Engaging in sickness presenteeism: How do people decide? The decision-making process behind sickness presenteeism, and implications for its management.

Presenteeism, defined as the act of attending work when ill, is an extremely costly phenomenon in terms of both employee health and business productivity. However, existing understanding regarding the phenomenon, the mechanisms and processes that can lead to it, and how it should be dealt with remains underdeveloped.

Reported to be 1.8 times to three times more costly than absenteeism, presenteeism is not only associated with significant business costs due to lost productivity, but can also exacerbate existing medical conditions, impair quality of working life, and invite feelings of ineffectiveness at work (Johns, 2010). Research has identified it as a stronger predictor of health than sickness absence (Whysall et al., 2017), yet progress towards managing it is hampered by a distinct lack of practical and theoretical understanding of the phenomenon.

Whilst there is substantial interest in presenteeism from the media and employers, academic research and conceptual insights remain underdeveloped. We know that presenteeism is a complex phenomenon with multiple antecedents, mediators, and consequences. Associations have been found between presenteeism and a variety of individual and organisational factors, including psychosocial factors such as job dissatisfaction, perceived job insecurity, lack of social support and high job demands. However, the extent to which these factors are a cause or consequence of presenteeism is unclear.

A small amount of qualitative research has reinforced this notion that presenteeism is a multi-dimensional construct, and one that can be determined by both workplace and individual factors. These influence the decision between alternative attendance behaviours (absenteeism and presenteeism) when he or she is feeling unwell.

Despite its importance, the decision-making process behind presenteeism behaviour has received very little research attention. This PhD programme will build on the supervisors’ collective work to examine how individuals choose between absenteeism or presenteeism, the criteria they use for this decision-making process, the outcomes of this decision for recovery and productivity, and the implications for management.

This PhD programme will involve the generation of much needed and innovative research to inform our understanding of the decision-making process behind sickness, drawing upon established psychological and organisational theory, to develop a conceptually-grounded understanding of presenteeism behaviour. It is likely to involve a mixed-methods approach, the findings from which, it is hoped, will provide a valuable basis for practical, evidence-based guidance for policy makers, practitioners, and employers, regarding the most effective ways in which to manage employee health and productivity.