Presenteeism

Does Being Present Mean Availability?

Presenteeism in the workplace is an overt behavior or an act that pertains to employees forcing themselves to attend work even when they feel physical discomfort that qualifies for sick leave (Cooper & Lu, 2016).

In the literature, presenteeism is predominantly associated with health in that it occurs when a worker is ill but continues to work and often results in a loss of productivity, which is noted as the amount of work performed within a given timeframe, as well as a loss in work quality.

One of the most important objectives of the business is to earn profit. Productive and physically and mentally healthy employees are required to achieve this goal.

However, irregular and long working hours and working conditions that exceed legal regulations adversely affect the employees and work life balance. This situation can cause employees to face the problem of presenteeism in the workplace.

Results of Presenteeism

Presenteeism is an important phenomenon for organizations. Among the results of presenteeism, the most important factors are decrease in productivity Opens in new window, absenteeism Opens in new window and cost. Presenteeism damages the quality of work life and causes failure because it reduces productivity (Radix, Mora & Johnson, 2013, p.9).

The most important factor affecting the productivity of business is the human element. While the financial losses of business can be easily eliminated, it is often difficult to eliminate the losses arising from the habits and mistakes of the employees (Kaplan et al., 2001, p.93).

The continuation of work while the employee is sick reduces both the numerical efficiency and the quality of the work done (Thompson & Waye, 2018). Presenteeism not only results in loss of productivity but also creates safety and health problems for employees.

Prater and Smith (2011, p.1) state that workers’ productivity losses due to health and similar problems cost about one billion dollars a year for business.

On the other hand, it is seen in the researches that although the employees are physically at work, continuing to work due to illness or different reasons causes more productivity loss than their absence (John, 2010).

Presenteeism also causes significant losses that negatively affect businesses (Cser, 2010). In addition, health status of employees who have presenteeism in the workplace may be adversely affected in later life. Therefore, it is accepted that presenteeism has negative consequences for business and individuals (Holland & Collins, 2018, p. 404).

Relationship Between Presenteeism and Absenteeism

Sickness absenteeism and presenteeism are thought to be similar concept. It is called absenteeism Opens in new window. Sickness absenteeism is defined as not going to work due to illness.

When the relationship between presenteeism and absenteeism Opens in new window is examined, the cost of absenteeism to the business is the decrease in productivitiy and cost due to the absence of the employees.

The cost of presenteeism is hidden because the employee is at work but cannot finish the job. In absenteeism, most employees do not come to work if they do not feel well. Conditions like allergies, back pain, calcification, etc. affect them and their productivity the most.

Some employees come to work with illnesses such as cold and flu and that cause them to perform below normal. In studies, it was found that presenteeism causes more cost loss than absenteeism. However, both presenteeism and absenteeism are factors that cause loss of productivity (Caverley et al., 2007, p.304).

Causes of Presenteeism

Sick individuals may continue to work because of some reasons. Loss of income, lack of substitute staff, concerns caused by the burden on patients, customers or colleagues, and competitive disadvantage are among these reasons.

The reasons of presenteeism vary according to the occupational and workplace environment (Laupland et al., 2019, p.1) and the concerns of employees are ignored.

As mentioned earlier, presenteeism is predominantly associated with health, but also it is emphasized that individual, organizational and environmental factors are also important for this problem. In this context, the causes of presenteeism have been considered under three headings as:

1. individual,
2. organizational, and
3. environmental.

Individual Causes

Individual causes of presenteeism were examined under six headings: personality, burnout, stress, workaholism, demographic characteristics and health related issues.

1. Personality

A person first takes his place in the organization with his own personality structure. If the personality structure of the person is in harmony with the work and the organization, the success of the individual in work life increases.

When the studies on personality and presenteeism were examined, it can be said that responsible personalities positively affect presenteeism behaviors because there is desire to complete the job (Yildiz et al., 2015, p.207).

Also presenteeism has a positive effect on people who are open to experience, responsible and have emotional balance (Ulu et al., 2016, p.167).

2. Burnout

Burnout causes presenteeism, absenteeism, staff turnover and unwanted dysfunctional employee behaviors. It is also known that burnout negatively affect the organization and job satisfaction Opens in new window (Lee & Asforth, 1993, p.7).

Burnout can vary in gender. In studies, women’s emotional burnout level was found higher than men (Budak & Sürgevil, 2005, p.103). Time pressure also affects the occurrence of burnout (Freudenberger, 1974, p.159).

3. Stress

Work stress and change in the organization are now widely accepted as two important issues in organizational life (Vakola & Nikolaou, 2005, p.160).

