The relationship between effort-reward imbalance and presenteeism among nurses: a cross-sectional study from China

Currently, nurses are under great pressure and prone to the effort-reward imbalance and presenteeism, which hinders the development of medical health and has gained insufficient attention. The objective of this study is to investigate the actual situation of the effort-reward imbalance and presenteeism for nurses, alongside the exploration of the relationships between them, which is aimed to provide guidance for the alleviation of presenteeism and improvement of nursing quality.

This study was a cross-sectional survey. From October to December 2024, a convenience sampling method was used to conduct a survey among 2,095 nurses from four hospitals in Sichuan Province, China. Data were collected through Questionnaire Star. The questionnaire was composed of general data, the effort-reward imbalance scale and the Stanford Presenteeism Scale. Data analysis was conducted using SPSS 26.0 statistical software, including descriptive statistics and Pearson correlation analysis.

The effort-reward imbalance score of nurses was (55.91 ± 8.32), in which 52.1% of nurses were in the effort-reward imbalance state, and 44.9% of nurses were in the high-overcommitment state. The presenteeism score of nurses was (16.82 ± 5.85). Besides, the presenteeism of nurses under the state of effort-reward imbalance was relatively higher than those with effort-reward balance (t = -43.30, P < 0.001), and the presenteeism of nurses with high-overcommitment was higher than others (t = -41.77, P < 0.001). Overall, effort-reward imbalance and presenteeism were positively correlated (r = 0.340, P < 0.001).

The condition of effort-reward imbalance is serious among Chinese nurses, alongside the common presenteeism. Besides, effort-reward imbalance and presenteeism were positively correlated. Overall, it is recommended to alleviate the workload of nurses appropriately, alongside the improvement of their rewards and more attention to their physical and mental health.