Absent, present or both?

At the moment I 'am very busy with the data analysis of the survey and doing my interviews. In the meanwhile I will write about  interesting findings in relevant literature. Hopefully you'll appreciate this sharing in knowledge.

Three fascinating articles I read lately about the subject of 'sickness presenteeism'. As the opposite of sickness absence this concept describes the behaviour of employees who are going to work while feeling ill. And where sickness absence in general is seen as an interesting subject for research, one may ask oneself: 'what's the relevance of the first concept? These employees are at work, so leave them alone...what's the hush?' 
 

But the authors of these articles explain in a few sentences the relevance of this phenomenon. The first article, written by G. Bergström et al., 2009 (DOI 10.1007/s00420-009-0433-6) and is called 'Does sickness presenteeism have an impact on future general health?' The answer is quite clear: yes! The respondents were questioned in a survey and were followed in a longitudinal study at three moments: at the start, after 18 months and after 3 years. The survey was held  under employees working in the public sector and in the private sector. The results did show that 'at the baseline sickness presenteeism is consistently found to heighten the risk of fair/ poor health at both moments (18 months and 3 years)'. 
The second article 'Sick but yet at work' (Aronsson et al., 2000,) is about a study under 3,8001 Swedish employees. One-third out of this sample did go to their work despite being ill at two or more times in one year. Especially employees working in the educational or welfare sectors reported a heightened risk of sickness presenteeism. This was interpreted as indicating that individuals are more likely to keep on working with illness in occupations which involve caring for others where basic human needs are to be met, implying a strong demand on the employee to be present. Furthermore, sickness presenteeism was also more prevalent among employees having to catch up on work after being absent for a period. Symptoms related to presenteeism involved pain and distress, such as musculoskeletal pain, disturbed sleep, fatigue and minor depression. A positive correlation was found between sickness absence and sickness presenteeism, i.e. individuals reporting more absenteeism also tended to report more presenteeism'.

Important conclusions are: members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by the study results. The
categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most common combination is low monthly income, high sickness absenteeism and high sick presenteeism.

In the third article (Anne Grinyer & Vicky Singleton, 2000) with the challenging title 'Sickness absence as risk-taking behavior' the authors refer to the fact that as well in their research as in the research of McKevitt et al. (1997) under doctors were found the following outcomes. Cultural and organizational factors such as perceived pressures from colleagues, not to let them down and to cause them more work, were playing a crucial role in the decision to stay at work. 'Disapprovement of taking sick leave’ and `pressure of work’ (McKevitt et al., 1997) are the risks one has to take when one is reporting oneself ill. An additional organizational factor as the trigger point system, specifically designed to reduce sickness absence had also an unintended effect, and paradoxically, may did increase the absence rate. 



An other risk-taking situation had been the introduction of teamwork. While teamwork was intended by management to be empowering, the effect was to leave the staff the feeling that they had little choice but to attend work, even when unwell, as they would be `letting the team down’, thus risking personal and professional relationships in the process.
The main issue here is, maybe that in organizations to much attention is given to absence policy instead to the prevention of absence namely sickness presenteeism!