Sickness presenteeism has drastic consequences for the organization or employer, the health of the employee, the safety of healthcare consumers (clients and patients) and families of the employees (Roelen, Jensen, Stapelfeldt Groothoff, Nielsen and Bültmann, 2014;Sendén, Løvseth, Schenck -Gustafsson and Fridner, 2013). The aim of the study was to determine the level of illness presenteeism among nurses working in selected healthcare settings, identify predisposing factors and determine the relationship between job demand, locus of control and social support among nurses working in different types or categories of healthcare institutions operate.
INTRODUCTION AND BACKGROUND
Introduction
The purely economic focus on sickness presenteeism indicated the unforgiving attitude of employers towards their employees and the service consumers. Insofar as sickness presenteeism was "the biggest drain" on productivity, the health of employees and the safety of service consumers were equally or more important.
Background
- Overview
- Geographic location
- Population of Swaziland according to Central Statistics Office Data of 2007
- The healthcare system
- Levels of service delivery
- Health Profile
- The Swaziland Wellness Centre and workplace programs
- The Public Service HIV/AIDS Coordination Committee (PSHACC)
- Government policies on sick leave
- Challenges in the nursing fraternity
According to the Wellness Center Policy (WCP), 2011, nurses and other healthcare professionals are personally affected by communicable diseases and HIV/AIDS to the same extent as the general population. The nurses are part of the population affected by HIV/AIDS and tuberculosis.
PROBLEM STATEMENT
Within ten days of the onset of gastroenteritis, the disease had become an outbreak affecting twenty-three home residents and eighteen nurses (Widera, Chang, and Chen, 2010). Subsequently, weakening of the cardiovascular system, brain function and immune system occurs, and failure to manage acute and episodic illnesses results in complications that will reduce nurses' quality of life and increase the number of sick leave (Bergström et. al. , 2009b; Aronsson, Gustafsson and Mellner, 2011; Roelen et al., 2014).
PURPOSE OF THE STUDY
RESEARCH OBJECTIVESAND QUESTIONS
SIGNIFICANCE OF THE STUDY
Nursing education will be improved by including content that will reduce illness presenteeism and improve the quality of life of student nurses, nurses and teachers. The health of healthcare consumers will be protected by establishing regulations that will ensure their protection against infectious diseases that spread during illness presentence.
CONCEPTUAL AND OPERATIONAL DEFINITIONS
- Operational definitions
Likert scale questionnaire for determining the reasons for sick leave A questionnaire developed through the integration of literature related to the predisposing factors for sick leave was used. The questionnaire had a five-point Likert scale ranging from strongly disagree to strongly agree.
Conceptual model for sickness presenteeism
Health problems for employees can arise from sources of psychological stress in the workplace (demands and resources). As mentioned earlier, the negative effects of demands and resources are physical and mental health problems.
Conclusion
In addition, the objectives of the study were to determine the prevalence of disease presenteeism and to identify predisposing factors, so the concepts of the model were identified as relevant. Exploring the concepts (demands, control, social support, and health problems) that have been shown to be associated with illness presenteeism is a good starting point.
LITERATURE REVIEW
- Introduction
- Demand, control and support model in sickness presenteeism
- Demand
- Control
- Social support
- Health Problems
- Dialectical theory in sickness presenteeism
- The recovery theory in sickness presenteeism
- Factors contributing to sickness presenteeism
- Proposed interventions for reducing sickness presenteeism
- Conclusion
Linnerud (2013) explains that job demands in the nursing profession come from different perspectives such as top-down (manager to nurse), bottom-up (patient to nurse) and horizontal (between nurses on shift), which makes nurses more prone to presenteeism. Claims from a Danish study on disease presenteeism are that poor health, high workload, conflicts between work and family, lack of social support, reduced decision-making freedom and obesity cause disease presenteeism (Johansen et. al., 2014). Belita et.al., (2013) states that the low density of health workers, less than 2.5 per 1000 inhabitants in sub-Saharan countries, causes the tendency of nurses to presenteeism and additionally causes the deterioration of their health status.
Constanze et al. (2012) show that the risk of illness and ill health doubles during times of understaffing. This is evident from a study conducted among public and private employees, including nursing staff. Workplace wellness programs that involve active participation of supervisors or managers and target environmental factors that increase illness presenteeism are highly effective (Cancelliere et. al., 2011). Theories discussed include Karasek's demand, control, and social support model, the dialectical theory of illness presenteeism, and recovery theory.
RESEARCH METHOD
- Introduction
- Research design and methodology
- Research Setting
- Population and target population
- Simple random sampling
- Sampling method: Cluster random sampling
- Sample size
- Sampling frame
- The Pilot study
- Data collection tool
- Validity and Reliability
- Target population
- Variables measured
- Instrument development process
- Validity and reliability of Part D of the data collection tool
- Data collection
- Concepts of Part D used for data collection
- Maintaining Confidentiality in the study
- Data analysis
- Data management
- Ethics
- Conclusion
The study population was one thousand three hundred and sixty-four nurses working in the public service. Accessible population refers to the portion of the target population that is accessible to the researcher (Burns and Grove, 2009). The list of health facilities was obtained from the Statistics Information Department of the Ministry of Health.
