Predictors of Presenteeism Among Hospital Employees-A Cross-Sectional Questionnaire-Based Study in Switzerland.

OBJECTIVE: The aim of this cross-sectional study was to examine work- and person-related predictors of the largely "invisible" behavior and phenomenon of presenteeism among employees in a health-care setting in German-speaking Switzerland. METHODS: Self-reported survey data from 1840 employees of four hospitals and two rehabilitation clinics collected in 2015 and 2016 were utilized and analyzed. RESULTS: All studied work-related factors such as patient contact, job satisfaction, high work load, forced overtime, fear of job-loss, and particularly mental strain turned out to be significant and relevant predictors of presenteeism. Younger employees, female workers, and employees with a chronic disease also were more likely to show presenteeism. CONCLUSION: Work stress, work without patients, job dissatisfaction, a chronic disease, and/or a younger age or rather less work experience seem to increase the chances of presenteeism among health-care workers.

Presenteeism: Nurse perceptions and consequences.

AIMS: To describe factors leading to and consequences of nurse presenteeism. BACKGROUND: Presenteeism is more prevalent among nurses than other occupational groups. Existing literatures focuses on prevalence and consequences of presenteeism for patients, health care organizations, and nurses. However, we lack understanding of nurse perceptions of factors leading to and consequences of presenteeism. METHODS: A total of 295 free responses to a cross-sectional survey were analysed using conventional content analysis. RESULTS: Nurses consider multiple factors in deciding how to respond when presentee. These include illness, staffing, availability of leave time, patients, financial constraints and guilt. Consequences of presenteeism identified were decreased mental acuity and attitude leading to lessened communication both in-person and in documentation, transmission of illness, and decline in unit culture, patient care, and nurse health and well-being. CONCLUSIONS: Multiple factors lead to nurse presenteeism and there are negative consequences to nurses' health, work environment and patient care outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: This study leads to key discoveries to the reasons for and consequences of nurse presenteeism. Many of the factors leading to presenteeism can be addressed through culture and policy changes within organizations. The consequences to patient care outcomes and the work environment emphasize the importance of addressing presenteeism.

The Presenteeism Scale as a measure of productivity loss.

BACKGROUND: Work Ability Score (WAS) is a common instrument for assessing work ability but its validity in assessing presenteeism and productivity loss is unknown. AIMS: To validate a WAS-based measure, the Presenteeism Scale (PS), and to evaluate its accuracy as a presenteeism instrument among forestry employees. METHODS: This validation study was based on questions of perceived WAS assessed using the Work Ability-Personal Radar (WA-PR) instrument and on questions of perceived productivity loss and presenteeism assessed using a cross-sectional questionnaire survey. Pearson's correlation test was used to ascertain the associations between variables. The association of productivity loss with presenteeism was evaluated using a logistic regression model. The predictive ability of presenteeism was tested using the receiver-operating characteristic curve. RESULTS: There were 339 respondents in the cross-sectional survey, 257 in the WA-PR and 107 respondents participating in both surveys. The prevalence of presenteeism was 48%. Presenteeism was significantly (P < 0.05) higher among those reporting productivity losses. Presenteeism is extremely accurate in predicting perceived productivity loss but less accurate in predicting PS-based productivity loss. The odds ratio (OR) of self-estimated productivity loss was 77 times higher (OR 77.39, 95% confidence interval [CI] 25.36-236.12) among those with presenteeism. Correspondingly, OR of productivity loss based on the PS was three times higher (OR 3.05, 95% CI 1.16-8.04). CONCLUSIONS: The PS may be a valid tool for predicting productivity loss and may be as good as other instruments. However, further research is needed to improve its accuracy.

Prevalência do presenteísmo em trabalhadores de uma indústria / Prevalence of presentism in workers of an industry

Contexto: Comparecer ao trabalho doente com medo de perder o emprego é um comportamento frequentemente adotado pelos trabalhadores. O presenteísmo é um problema emergente, cujas repercussões socioeconômicas têm despertado a atenção de pesquisadores em diversas áreas e a preocupação de gestores por ser difícil de ser percebido. Objetivo: Determinar a prevalência de presenteísmo entre os trabalhadores em uma indústria do setor alimentício. Métodos: Estudo epidemiológico, de corte transversal, com população de 1.224 trabalhadores, com aplicação da Stanford Presenteeism Scale (SPS-6) como método de investigação do presenteísmo. Resultados: A avaliação do presenteísmo apontou que 30,6% da amostra teve um comportamento presenteísta nos últimos 12 meses e o SPS-6 identificou que 50,9% desses trabalhadores são presenteístas. Observou-se uma associação significativa do presenteísmo entre os trabalhadores sedentários, com excesso de peso, e alguns sintomas autorreferidos. Conclusão: Os resultados da elevada prevalência de presenteísmo e a associação entre sedentarismo e sintomas osteomusculares confirmam a relevância do tema e o impacto negativo para a saúde dos trabalhadores.

