from employees on perceived leadership were linked to the personnel register of a food industry company. The Presenteeism Scale method was used to determine the presenteeism percentage. Perceived leadership was measured as a composite variable of six individual items on motivating and participating leadership. Generalized linear models were used to determine the association of perceived leadership with presenteeism. Results: There were 847 participants. The majority of office workers of both genders reported better perceived leadership than factory workers. We found that perceived poor leadership was associated with a higher likelihood of presenteeism (rate ratio (RR) 1.64, 95% confidence intervals (CIs) 1.51-1.78). However, there was variation amongst and within occupational groups and genders, with a higher risk of presenteeism amongst male factory workers (RR 2.28, 95% CI 2.02-2.52) than female office workers. Conclusions: Leadership was found to be significantly associated with presenteeism, with a greater risk of presenteeism in those reporting poor perceived leadership. The association between levels of perceived leadership and presenteeism was stronger in men than women. Organizations should focus on motivating leadership practices to reduce the risk of presenteeism, especially among men.

Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial.

BACKGROUND: Inflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome. METHODS: A feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison. RESULTS: Fifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 h at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = -12.4 (SD 13.2); control = -2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status, indicating proof of concept. The preferred primary outcome measure was the WLQ, a presenteeism measure. CONCLUSIONS: This brief job retention VR is a credible and acceptable intervention for people with inflammatory arthritis with concerns about continuing to work due to arthritis. TRIAL REGISTRATION: ISRCTN 76777720 . Registered 21.9.12.

The Relation of Combined Aerobic and Muscle-Strengthening Physical Activities With Presenteeism.

BACKGROUND: There is a need to understand physical activity types associated with health-related work limitations (also known as presenteeism). This study tests whether additive effects between physical activity types are associated with health-related work limitations among employees from a public university system. METHODS: A cross-sectional study using health assessment data (n = 10,791) was used to examine aims. Analysis of covariance models tested differences in work limitations between physical activity groups based on combinations of stretching behavior, aerobic, and muscle-strengthening physical activities. Planned contrasts compared differences between selected groups. RESULTS: There were significant group differences (P < .001) in reported work limitations after controlling for demographic, season, and health-related variables. Employees who reported participating in aerobic physical activity had significantly lower work limitation levels compared with inactive employees (P = .027). Employees who reported participating in both aerobic and muscle-strengthening physical activities had the lowest work limitation levels compared with all groups and significantly lower work limitation levels compared with employees who participated in aerobic physical activity only (P = .026). CONCLUSIONS: Results provide evidence of an additive effect where participating in a combination of aerobic and muscle-strengthening physical activities may be most beneficial when targeting health-related work limitations.

The Estimation and Inclusion of Presenteeism Costs in Applied Economic Evaluation: A Systematic Review.

OBJECTIVE: Given the significant costs of reduced productivity (presenteeism) in comparison to absenteeism, and overall societal costs, presenteeism has a potentially important role to play in economic evaluations. However, these costs are often excluded. The objective of this study is to review applied cost of illness studies and economic evaluations to identify valuation methods used for, and impact of including presenteeism costs in practice. METHODS: A structured systematic review was carried out to explore (i) the extent to which presenteeism has been applied in cost of illness studies and economic evaluations and (ii) the overall impact of including presenteeism on overall costs and outcomes. Potential articles were identified by searching Medline, PsycINFO and NHS EED databases. A standard template was developed and used to extract information from economic evaluations and cost of illness studies incorporating presenteeism costs. RESULTS: A total of 28 studies were included in the systematic review which also demonstrated that presenteeism costs are rarely included in full economic evaluations. Estimation and monetisation methods differed between the instruments. The impact of disease on presenteeism whilst in paid work is high. CONCLUSIONS: The potential impact of presenteeism costs needs to be highlighted and greater consideration should be given to including these in economic evaluations and cost of illness studies. The importance of including presenteeism costs when conducting economic evaluation from a societal perspective should be emphasised in national economic guidelines and more methodological work is required to improve the practical application of presenteeism instruments to generate productivity cost estimates.

Presenteeism in the New Zealand senior medical workforce-a mixed-methods analysis.

AIM: To estimate rates of presenteeism in the New Zealand senior medical workforce and identify reasons why this workforce feels pressured to work through illness. METHODS: A cross-sectional survey was returned by 1,806/3,740 publically employed senior doctors and dentists (48%). Relationships between rates of presenteeism, sick leave and demographic factors were explored alongside views on cultural and professional norms. RESULTS: Presenteeism was reported by 88% of respondents. Women and younger doctors had highest rates of presenteeism. Reasons for presenteeism included difficulties accessing short-term sickness cover and concern for the impact of sick leave on patients as well as sociocultural norms. CONCLUSIONS: Presenteeism is a widespread behavioural norm in this medical workforce. Choosing whether to work through illness reflects the high value placed on duty of care, but also tensions around defining responsible behaviour in this regard.