Stress is one of the most important factors that inducing presenteeism. To prevent stress,

• workplace and environmental conditions should be improved,
• adequate lighting and ventilation should be provided, and
• noise should be reduced (Bacak & Yigit, 2010, p.43).

In a study conducted on hotel employees, it was found that a stressful work environment greatly affected employees’ health. When perceived work stress is low in the work environment, hotel workers experience low levels of presenteeism (China & Chu, 2016, p.52-53).

4. Workaholism

Another reason of presenteeism is the concept of workaholism. In a study, it was seen that those working in accommodation establishments were or might be workaholics, and a positive relationship was found between workaholism and service orientation.

However, the increase in the tendency of workaholism causes a decrease in the service levels of the employees. It is seen that there is a decrease in the service levels since there is an increase in the error making levels of people who tend to do more work.

According to the study conducted on small and medium-sized business owners/managers, 38.7% of the participants experienced absenteeism, 82.5% experienced presenteeism and presenteeism caused 50% less productivity (Cocker et al., 2013, p.5062).

It is also stated that presenteeism mediates the relationship between workaholism and work-family conflict (Mazzetti et al., 2017, p. 174).

5. Demographic Characteristics

Researchers show that women experience more presenteeism (Bockerman & Laukkanem, 2009, p.43). The role of women as mothers is one of the most important reasons for this. As this role brings responsibilities, the illness or problems experienced by the child cause the mother to be directly affected.

Male dominance of business organizations is also a problem for women. If the employee is not satisfied with the family life or wants to escape from family responsibilities, he may start to devote more time to the job.

On the other hand, it is stated that age has an effect on presenteeism but it can be seen in many age groups.

It is stated in the studies that presenteeism increased with the advancement of age (Bierla et al., 2013, p.1536), or vice versa, presenteeism decreased with the advancement of age (Macioch et al., 2006). And presenteeism is seen more in the young or middle age groups (Reuter et al., 2019, p.1).

6. Health Related Causes

Chronic diseases such as asthma, arthritis, allergies, depression (burnout, stress), painful diseases, diabetes, respiratory disorders, influenza (flu), headache and obesity are among the leading health-related causes of presenteeism (Willingham, 2008, p.11).

It is clear that working life has an impact on health. However, the degree of this impact remains unclear. Some studies have found positive effects, while others have found negative effects. It is reported that health problems such as muscle pain, fatigue, increased stress and physical and mental problems arise as the working hours increase (Berniell, 2012, p.3).

Organizational Causes

Presenteeism has been found to be significantly related to job security, employer support and job satisfaction (Caverley et al., 2007, p.304).

• Work related causes to the presenteeism are defined as overtime, role stress and initiative.

• Factors affecting presenteeism in individuals and companies can be stated as health and life quality, increasing health care costs, having negative colleagues, increased occupational accidents associated with distraction, decreased service and product quality (Lack, 2011, p.77).

1. Overtime

People have a limited amount of energy, and they try to distribute it in accordance with the tasks they will do during the day. Employees adjust their energy by taking into consideration the time they will spend in their workplaces.

In case of overtime without the necessary planning and working hours, without considering the social and cultural needs of the employees; the balance between work efficiency and working hours deteriorates and individuals appear to be over-tied (Camkurt, 2007, p.89). Cooper (2006) states that overtime is an important factor that causes presenteeism.

2. Role Stress

Different definitions of stress have been made over the years. Initially, it was defined as the pressure from the environment and later as the pressure within the person. Today, however, the generally accepted definition is:

It refers to the psychological and physical condition when the individual’s resources are insufficient to deal with the demands and pressures of this situation. Therefore, in some cases and in some individuals, stress is experienced more intensely than others. Stress can prevent the achievement of goals for both individuals and organizations (Michie, 2002, p.67).

Stress reduces job satisfaction and increase health costs, reduces the quality and quantity of care, leads to absenteeism due to illness, high staff turnover and inefficient organizations.

For these reasons, role stress increases. Performance decreases under stressful situations. In some studies, it has been determined that there is a relationship between job performance and job stress and low job performance causes high job stress. The presenteeism level increases when high work stress is experienced. Work stress is among the main causes of presenteeism.

3. Initiative

Taking an initiative means activating your creativity, solving a problem, taking advantage of opportunities, making creative changes in customer service or changing the current business environment. If employees cannot take initiative or do not know their duties and responsibilities fully, the uncertainty they have experienced and the uneasiness of being unable to do their jobs cause problems related to mental health and then physical health. For this reason, it is inevitable that they face presenteeism.

4. Work Environment

When employees feel comfortable in the work environment, their job satisfaction will be high and they use their unpredictable capacity limits efficiently. Psychosocial work environment is one of the important issues related to the work environment in contemporary societies.

