Abstract
Background: Employees who are physically present but work insufficiently because of illness are deemed as having presenteeism. In the health care setting, the issue has taken on greater importance because of the impairment of the physical and mental health of nurses and the nursing safety of the patients. According to the Job Demand-Resource Model, burnout may link emotional labor with presenteeism. Thus, this study analyzed the role of burnout as a mediating factor between the three types of emotional labor strategies and presenteeism among nurses in tertiary-level hospitals.Methods: A cross-sectional study of 1,038 nurses from six Chinese hospitals was conducted. The questionnaires, including the 14-item emotional labor strategies scale, 22-item Maslach Burnout Inventory scale, 6-item Stanford Presenteeism Scale, and items about demographic characteristics and work-related factors, were used to collect data. A multivariable linear regression was used to predict work-related factors and investigate the correlation of emotional labor, burnout, and presenteeism. The structural equation model was implemented to test the mediating effects of job burnout.Results: The results of the study showed that the average presenteeism score of the participants was 14.18 (4.33), which is higher than in Spanish, Portuguese, and Brazilian nurses. Presenteeism was explained by 22.8% of the variance in the final model in multivariable linear regression (P < 0.01). Presenteeism was found to be positively correlated with surface acting, emotionally expressed demands, deep acting, emotional exhaustion, depersonalization, and low personal accomplishment (P < 0.01). Notably, presenteeism was negatively correlated with deep acting (P < 0.01). In addition, burnout partially mediated the correlation between emotionally expressed demands, deep acting, and presenteeism with a mediatory effect of 24 and 63.31% of the total effect. Burnout completely mediated the association between surface acting and presenteeism, a mediating effect of 86.44% of the total effect.Conclusions: The results of this study suggested that different emotional labor strategies affect presenteeism, either directly or indirectly. Nursing managers should intervene to reduce presenteeism by improving the ability of the nurses to manage emotions, thereby alleviating burnout.
Highlights
Presenteeism has become a common phenomenon in the workplace which is defined as impaired productivity or performance while ill but still working [1,2,3,4]
Based on previous studies and the foundation of the Job Demand-Resource Model, we proposed the hypothesis that emotional labor affects presenteeism through the mediating effect of job burnout
Based on the Job Demand-Resource Model and Emotional Labor Theory, this study examined the correlations between emotional labor, burnout, and presenteeism and the mediating effect of burnout and the relationship between emotional labor and presenteeism in mitigating the low productivity of nurses
Summary
Presenteeism has become a common phenomenon in the workplace which is defined as impaired productivity or performance while ill but still working [1,2,3,4]. One cross-sectional study reported that 74% of Chinese employees must work despite being ill; the frequency of presenteeism is almost once a month [8]. The presenteeism phenomenon may impair the physical and mental health of nurses [8, 17] and reduce health-related productivity and increased economic costs [18, 19]. Employees who are physically present but work insufficiently because of illness are deemed as having presenteeism. This study analyzed the role of burnout as a mediating factor between the three types of emotional labor strategies and presenteeism among nurses in tertiary-level hospitals
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