Context: Going to work ill has been a common behavior for workers. The presenteeism is a rising problem, and its economical and social repercussions have awaked the researchers' attention in diverse areas and, being difficult to perceive, it cause concern to managers. Objective: To determine the presenteeism prevalence at a food industry. Method: Transversal epidemiological study, cross-sectional, on population of 1,224 workers applying the Stanford Presenteeism Scale (SPS-6) as a presenteeism research method. Results: In the last 12 months, 30,6% of the workers showed presenteeist behavior and the evaluation by SPS-6 found presenteeism prevalence of 50,9% on this sample. A significant association of presenteeism between sedentary, overweight and self-reported symptoms was observed. Conclusion: The results of the high prevalence of presenteeism and the association between sedentary lifestyle and musculoskeletal symptoms confirm the relevance of the issue and the negative impact on the health of workers.

The Effect of Endometriosis Symptoms on Absenteeism and Presenteeism in the Workplace and at Home.

BACKGROUND: Characterized by pain symptoms, endometriosis affects women's productivity in their prime working years. OBJECTIVE: To evaluate the effect of individual endometriosis symptoms on household chore and employment productivity as measured by presenteeism and absenteeism in a population survey of women with endometriosis. METHODS: An online survey of U.S. women was conducted to evaluate the prevalence of endometriosis, as well as symptoms, demographics, and clinical characteristics of the respondents. Women aged 18-49 years (inclusive) with endometriosis completed the Health-related Productivity Questionnaire to assess presenteeism and absenteeism for employed and household work. Descriptive statistics were used to describe the sample, survey responses, and the effect of endometriosis symptom severity on household chore and employment productivity. Regression analyses were performed to examine the effect of individual endometriosis symptoms on employment and household productivity lost because of presenteeism and absenteeism. RESULTS: Of 59,411 women who completed the prevalence screener, 5,879 women (9.9%) met the inclusion criteria for completing the survey; 1,318 women (2.2%) reported endometriosis and at least 1 hour of scheduled household chores in the past 7 days. Of these, 810 women had least 1 hour of scheduled employment in the past 7 days. Mean age was 34.6 years (standard error [SE] ± 0.32); 77.2% of the women were white; 59.3% were married or in a civil union; and 59.1% were employed full or part time. Women with endometriosis had a weekly loss of an average of 5.3 hours (SE ± 0.4) because of employment presenteeism, 1.1 hours (SE ± 0.2) of employment absenteeism, 2.3 (SE ± 0.2) hours of household presenteeism, and 2.5 (SE ± 0.2) hours of household absenteeism. Hourly losses in employment and household chore productivity were significantly greater with increasing symptom severity (mild vs. severe: 1.9 vs. 15.8 total employment hours lost and 2.5 vs. 10.1 total household hours lost; P < 0.0001). Women who experienced 3 endometriosis symptoms concurrently lost a significantly greater number of employment hours because of absenteeism and presenteeism compared with those experiencing 1 or 2 symptoms (P < 0.001). Regression analyses showed that a range of endometriosis symptoms predicted employment and household losses because of presenteeism and absenteeism. CONCLUSIONS: There was a significant relationship between the number and patient-reported severity of endometriosis symptoms experienced and hours of employment and household productivity lost because of presenteeism and absenteeism. Study findings indicate a need for guidance strategies to help women and employers manage endometriosis so as to reduce productivity loss. DISCLOSURES: The design and financial support for this study was provided by AbbVie. AbbVie participated in data analysis, interpretation of data, review, and approval of the manuscript. Coyne and Gries are employees of Evidera- Evidence, Value & Access by PPD and were paid scientific consultants for AbbVie in connection with this study. Soliman, Castelli-Hayley, and Snabes are AbbVie employees and may own AbbVie stock or stock options. Surrey is affiliated with Colorado Center for Reproductive Medicine and was paid by AbbVie as a consultant for this project. Surrey serves as a consultant for AbbVie outside of this project. All authors participated in data analysis and interpretation, and contributed to the development of the manuscript. The authors maintained control over the final contents of the manuscript and the decision to publish. Study concept and design were contributed by Soliman, Coyne, Gries, and Castelli-Haley. Soliman, Castelli-Haley, Coyne, and Gries collected the data, and data interpretation was performed by Snabes, Surrey, Soliman, Coyne, and Gries. The manuscript was written and revised by Soliman, Coyne, and Gries, along with the other authors.

