University of East Anglia
High job demands, stress and job insecurity are among the main reasons why people go to work when they are ill, according to new research by an academic at the University of East Anglia (UEA).
The study aims to improve understanding of the key causes
of employees going to work when sick, known as presenteeism, and to help make
managers more aware of the existence of the growing phenomenon, what triggers
the behavior and what can be done to improve employees' health and
productivity.
A key finding of the study, published in the Journal
of Occupational Health Psychology, is that presenteeism not only stems from
ill health and stress, but from raised motivation, for example high job satisfaction
and a strong sense of commitment to the organisation.
This may motivate people to 'go the extra-mile', causing them to work more intensively, even when sick.
This may motivate people to 'go the extra-mile', causing them to work more intensively, even when sick.
One of the significant links to presenteeism is the
severity of organisational policies used to monitor or reduce staff absence,
such as strict trigger points for disciplinary action, job insecurity, limited
paid sick leave, or few absence days allowed without a medical certificate.
Lead author Dr Mariella Miraglia, a lecturer in organisational behavior at UEA's Norwich Business School, argues that presenteeism is associated with work and personal factors, not just medical conditions. Also, that these factors are more strongly related to, and so more able to predict, presenteeism than absenteeism.
In previous research presenteeism has been associated
with both negative and positive effects on employee productivity and welfare,
with contradictory causes and consequences for individuals and organisations.
It has been linked to errors, lower performance, exacerbating health problems
and affecting wellbeing, with more productivity loss than absenteeism.
The
Centre for Mental Health calculated that presenteeism from mental ill health
alone costs the UK economy £15.1 billion a year.
"This study sheds light on the controversial act of
presenteeism, uncovering both positive and negative underlying processes,"
said Dr Miraglia, who worked with Dr Gary Johns of Concordia University in
Montreal, Canada. "It demonstrates that presenteeism is associated with
work features and personal characteristics and not only dictated by medical
conditions, in contrast to the main perspective of occupational medicine and
epidemiology.
"Working while ill can compound the effects of the
initial illness and result in negative job attitudes and withdrawal from work.
However, the possible negative consequences of being absent can prompt
employees to show up ill or to return to work when not totally recovered.
Organisations may want to carefully review attendance policies for features
which could decrease absence at the cost of increased presenteeism."
The research analysed data from 61 previous studies
involving more than 175,960 participants, including the European Working
Conditions Survey which sampled employees from 34 countries.
Dr Miraglia
developed an analytical model to identify the most significant causes of
presenteeism and absenteeism, with work and personal characteristics relating
differently to presenteeism depending on whether they followed a 'health
impairment' or 'attitudinal/motivational' path.
Job demands, such as workload, understaffing, overtime
and time pressure, along with difficulty of finding cover and personal
financial difficulties, were found to be key reasons why people might not take
a day off.
Conflict between work and family, and vice versa, and being exposed
to harassment, abuse, and discrimination at work were also positively related
to presenteeism. This is because these negative experiences can exacerbate
stress and harm health, requiring employees to choose between going to work and
staying away.
Those who had a supportive work environment, for example
supportive colleagues and a good relationship with managers, felt they did not
have to go to work when ill, and were both more satisfied with their jobs and
healthier. Optimism was linked to presenteesim, in that those with a positive
outlook were more willing to carry on with their work while ill.
"Because presenteeism is more predictable than
absenteeism, it is easy to modify by management actions," said Dr
Miraglia. "Workplace wellness and health programmes may be desirable to
reduce stress and work-related illness.
Furthermore, although increasing job
resources, such as job control and colleague, supervisor, and organisational
support, can be helpful in tackling presenteeism through their positive impact
on health, our results suggest that controlling job demands represents a key
line of defence against the behavior.
"Organisations may benefit from well-designed jobs
that limit the level of demands to which employees are exposed to every day,
for example by reducing excessive workload, time pressure and overtime work, as
well as making sure they have the resources they need."
Dr Miraglia said further research was needed to
understand when going to work while ill could be a "sustainable" and
positive choice, for example in the case of a gradual recovery from long-term
sickness, to improve self-esteem in the face of chronic illness or being an
example of citizenship behavior.
"It could be a good thing for some people, a way of
integrating back into work again," she added. "But it would depend
how much the individual and organisation wanted it and were prepared to be
flexible, for example by modifying job descriptions or offering flexy time."