Researches show that a large proportion of employees in the European Union are exposed to psychosocial stressors at work. The negative effects include:

• skeletal disorders,
• heart disorders,
• mental disorders,
• stress,
• burnout,
• decrease in quality of life,
• illness,
• absenteeism,
• labor turnover rate and decrease in motivation and productivity (Kristensen et al., 2005).

These results are consistent with the reasons of presenteeism and cause employees to experience presenteeism.

5. Organizational Culture

Organizational culture Opens in new window is a system of cooperation that results from the union of the efforts of two or more people to achieve a specific purpose.

Organizational culture consists of emotions, norms, interactions, activities, expectations, assumptions, beliefs, attitudes and values shared by members of the organization. Organizational culture, which is defined as attitudes and values shared jointly within an organization (Erdem, 2007, p.64), is a strong organizational component for employees in the working life (Iscan & Timuroglu, 2007, p.121).

The pressures by the organizational culture on the person can cause presenteeism. Most of the organizational culture develops as a result of leadership.

Organizational culture can also affect development. For example; operational leaders have organizational culture, rules, procedures and norms. Transformational leaders interpret the existing organizational culture with a new perspective on shared values and norms (Bass & Avolio, 1993, p.112). It can be said that the characteristics of the leaders of the organization also affect presenteeism in the organization.

6. Job Satisfaction

Satisfaction is particularly important for both employees and business as it has the potential to be a source of happiness or unhappiness for employees in their business and private lives, and it can increase or decrease productivity and quality for business. At the same time, job satisfaction Opens in new window is an important indicator of a healthy and productive environment in the organization (Toker, 2007, p.93).

According to a study on office workers under the headings of employee engagement, job dependence, job satisfaction, a negative relationship between presenteeism and job satisfaction was found. As job satisfaction increases, both work dependence and employee loyalty increase and presenteeism decreases (Murray et al., 2015, p.100).

7. Mobbing

The phenomenon of mobbing means acting together with someone or psychologically applied terror. Mobbing leads to severe work and psychological consequences (Leymann, 1990, p. 119).

Mobbing is defined as severe forms of social stressors at work.

Among the reasons that arise from the organization that causes mobbing, leadership and business organization cause mobbing (Zapf, 1999, p.70). It is said that employees are adversely affected by pressures in the workplace and it cause presenteeism (Dietz & Scheel, 2017, p.1).

Environmental Causes

Globalization and technology make working life easier in some respects and also make it difficult in some respects. The environmental causes of presenteeism are:

1. economic and political uncertainties,
2. environment and traffic problems.

1. Economic and Political Uncertainties

Uncertainties in the country or the world economy, crises, unemployment and dismissals, cost of living, high inflation, low level of welfare and the inability of individuals to meet their basic needs are important sources of stress. And stress is one of the most important factors causing presenteeism.

2. Environment and Traffic Problems

Heavy traffic, noise and all kinds of pollution arising from it are important sources of stress in the city where the workplace is located.

Both for a clean environment and for the peace of mind of employees, it is important for the business to follow environmentally sensitive policies, to ensure that its employees adopt these policies and to raise public awareness about the environment (Baysal, 2012, p.17).

Solution and Recommendations

Presenteeism in the workplace can lower productivity and business competitiveness and may cause customer dissatisfaction as a result of the service that cannot be provided correctly. There are several factors that provide protection from presenteeism. These include:

• regular working hours,
• daily plans,
• sleeping adequately,
• eating a balanced diet,
• exercising,
• knowing the time when the person has high energy levels,
• maintaining the balance between work and family life,
• not ignoring the leave days and
• creating time for relaxing (Shuster & Cynthia, 2003).

Since these factors will positively affect employees’ physical and mental health, they will support them in avoiding presenteeism. To avoid presenteeism, employees should not think that s/he will lose his/her job if s/he cannot continue to work due to any illness or various reasons.

Psychological relief of employees, and low anxiety and stress is very important for the health of the employees and the businss. If measures are not taken on these issues, they are more likely to experience presenteeism.

There are studies indicating that a supportive working culture should be established for the employees and communication should be established with them to reduce presenteeism (Nagar, 2018, p.74).

Improvement practices such as leave of absence with pay when employees become ill, improvements in medication and treatment aids, paid leave on sick days, free medication and flexible working hours will ensure the reduction of presenteeism (Cohan & Harman, 2012, p.172).

In addition, the organization of necessary human resources policies and improving the sensitivity of managers and employees through training are among the measures that can be taken (Dalkilic & Seren, 2018, p.129).