Free AccessPresenteeism Is Reloaded and Ready for Further Research – A Commentary on Priebe, J. and Hägerbäumer, M. (2023)Heiko Breitsohl, Lena Zöhrer, and Sascha A. RuhleHeiko BreitsohlUniv.-Prof. Dr. Heiko Breitsohl, Department of Organization, Human Resources, and Service Management, University of Klagenfurt, Universitätsstr. 65 – 67, 9020 Klagenfurt, Austria, heiko.breitsohl@aau.atDepartment of Organization, Human Resources, and Service Management, University of Klagenfurt, AustriaSearch for more papers by this author, Lena ZöhrerDepartment of Organization, Human Resources, and Service Management, University of Klagenfurt, AustriaSearch for more papers by this author, and Sascha A. RuhleDepartment of Human Resource Studies, Tilburg University, The NetherlandsSearch for more papers by this authorPublished Online:April 05, 2023https://doi.org/10.1026/0932-4089/a000411PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreKommentar zum Dialog Priebe and Hägerbäumer (2023). Presenteeism Reloaded – We Need a Revised Presenteeism ApproachIn their essay, Priebe and Hägerbäumer (2023) propose that due to recent changes in many workplaces around the globe, such as the sharp increase in remote work (especially work from home)1 caused by the COVID-19 pandemic, the concept of sickness presenteeism (SP) needs to be “reloaded” (i. e., adapted). Specifically, Priebe and Hägerbäumer (2023) suggest that aspects of SP to be reconsidered are (1) what it means to be “present” when work can be performed anywhere (i. e., the presence problem), (2) what it means to be “working” when remote workers have considerable discretion over the duration, kind, and amount of work they perform (i. e., the threshold problem), and (3) what the shifting of “work activities into the home environment” (Priebe & Hägerbäumer, 2023) implies for the prevalence of SP.We agree with Priebe and Hägerbäumer (2023) that SP research should stay abreast of changes in the workplace, including the recent unprecedented increase in remote work. However, we submit that this is already the case. The remainder of our commentary on Priebe and Hägerbäumer’s (2023) propositions proceeds in four steps. First, we demonstrate that SP research is already addressing the presence/shifting problem, both conceptually and empirically. Second, we argue that the ostensible threshold problem is a conflation of potential reasons for engaging in SP and its downstream outcomes, and that the solution is to keep them separate conceptually while investigating them jointly. Third, we argue that increased attention to remote work should not divert SP research from jobs for which working from home is not an option. Fourth and finally, we briefly discuss some opportunities for future research resulting from our lines of argument.Sickness Presenteeism ResearchIs Already Operating ona Location-Inclusive BasisPriebe and Hägerbäumer (2023) propose that the concept of presenteeism should “focus on carrying out work when people are ill independent from the place where this work is carried out [emphasis added]”, partly due to the COVID-19 pandemic. While we agree with the proposition, we submit that this is already happening. Indeed, Ruhle et al. (2020) defined (sickness)2 presenteeism as the “behaviour of working in the state of ill-health” (Ruhle et al., 2020, p. 346). This definition is independent of any particular work location, in contrast to previous conceptualizations of SP (e. g., “attending work while ill”; Johns, 2010, p. 521, or “the phenomenon of people, despite complaints and ill health that should prompt rest and absence from work, still turning up at their jobs”; Aronsson et al., 2000, p. 503) and therefore does not imply a specific physical change of location when working. In addition to this reconceptualization, Ruhle et al. (2020) explicitly called for SP research to address “changes in the working life of individuals, triggered by societal, economic and technological developments,” including “the possibility to decide when and where to work,” “work flexibility,” and “boundarylessness of work” (p. 356). Moreover, early in the COVID-19 pandemic, Kinman and Grant (2021) pointed out the importance of SP while working from home, especially with regard to missing physical boundaries between the work and personal domains. Thus, some steps toward “reloading presenteeism” conceptually have been taken, and recent research has adopted this location-inclusive definition (Brosi & Gerpott, 2022; Ruhle & Breitsohl, 2022).In addition, recent SP research has devoted particular attention to the context of remote work and is offering valuable new insights into its consequences for SP. For instance, Steidelmüller et al. (2020) reported results of a cross-national comparative investigation of the positive association between home-based telework and SP. Additionally, researchers have suggested that this positive relationship might be