Evolución histórica del concepto ‘presentismo’ en enfermería / Evolução histórica da enfermagem presenteísmo / Historical evolution of presenteeism nursing

Introducción: Un hospital que no cuida de la seguridad, la salud y el bienestar de sus trabajadores no puede ser un hospital seguro para sus pacientes. Seguridad del trabajador y Seguridad del Paciente son dos caras de la misma moneda y cada vez empezamos a encontrar más estudios que orientan hacia la idea de que una peor salud y bienestar de los trabajadores sanitarios puede tener importantes repercusiones para la calidad y la seguridad de los cuidados que los pacientes reciben. Objetivo: revisar el fenómeno emergente del presentismo en el colectivo de enfermería, referido a aquellos empleados que, a pesar de encontrarse enfermos o con alguna lesión que los obligarían a ausentarse, se presentan a trabajar. Metodología: Hemos llevado a cabo una revisión sistemática utilizando la base de datos MEDLINE (Pubmed), con la cual hemos podido comprobar la importancia de dicho objetivo para nuestra sociedad. Se excluyeron los artículos referidos al presentismo en su acepción a aquellos empleados que se ausentan menos en sus trabajos o que no utilizan los permisos que les corresponden, así como los artículos en su acepción pérdida de tiempo en actividades no productivas en el trabajo. Se pretende responder a las siguientes preguntas: ¿Es enfermería una profesión presentista?, ¿Qué implicaciones tiene este fenómeno para la seguridad del paciente? Resultados: Existe aún un número escaso de investigaciones centradas en el presentismo en el colectivo de enfermería. Conclusiones: Expertos en salud laboral, gestión sanitaria o en calidad asistencial deberían incluir este nuevo fenómeno en sus agendas de trabajo, diseñando investigaciones para conseguir encontrar una mejor evidencia científica (AU)

Introduction: A hospital that does not care for the safety, health and welfare of their employees may not be a secure hospital for their patients. Worker and Patient Safety security are two sides of the same coin and increasingly began to find more studies oriented towards the idea that poorer health and welfare of health workers may have important implications for the quality and safety of care that patients receive. Objective: To review the emerging phenomenon of presenteeism in the group of nurses, referred to employees despite being sick or an injury that would force them to leave, report to work. Methodology: We conducted a systematic review using MEDLINE databases, with which we have seen the importance of this objective for our society. It´s excluded articles related to presenteeism that meaning to those employees who are absent less in their jobs or who do not use the permits to which, as well all articles in its meaning waste of time in nonproductive activities at work. We sought to answer the following questions: Is one presentista nursing profession? What implications does this phenomenon to patient safety? Results: There is still a small number of research focused on presenteeism in the group of nursing. Conclusions: Experts in occupational health, health management or healthcare quality should include this new development in their agendas, designing research to find the very best scientific evidence (AU)

Introdução: Um hospital que não se importa com a segurança, saúde e bem-estar de seus funcionários pode não ser um hospital seguro para seus pacientes. Segurança do traba- Cultura de los Cuidados 2º Cuatrimestre 2016 • Año XX - N.° 45 75 lhador e segurança do paciente são dois lados da mesma moeda e cada vez mais começou a encontrar mais estudos voltados para a idéia de que a saúde e bem-estar mais pobre dos trabalhadores de saúde podem ter implicações importantes para a qualidade e segurança importa que os pacientes recebam. Objetivo: Revisar o fenômeno emergente de presenteísmo na comunidade de enfermagem, baseado em aqueles empregados que, apesar de estar doente ou lesão que iria forçá-los a sair, relatório para o trabalho. Métodos: Foi realizada uma revisão sistemática utilizando banco de dados MEDLINE (Pubmed) de dados, que têm visto a importância deste objectivo para a nossa sociedade. Artigos relacionados com presenteísmo em seu significado para os trabalhadores que estão ausentes menos em seus empregos ou que não usam as licenças para o qual eles são excluídos, bem como artigos em seus resíduos significado do tempo em atividades não-produtivas no trabalho. Destina-se a responder às seguintes perguntas: É uma profissão de enfermagem presentista? Que implicações que isso tem para a segurança do paciente? Resultados: Não é ainda um pequeno nú- mero de pesquisas voltadas para o presenteísmo na comunidade de enfermagem. Conclusões: Especialistas em saúde ocupacional, gestão da qualidade dos cuidados de saúde ou este novo fenómeno deve incluir em suas agendas, o desenho de pesquisas para tentar encontrar uma melhor evidência científica (AU)

Comparison of the Utility of Two Assessments for Explaining and Predicting Productivity Change: Well-Being Versus an HRA.

