Presenteeism and Its Associated Factors Among Rotating Nurse Managers: A Cross-Sectional Study

To investigate the current status of presenteeism and its associated factors among rotating nurse managers in Western China and to provide insights for nursing practice.

A cross-sectional study.

A convenience sampling method was used. The questionnaire was distributed through nursing management departments and professional contacts across 15 secondary and tertiary general hospitals in Western China, and 97 eligible nurse managers with recent rotation experience completed the survey. Data were collected using a general information questionnaire, the Stanford Presenteeism Scale-6 (SPS-6), and the Work Limitations Questionnaire (WLQ). Associations with SPS-6 scores were examined using univariate analysis, correlation analysis, and multiple linear regression. The number of rotations was treated as a categorical predictor, and a sensitivity analysis was additionally performed by adjusting for years as a nurse manager as a theoretically relevant covariate.

The questionnaire was distributed across 15 secondary and tertiary general hospitals in Western China in 2025, and data from 97 eligible rotating nurse managers were included in the analysis.

The mean SPS-6 score among the 97 rotating nurse managers was 16.22 ± 5.22, with higher scores indicating greater health-related productivity impairment. Univariate analysis showed significant differences in SPS-6 scores according to hospital level, rotation frequency, health status, perception of the rotation system, and informed consent prior to rotation (all p < 0.05). Correlation analysis showed a weak positive correlation between physical demands and SPS-6 scores (r = 0.228, p < 0.05). In the primary multiple linear regression model, health status (B = 2.907, 95% CI: 0.725-5.089, p = 0.010), perception of the rotation system (B = 2.189, 95% CI: 0.197-4.181, p = 0.032), and informed consent prior to rotation (B = 2.977, 95% CI: 1.057-4.897, p = 0.003) were significantly associated with SPS-6 scores. Hospital level, physical demands, and the individual rotation-frequency categories were not significantly associated with SPS-6 scores in the multivariable model. The model explained 38.0% of the variance (R² = 0.431, adjusted R² = 0.380; F = 8.345, p < 0.001). The main findings remained consistent in the sensitivity analysis after additional adjustment for years as a nurse manager.

Health status, perception of the rotation system, and informed consent prior to rotation were independently associated with SPS-6 scores among rotating nurse managers. Given that higher SPS-6 scores indicate greater health-related productivity impairment, these findings suggest that both health-related and organizational factors are relevant to presenteeism in this population. Given the cross-sectional design, the observed associations should not be interpreted as causal relationships.

The findings highlight the importance of considering nurse managers' health status and organizational factors related to the rotation process. Healthcare institutions may consider strengthening communication, participation, and organizational support during nurse manager rotation.

This study provides evidence on presenteeism and its associated factors among rotating nurse managers. The findings may inform the development and refinement of organizational support and rotation-management practices for nurse managers.

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

No patients or members of the public were involved in the design, conduct, reporting, or dissemination of this study.