related to pre-pandemic experience with telework and with using telework for work intensification (Gerich, 2022), or might be specific to low psychosocial safety climates in the work environment (C. Biron et al., 2021). Furthermore, Brosi and Gerpott (2022) explored guilt as a driver of SP both at work and when working from home. Finally, prompted by the COVID-19 pandemic, Ferreira et al. (2022) offered a multilevel conceptual treatment of remote-work SP, and Ruhle and Schmoll (2021) conducted a qualitative study into perceptions of working from home, and decisions to work in the state of ill health, which resulted in six propositions to further advance the understanding of SP in the remote work context. In sum, the presence problem and the shifting problem proposed by Priebe and Hägerbäumer (2023) have already been acknowledged and are being addressed by SP research.Sickness Presenteeism Research Should Distinguish Between (Any Amount of) Working in the State of Ill Health and Its Functional and Dysfunctional OutcomesPriebe and Hägerbäumer (2023) propose that there is a threshold problem, such that it is unclear what minimum amount of performing work is required to qualify as SP. Priebe and Hägerbäumer (2023) further propose that SP might be less severe when working remotely, due to workers’ relatively greater discretion (i. e., adjustment latitude) in organizing their work. While we agree that the increase in adjustment latitude might make SP more prevalent in the context of working from home (and potentially less severe concerning the detrimental consequences for the individual), we disagree with this generalization regarding the valence of the consequences of SP. We argue that there is no threshold problem based on principles of construct clarity as well as conceptual considerations.The ostensible threshold problem seems to arise because it conflates the definition of SP, that is, working (in the state of ill health), as well as potential reasons for engaging in SP, with downstream outcomes, that is, the amount of harm inflicted on the worker. In our view, this approach is not optimal with respect to construct clarity (Podsakoff et al., 2016). Specifically, Priebe and Hägerbäumer (2023) appear to make the implicit assumption that there is some harmless, or even benign, amount of work that can be performed (remotely) in the state of ill health. However, to what extent SP is harmful, neutral, or helpful to workers is indicated solely by its outcomes, not by SP itself. In principle, SP may have a range of different effects on ill workers (e. g., Lohaus et al., 2021; Lohaus & Habermann, 2019; Ruhle et al., 2020), including a deterioration in health (Skagen & Collins, 2016), but also access to valuable social connections (Karanika-Murray & Biron, 2020) or better performance evaluations (Wang et al., 2022). The overall extent to which SP is “functional” or “dysfunctional” (Ruhle et al., 2020) in terms of its outcomes might depend on a host of factors, including the nature and severity of the health condition, the working conditions of the individual, and the amount of effort expended (Holland & Collins, 2018; Karanika-Murray & Biron, 2020; Ruhle & Schmoll, 2021). In addition, the underlying motives for engaging in SP might play a crucial role in its further (health-related) outcomes (Lohaus et al., 2021; Lu et al., 2013; Ma et al., 2018).Moreover, defining a minimum threshold amount of work would ignore the subjective nature of work. Adopting an example offered by Priebe and Hägerbäumer (2023), while checking work email from home may be too brief and superficial to be considered work by some workers, other individuals may perceive any engagement with work tasks as work. Indeed, one important aspect of remote work, as Priebe and Hägerbäumer (2023) point out, is the blurring of boundaries between work and non-work domains. The “new ways of working” (Demerouti et al., 2014), including increased use of information and communication technology, allow for greater flexibility (i. e., adjustment of spatial and temporal boundaries) and permeability (i. e., physical location in one domain with simultaneous behavioral or psychological engagement in another) of the boundaries between workers’ different life roles (Ashforth et al., 2000; Hall & Richter, 1988). Greater flexibility and permeability of boundaries may contribute to a substantial relief for workers, such as providing them with a more satisfactory balance between their multiple life roles. Yet, flexibility and permeability may also contribute to an easier intrusion of work matters into spheres usually reserved for non-work activities (Shockley & Allen, 2010; Thörel et al., 2022), such as resting when in the state of ill health. We argue that the extent to which the blurring of boundaries will be experienced as a relief or a burden depends on the individual worker and their preferences to segment (vs. integrate) their multiple life roles (Kreiner, 2006; Piszczek, 2017; Shockley & Allen, 2010).In sum, we agree that understanding how workers manage working from home in the state of ill health is important. However, we argue that SP research should avoid conflating SP with its functional or dysfunctional outcomes. As a starting point, any amount of working in the state of ill health should be considered SP. Whether or not (health) effects on workers will be positive or negative depends on the multiple points raised above and, therefore, an interplay between workers and their different environments (see also Proposition 6 by Ruhle & Schmoll, 2021).Sickness Presenteeism Research Should Avoid Excluding Any Types of JobsPriebe and Hägerbäumer (2023) propose that, until recently, remote work was largely uncommon because it was unfeasible, and that there is a global “shift” to remote work. Priebe and Hägerbäumer (2023) state that (physical) presence “is not mandatory for showing presenteeism in the modern work environment”. We agree with the latter statement and advocate for a universal conceptualization of SP (see above). Yet, we urge researchers not to divert attention away from a large portion of the working population for whom the “modern work environment” is not applicable, as a shifting of their work location (and therefore working remotely) is simply not possible due to, for example, the nature of their job. This issue became more visible during the COVID-19 pandemic and the associated shutdowns worldwide, where it was feasible for some workers to relocate their workplace into their homes, whereas other workers, considered “essential” or “life-sustaining,” needed to continue their work “on-site” (Kniffin et al., 2021, p. 65).We agree with the prediction of a continuing increase in remote work opportunities (especially working from home), even in the aftermath of the COVID-19 pandemic, as offered by Priebe and Hägerbäumer (2023): “Remote work may become more the rule than the exception in many professions”. Nevertheless, we want to emphasize that there are many jobs for which work on-site will remain the norm (e. g., jobs in the healthcare sector, hospitality, or retail; Kniffin et al., 2021). We thus want to highlight the risk that a sole (or at least predominant) focus of future investigations on work-from-home arrangements would add to the questionable trend in industrial and organizational psychology to overrepresent “samples of salaried, core, highly educated, highly skilled, managerial, professional, and executive employees” (Bergman & Jean, 2016, p. 85), as those groups also tend to be the ones most able to adjust their work location (C. Biron et al., 2021; Eurofound, 2020). Bergman and Jean (2016) raise important points (e. g., a lack of attention to boundary conditions in previous theory development) on why such a narrow focus is problematic and might not help us “fully understand our phenomena of interest” (p. 89). To conclude, we urge (SP) researchers not to fall prey to developing a tunnel vision and directing their research endeavors only to those who work from home, which we deem as dangerous on an individual, organizational, as well as societal level (e. g., against the backdrop of inequality in access to remote work).Opportunities for Future Research From an Inclusive and Individualized PerspectiveTaken together, Priebe and Hägerbäumer’s (2023) propositions and our responses indicate several potential opportunities for future research on SP (in the context of remote work). We disagree with the need for a “revision of the presenteeism concept,” raised by Priebe and Hägerbäumer (2023). This need has already been met. What SP research should tackle in going forward is a more nuanced, individualized approach in the context of remote work as well as in more “traditional work settings” (i. e., working on-site), as those work arrangements will not disappear in the near future.First, we deem it necessary to consider the potential mediating mechanisms between (new) work characteristics and SP (see also Ruhle et al., 2020). Here, an important question pertains to the underlying motives of engaging in SP (when working from home), as those might be crucial in understanding SP and its downstream (health-related) outcomes (Karanika-Murray & Biron, 2020; Lohaus et al., 2021; Lu et al., 2013; Ma et al., 2018). What potential characteristics of the work environment foster autonomous motivation (i. e., engaging in SP by one’s free will), and what might lead to controlled motivation and, therefore, a sense of obligation to work in the state of ill health (Deci et al., 2017; Ma et al., 2018; Miraglia & Johns, 2016; Ruhle et al., 2020)? The former may contribute to the development of SP as “a purposeful and adaptive behaviour” (Karanika-Murray & Biron, 2020, p. 243). Especially the “new” ways of working (e. g., working from home) hold the potential to foster