| Summary: | Background: Most commonly conceptualised as attending work whilst ill, sickness presenteeism (SP) contrasts with sickness absence (SA), which involves avoiding work when ill. Due to shortcomings in SP research and theory, its predictors and consequences remain unclear. The healthcare sector experiences a particularly high prevalence of SP. Despite this, SP and its consequences have not been studied in a healthcare setting in Malta.
Aims: To explore the factors that foster SP, SA and their consequences in ward-based nurses working with older adults in Malta.
Methods: An exploratory mixed-methods study was conducted at two medical facilities which catered for older adults in Malta. Data were collected from nurses in two phases. During Phase I, recorded semi-structured qualitative interviews (N=18) investigated the predictors and consequences of SP and SA. These were analysed thematically, and the emerging themes guided the development of a quantitative questionnaire that was distributed cross-sectionally (Phase II). The obtained data (N=270) were analysed in three sets of analyses to identify; (i) the correlates of SP and SA frequency and propensity (ii) explore how illness perceptions vary between SP and SA episodes; and (iii) identify correlates of the main consequences of SP and SA, namely performance loss and illness outcomes
Results: SP and SA were found to be common, with SP associated with negative illness outcomes and poor levels of work performance. SA was believed to be salutogenic. Four categories of factors were associated with SP and SA and their consequences: (i) illness perceptions, which referred to participants’ experiences and views of their illness episodes; (ii) work attitudes, which included feelings and behaviours towards different aspects of occupational life; (iii) organisational factors, which included workplace factors and administrative measures; and (iv) personal factors, including illness behaviour preference and personal life. The perceived consequences of attending work and staying home when ill also appeared to influence SP and SA decisions.
Implications: Interventions that foster primary, secondary and tertiary prevention may benefit nurses’ health and reduce SP and SA frequency. The investigation’s findings also led to the development of a model of SP and SA decisions.
Conclusion: Illness perceptions, work attitudes, organisational factors and personal factors all appeared to play a role in SP and SA decisions and their consequences. In-view of the findings, suggestions were made regarding future SP research, theory and practical implications.
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