Fifty percent of the health facilities were selected to represent specific categories of health facilities. A new set of Likert scale questions was developed by the researcher and included as Part D of the data collection tool. This is confirmed by establishing a relationship between the statements and the concepts of the study.
DATA ANALYSIS AND FINDINGS
Introduction
Data analysis
Results
- Respondents’ characteristics
- The existence of sickness presenteeism
- Sickness presenteeism findings based on Stanford Presenteeism Scale 6
- Factors contributing to sickness presenteeism
- Job demand
- Locus of control (adjustment latitude)
- Social support
- Social support policy and health-related problems as predisposing factors for
In addition, 69% of respondents indicate that they would still like to work despite a health problem if there is a staff shortage. A total of 40.9% of respondents stated that they would still go to work despite a health problem if they were scheduled for a night shift. Conversely, 36.8% of respondents stated that they would not go to work if they were sick, despite being pressured to do so, and 18.2% of respondents were unsure what their response would be.
Where strict management of sickness absence and unacceptable sickness absence by managers was observed, 39.8% of respondents agreed. Another 31.3% of respondents indicated that these factors would not force them to go to work while sick, and 18.9%. The results of the study were that acute illnesses accounted for 61.7% of sick leave, and episodic illnesses for 46.2%.
DISCUSSIONS
Introduction
High job demands in nursing
- Staff shortage
The high burden of disease resulting from communicable, non-communicable diseases and injuries increases the number of patients seeking health care services for complex illnesses, and this puts a small burden on the remaining nurses, prompting them to become involved in disease presentation. These findings are consistent with the results of studies conducted by Aronsson, Gustafsson and Dallner (2000), and Demerouti, Le Blanc, Bakker, Schaufeli and Hox (2009). Staff shortages, reflected by reports of 150 nurses per 100 000 population members in Swaziland, exposed nurses to high workloads, resulting in nurses reporting for work despite having health problems (HRHSP, 2012). The literature found that health facilities that were under-staffed and had no health promotion programs for health care workers had a high number of ill health care workers constantly going to work (Whitehead, 2006).
The findings suggest that vigilant managers need to make efforts to stem staffing shortages and ensure the right staffing and distribution of nurses to counter the effects of skills shortages and staffing shortages. The workload indicator of staffing needs should be calculated to determine the staffing status and human resource needs of health facilities and reports should be used to mitigate staffing shortages (Nayak, 2014). The strategies highlighted may be effective for Swaziland, based on the high attrition rates associated with the emigration of nurses scouting for lucrative remuneration packages in neighboring countries and abroad.
Ease of replacement and locus of control
Social Support
Unacceptability and heavy-handed handling of sickness absence from managers was seen as a sign of lack of sympathy on the manager's part. According to the results of the study, a lack of appraisal support, that is, losing promotion and reducing pay, would not force nurses to go to work when they are sick. This was evidenced by a disagreement of 43.9% in responses to the questionnaire, while 22.3% of nurses were unsure whether they would feel compelled to come to work under these circumstances and 33.8% agreed , that they themselves would volunteer for service. even if it's bad.
Other insignificant forms of support were informational support, which included sick leave policies (authority for sick leave and guidelines for self-prescribing medicines and use of over-the-counter medicines and pharmaceuticals). The survey found that 39.1% of nurses agreed that seeking health care from health care providers who were not authorized to provide sick leave would make them go to work even if they had health problems, yet 42, 1% of nurses disagree with this statement. Regarding approval of self-prescription of medication and use of over-the-counter medications and pharmaceuticals, 42% of nurses agreed that they report to work when sick, whereas 40.2% of nurses stated that they would not . Curiously, 61.7% of participating nurses disagreed that suffering from a long-term illness would cause them to continue working every day while suffering from illness.
Health problems
Limitations of the study
Dissemination of findings
Conclusion
The literature shows that working while ill can have adverse long-term effects on health, confirming the seriousness of illness presence. The predisposing factors of sickness absence include a high demand for work, a shortage of staff, a lack of comfort for the replacement of nurses, an inability to adjust work to suit the health status of nurses, a lack of social support (instrumental, emotional and informational). ) and health problems that are either acute, episodic, chronic and/or psychological. Trustworthy nurse managers, supportive work environment and the provision of privacy and confidentiality are essential to promote the openness of nurses about health problems and personal matters, thus combating sickness absence.
Instilling the importance of maintaining confidentiality among nurse managers and their subordinates would decrease the incidence of illness presenters. Effective strategies to reduce sick leave include increasing supportive supervision of nurses and providing job satisfaction programs, according to Martinez and Ferreira (2012). Mitigating staff shortages through appropriate recruitment of nurses, utilization of workload indicators, staffing needs calculations and ensuring the appropriate number, distribution and skill mix of nurses is essential.
Recommendations
Illness presentation is more than an alternative to illness absence: results from the population-based SLOSH study. A dialectical theory of the decision to go to work: bridging absenteeism and presenteeism. Human resource Management. A study on the relationship between traditional male role norms and illness presentation among Danish ambulance workers.
A dialectical theory of the decision to work: Combining absenteeism and presenteeism. Human resource management. Combined effects of workload and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Managerial leadership is associated with self-reported sickness absence and the presence of illness among Swedish women.
What makes doctors go to work when they are sick: a comparative study of illness presentation in four European countries (HOUPE). STUDY DATA COLLECTION FOG Thank you for being part of the study participants.
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