OBJECTIVE: To compare utility of employee well-being to health risk assessment (HRA) as predictors of productivity change. METHODS: Panel data from 2189 employees who completed surveys 2 years apart were used in hierarchical models comparing the influence of well-being and health risk on longitudinal changes in presenteeism and job performance. Absenteeism change was evaluated in a nonexempt subsample. RESULTS: Change in well-being was the most significant independent predictor of productivity change across all three measures. Comparing hierarchical models, well-being models performed significantly better than HRA models. The HRA added no incremental explanatory power over well-being in combined models. Alone, nonphysical health well-being components outperformed the HRA for all productivity measures. CONCLUSIONS: Well-being offers a more comprehensive measure of factors that influence productivity and can be considered preferential to HRA in understanding and addressing suboptimal productivity.

Determinants of presenteeism prevalence and propensity: Two sides of the same coin?

Research on the determinants of sickness presence can be based on employees' number of sickness presence days or employees' propensity to "opt" for presenteeism in case of sickness. This study compares associations between potential determinants and presenteeism in cross-sectional data from a sample of Austrian employees by considering days of sickness absence and presence and an estimator for sickness-presence propensity as outcome variables. The sets of significant determinants for the number of sickness presence days and propensity were found to be overlapping, but not equivalent. Whereas determinants of the number of days can help to identify groups with high presenteeism prevalence, determinants of propensity can help to identify factors that restrict the decision process in case of sickness. With respect to possible interventions aimed at reducing presenteeism, results relating to both perspectives should be considered.

Longitudinal Analyses of Presenteeism and Its Role as a Predictor of Sick Leave in Patients With Ankylosing Spondylitis.

OBJECTIVE: To investigate, in a cohort of patients with ankylosing spondylitis (AS) adequately treated with infliximab, changes over time in presenteeism and the role of presenteeism relative to that of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in predicting sick leave. METHODS: Data were analyzed from 71 patients with paid work and taking a stable dose of infliximab participating in a 96-week study with 5 assessment points. Covariates included presenteeism, sick leave, time, sex, age, BASDAI, BASFI, Bath Ankylosing Spondylitis Metrology Index, and part- or full-time work. Presenteeism represented the AS impact on productivity (by visual analog scale, range 0-10, where 10 = completely unproductive). Sick leave represented the number of days absent from work due to AS in the last 6 months. A linear mixed-effects model for presenteeism, and hurdle and zero-inflated count models for sick leave were explored. RESULTS: Mean ± SD presenteeism ranged from 2.2 ± 2.2 to 3.8 ± 7.8, and sick leave occurred in 8-17% of the patients during the 6-month period. Presenteeism positively correlated with BASDAI and BASFI, but was not significantly influenced by time. The chance of incurring sick leave was affected by presenteeism but not by BASDAI and BASFI. Conditional on being absent from work, the effect of presenteeism on the length of sick leave (in days) was much stronger than BASDAI and BASFI. For presenteeism ≥5, an increase of 1 unit in presenteeism yielded an increase by 36-40% (or 2-12 days) in the length of sick leave during the following 6 months. CONCLUSION: Presenteeism, even measured by a simple visual analog scale, was an important factor to explain future sick leave.

Well-being improvement in a midsize employer: changes in well-being, productivity, health risk, and perceived employer support after implementation of a well-being improvement strategy.

OBJECTIVE: To evaluate employee well-being change and associated change in productivity, health risk including biometrics, and workplace support over 2 years after implementation of a well-being improvement strategy. METHODS: This was an employer case study evaluation of well-being, productivity (presenteeism, absenteeism, and job performance), health risk, and employer support across three employee assessment spanning 2 years. Employee well-being was compared with an independent sample of workers in the community. RESULTS: Well-being and job performance increased and presenteeism and health risk decreased significantly over the 2 years. Employee well-being started lower and increased to exceed community worker averages, approaching significance. Well-being improvement was associated with higher productivity across all measures. Increases in employer support for well-being were associated with improved well-being and productivity. CONCLUSIONS: This employer's well-being strategy, including a culture supporting well-being, was associated with improved health and productivity.