Sickness presenteeism, job burnout, social support and health-related productivity loss among nurses in the Chinese nurses' health cohort study (TARGET): A cross-sectional survey.

Background: Sickness presenteeism has potential negative impacts on job burnout and health-related productivity loss among clinical nurses, whereas social support has been identified as a potential mitigating factor for such impacts. However, there is limited evidence regarding the relationships and mechanisms between sickness presenteeism, job burnout, social support, and health-related productivity loss.

Objective: To explore the role of job burnout and social support in the association between sickness presenteeism and health-related productivity loss among female nurses.

Design: A cross-sectional study.

Setting(s): 105 hospitals conveniently selected from 36 cities in 15 provinces in China.

Participants: 50,653 registered female nurses.

Methods: This study utilizes the cross-sectional data from the baseline survey of the Chinese nurses' health cohort study (Towards A Revolution in GETting nurses' health ticked, TARGET), conducted from December 2020 to February 2024. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Maslach Burnout Inventory, and Perceived Social Support Scale. Data analyses were performed using independent sample t-tests, Pearson correlation analysis, one-way analysis of variance, multivariate linear regression analysis, and the Process 4.0 macro plug-in method.

Results: A total of 42,843 valid questionnaires were collected with an 85% response rate. The incidence of sickness presenteeism among female nurses was 62 %. Sickness presenteeism was positively correlated with job burnout and health-related productivity loss, and job burnout was also positively correlated with health-related productivity loss. Conversely, social support was negatively associated with sickness presenteeism, job burnout and health-related productivity loss. The findings showed that the association between sickness presenteeism and health-related productivity loss was partially mediated by job burnout. Moreover, the direct and indirect effects within the mediation model were moderated by social support. When levels of social support were high, the impact of sickness presenteeism on job burnout and health-related productivity loss was weaker, as was the impact of job burnout on health-related productivity loss.

Conclusions: Hospital administrators and nurses themselves can mitigate the adverse effects of sickness presenteeism on health-related productivity loss by alleviating job burnout and increasing levels of social support. By addressing these significant challenges, they can more effectively manage the consequences of sickness presenteeism and job burnout among nurses.

Registration: The protocol of TARGET was registered in the China Clinical Trial Registry (ChiCTR2100043202).

Tweetable Abstract: The study analyses TARGET data to explore the mechanisms between sickness presenteeism and health-related productivity loss.