autonomous motivation through the greater amount of flexibility and adjustment latitude (e. g., in terms of time or location) they offer workers. These work characteristics might contribute to reducing some of the harmful effects of engaging in SP (Karanika-Murray & Biron, 2020; as also proposed by Priebe and Hägerbäumer, 2023). However, it is equally crucial to consider the potential downsides of those flexible work arrangements, exemplified by the autonomy paradox and its often associated (unconsciously) felt obligation to deliver additional work effort (Kelliher & Anderson, 2010; Pérez-Zapata et al., 2016; van Echtelt et al., 2006), or the organizational use of electronic monitoring of workers, which may foster controlled motivation (Ferreira et al., 2022; Ruhle et al., 2020). In addition, especially work-from-home arrangements can promote a blurring of work and non-work domains, which might lead to autonomous as well as controlled motivation.Therefore, secondly, we want to revisit the point that there might be important individual boundary conditions affecting whether, for example, such a blurring of boundaries might lead to helpful or harmful downstream (health-related) effects. These boundary conditions may lie within the worker, such as individual segmentation preferences regarding work and non-work domains. While segmenters prefer a stricter demarcation of their multiple life roles, integrators profit from merging their work and non-work domains (Kreiner, 2006; Piszczek, 2017; Shockley & Allen, 2010). Therefore, a blurring of boundaries might have negative health-related effects for segmenters, whereas integrators potentially benefit (and might even want to continue with some parts of their work at home while they are ill). Another important aspect may result from the nature of the health event (e. g., acute vs. episodic vs. chronic health issues; Johns, 2010). Workers with different health impairments potentially have different reasons and motives to keep working. For example, Holland and Collins (2018) reported that workers suffering from a chronic disease (i. e., rheumatoid arthritis) had a high motivation to keep working, which resulted in voluntary SP (facilitated by higher flexibility of their work arrangement).It is also important to note that employees’ health literacy might further impact the consequences of SP (while working from home). Health literacy describes “the degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions” (Berkman et al., 2010, p. 16). We argue that engaging in SP should be considered a health decision, and initial evidence suggests that knowing about potential functional and dysfunctional consequences of SP is a crucial aspect of the decision process (Brosi & Gerpott, 2022). Other boundary conditions may originate from the organization, such as the degree of regulation in working from home. Workers, depending on individual boundary conditions (e. g., segmentation preferences or family responsibilities), might profit from work characteristics that are fixed (or controlled by the organization, e. g., working time) versus kept flexible (or relegated to personal accountability) in an individualized arrangement (see also M. Biron & van Veldhoven, 2016).Finally, we emphasize the need for future research (on SP) to be inclusive of “all jobs.” The world of work is changing, and new ways of working are at the forefront (especially remote work settings), but this does not mean that industrial and organizational psychology and related fields should forget about “other workers outside managerial, professional, and executive positions” (Bergman & Jean, 2016, p. 84). Beyond jobs that simply cannot be conducted remotely (see above), we want to draw attention to precarious work arrangements that combine “uncertainty in the amount and continuity of work with limited autonomy and access to power” (Rudolph et al., 2021, p. 18). Evidence from a meta-analysis indicates that greater job insecurity and financial difficulties are associated with greater SP, including via an impairment of workers’ health (Miraglia & Johns, 2016). Therefore, workers in precarious work settings may tend to feel obliged to engage in SP (i. e., controlled motivation), which might foster the harmful effects of SP (e. g., in terms of their future health and well-being), making this group of workers an especially important group to investigate. 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We consistently use “sickness presenteeism” for the sake of precision, and because recent research has expanded to other forms of presenteeism (Ruhle & Breitsohl, 2022).FiguresReferencesRelatedDetails Volume 0Issue 0ISSN: 0932-4089eISSN: 2190-6270 InformationZeitschrift für Arbeits- und Organisationspsychologie A&O (2023), 0,https://doi.org/10.1026/0932-4089/a000411.© 2023Hogrefe VerlagPDF download
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Open Access