Contributing Factors of Presenteeism among Portuguese and Swiss Nurses: A Qualitative Study Using Focus Groups

Nursing Staff Presenteeism Scale: Development and psychometric test

BACKGROUND AND OBJECTIVES

Nurses tend to exhibit higher rates of presenteeism compared to other professions. Presenteeism can cause the work performance of nurses to suffer, jeopardizing their own and their patients' safety and leading to decreased quality of care and increased risks of errors. However, there is a lack of a validated assessment tool for presenteeism in Taiwan. Thus, the purpose of this study was to develop a Nursing Staff Presenteeism Scale (NSPS).

METHODS

To develop questionnaire items, participants from three medical centers in Taiwan were recruited. Through convenience sampling, 500 nurses who met the selection criteria were recruited from November 1, 2022 to January 18, 2023. The scale was developed based on a systematic literature review, a previous study, and expert consultation, and 50 items were initially generated. After removing three items that lacked discriminative power, the reliability and validity of the remaining 47 items were evaluated. An exploratory factor analysis was used to establish the construct validity. A confirmatory factor analysis and structural equation modeling for cross-validation were used to assess relationships of factors with items and the overall NSPS.

RESULTS

The final scale consisted of 44 items assessed on a five-point Likert scale that loaded onto three different factors of physical or mental discomfort (18 items), work performance (15 items), and predisposing factors (11 items). These three factors were found to explain 63.14% of the cumulative variance. Cronbach's alpha for the overall final scale was 0.953. The item-to-total correlation coefficients ranged 0.443 to 0.795.

CONCLUSIONS

The NSPS exhibited satisfactory reliability and validity. It can be applied to assess the level of presenteeism among clinical nurses and provide medical institutions with information regarding the causes of presenteeism, predisposing factors, and the impacts of presenteeism on their work performance to enhance the safety and quality of clinical care.

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

Background

The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover.

Objective

This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism.

Methods

In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between.

Results

Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect).

Conclusion

Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.

A preliminary investigation of presenteeism and cognitive preferences among head nurses: a cross-sectional study

BACKGROUND

Individual health is essential for productivity at work. However, presenteeism, which is defined as attending work while ill, is common. Nursing is a profession with a high incidence of presenteeism, leading to diverse negative outcomes. Considering the unique and significant role of head nurses and the influence of cognitive factors on presenteeism, the current study aimed to investigate the incidence of presenteeism among head nurses, their cognitive preference towards presenteeism, and the association between the two.

METHODS

This preliminary investigation was a cross-sectional study conducted from July to August 2022. Participants were 233 head nurses recruited via convenience sampling from six hospitals located in Zhengzhou, Henan Province, China. The Nurse Presenteeism Questionniare (NPQ) and an original cognitive preference questionnaire were used to measure head nurses' experience of presenteeism and cognitive preference towards presenteeism. Descriptive statistics and sample t-tests were performed for data analysis.

RESULTS

In the past six months, 96.6% of the head nurses exhibited signs of presenteeism. The specific symptoms were discomfort in the lower back, dizziness or headache, cold (e.g., stuffy nose or cough), abdominal pain (including menstrual pain), and whole-body fatigue or discomfort. 95.7% of head nurses' anticipation preference toward presenteeism inclined to rest at home; additionally, more than 80% of the head nurses considered presenteeism detrimental to both individuals and organizations. Further, 63.9% of the head nurses were inclined toward conduct discouragement in the face of subordinates' presenteeism. There was no significant difference in presenteeism between head nurses with various anticipation preferences (p > 0.05) and benefit preferences (p > 0.05). However, the differences in presenteeism among head nurses with various management preferences were significant (t = 2.60, p = 0.01). Specifically, head nurses who favored encouraging subordinate presenteeism had higher presenteeism scores compared to those who discouraged it.

CONCLUSIONS

Presenteeism among head nurses remains a universal workplace phenomenon. There was inconsistency among head nurses' anticipation preferences, benefit preferences, and presenteeism. However, there was consistency between head nurses' management preferences and presenteeism.

Consequences of Nurse Presenteeism in Switzerland and Portugal and Strategies to Minimize It: A Qualitative Study

Nurses exhibit higher rates of presenteeism than other professionals, with consequences for the quality of care and patient safety. However, nurses’ perceptions of these issues have been poorly explored. This study investigated the perceptions and experiences of frontline nurses and nurse managers in Switzerland and Portugal about the consequences of presenteeism and strategies to minimize it in different healthcare settings. Our qualitative study design used video focus groups involving 55 participants from both countries. Thematic analysis of their transcribed discussions revealed six themes surrounding the consequences of presenteeism: the personal impact on nurses’ health and wellbeing, on their family relationships, and on professional frustration and dissatisfaction; the professional impact on work dynamics; the social impact on the quality of care and patient safety and on society’s impressions of the profession. At the individual, collective, and institutional levels, six strategies were evoked to minimize presenteeism: encouraging professionals’ self-knowledge; creating a positive work atmosphere; facilitating communication channels; developing a positive organizational culture; implementing preventive/curative institutional interventions; identifying and documenting situations linked to presenteeism. Nurses’ perceptions and experiences provided a deeper understanding of their presenteeism and revealed underused pathways toward preventing and minimizing presenteeism via bottom-up approaches.