[Presenteeism, Absenteeism and psychosocial stress at work among German clinicians in surgery]

Presenteeism is determined as turning up at work despite ill health. In the last decade this phenomenon became much more relevant and will be a central topic for future research in workplace health, health promotion and productivity loss. Compared to absenteeism research data about presenteeism are comparatively rare. Especially employees in health care are at high risk for presenteeism. The present study examines the degree of presenteeism and absenteeism among German hospital clinicians in surgery focussing on associations with psychosocial stress at work.

The stratified randomised sample consisted of 1 311 German clinicians in surgery from 489 hospitals. The frequencies of presenteeism and absenteeism were respectively assessed by one item. Psychosocial stress at work was measured by the effort-reward imbalance model and the demand-control model.

About 90% of the respondents indicate that they were working despite illness at least once a year, 65% actually answered sometimes or often. Nearly two thirds were absent due to illness for a minimum of once a year. Multivariate logistic regression analyses show that organisational and work-related factors are clearly associated with presenteeism. Compared to absenteeism, presenteeism shows stronger associations with psychosocial workload. Significant associations with different components of psychosocial stress reveal elevated odds ratios between 1.4 and 2.8. High efforts and demands, low rewards and increased overcommitment were notably emerging factors.

Clinicians in surgery are affected by presenteesim to a high degree whereas rates of absenteeism are less striking. As potential causes for elevated presenteeism different aspects of psychosocial stress at work were identified. Workplace health promotion on different levels can reduce presenteeism to improve the health status and job performance among this occupational group that bears heavy responsibility.