The mediating role of perceived social support between work-family conflict and presenteeism among ICU nurses working shift work in Chinese public hospitals: A cross-sectional investigation.

OBJECTIVE: Relative to explicit absenteeism, nurses' presenteeism has a more lasting impact and is more harmful and costly. This study aimed to explore the relationship between work-family conflict, perceived social support, and presenteeism and whether perceived social support mediates the relationship between work-family conflict and presenteeism among ICU nurses working on shifts in Chinese public hospitals. MATERIALS AND METHODS: A cross-sectional research design was conducted from January to April 2023 in Sichuan Province, China. A total of 609 valid questionnaires were collected. The questionnaires contained information on demographic characteristics, the Work-Family Conflict (WFC) scale, the Perceived Social Support Scale (PSSS), and Stanford Presenteeism Scale-6 (SPS-6). Multiple stratified regression was used to explore the mediating role of perceived social support between work-family conflict and presenteeism. The mediating effect of perceived social support in work-family conflict and presenteeism was tested by Model 4 in the PROCESS 4.1 macro program in SPSS. RESULTS: A total of 609 nurses were included in this study, and the mean presenteeism score for ICU nurses working on shifts was 16.01 ± 4.293 (Mean ± SD), with high presenteeism accounting for 58.46%. After controlling for sociodemographic characteristic variables, work-family conflict was positively associated with presenteeism, explaining 7.7% of the variance. High perceived social support was related to low presenteeism, explaining 11.5% of the variance. Perceived social support mediated the association between work-family conflict and presenteeism among ICU nurses working on shifts. CONCLUSIONS: Chinese shift-work ICU nurses' high presenteeism scores deserve managers' attention. Work-family conflict is a significant predictor of nurses' presenteeism. Perceived social support is essential in improving nurses' work-family conflict and mediates the relationship between work-family conflict and presenteeism. Improving social support can reduce the impact of work-family conflict on presenteeism among nurses working shifts.

Designing a test battery for workers' well-being: the first wave of the Tsukuba Salutogenic Occupational Cohort Study.

BACKGROUND: In recent years, there has been a diversification of working styles. The concept of workers' well-being is no longer limited to material wealth, such as how satisfied they are with their wages. Psychological enrichment, encompassing factors like motivation and interpersonal relationships, is also important. This study was established to develop a scale to evaluate the well-being of workers, named the Abundance Index for Workers (AIW). This new concept proposed by the authors comprehensively considers both job-related resources and personal and societal resources. METHODS: This study was carried out as part of the Tsukuba Salutogenic Occupational Cohort Study (T-SOCS). We utilized data from a survey targeting workers affiliated with institutions under the Tsukuba Science City Network, examining aspects of their daily life, work, and mental health. The deviation scores for each survey item were averaged to calculate an overall score. The correlations of the comprehensive score with the Patient Health Questionnaire-9 (PHQ-9) index for depression and the Single-item Presenteeism Question (SPQ) index for presenteeism were analyzed to determine criterion-related validity. RESULTS: The number of participants analyzed was 2,745. Factor analysis categorized the data into three factors: workplace mental health, societal resources, and lifestyle habits. Cronbach's α coefficient was 0.688. There were correlations of -0.363 (p < 0.001) between the total score and SPQ, and -0.558 (p < 0.001) between the total score and PHQ-9, suggesting a degree of criterion-related validity. CONCLUSIONS: In this study, we designed a test battery that assesses workers' well-being based on job-related resources and the richness of societal resources. The internal consistency of this battery was not as high as expected due to the broad scope of well-being. Although it is difficult to evaluate workers' well-being on a single scale, we believe that the AIW functions well as a test battery by combining scales with different attributes, which enables well-being to be captured from as many different perspectives as possible. This tool is designed to assist individuals in evaluating their own well-being and recognizing factors that can enhance it. TRIAL REGISTRATION: Not applicable; this study is not an intervention trial.

Incidence of laboratory-confirmed influenza and RSV and associated presenteeism and absenteeism among healthcare personnel, Israel, influenza seasons 2016 to 2019.

BackgroundHealthcare personnel (HCP) are at high risk for respiratory infections through occupational exposure to respiratory viruses.AimWe used data from a prospective influenza vaccine effectiveness study in HCP to quantify the incidence of acute respiratory infections (ARI) and their associated presenteeism and absenteeism.MethodsAt the start and end of each season, HCP at two Israeli hospitals provided serum to screen for antibodies to influenza virus using the haemagglutination inhibition assay. During the season, active monitoring for the development of ARI symptoms was conducted twice a week by RT-PCR testing of nasal swabs for influenza and respiratory syncytial virus (RSV). Workplace presenteeism and absenteeism were documented. We calculated incidences of influenza- and RSV-associated ARI and applied sampling weights to make estimates representative of the source population.ResultsThe median age of 2,505 participating HCP was 41 years, and 70% were female. Incidence was 9.1 per 100 person-seasons (95% CI: 5.8-14.2) for RT-PCR-confirmed influenza and 2.5 per 100 person-seasons (95% CI: 0.9-7.1) for RSV illness. Each season, 18-23% of unvaccinated and influenza-negative HCP seroconverted. The incidence of seroconversion or RT-PCR-confirmed influenza was 27.5 per 100 person-seasons (95% CI: 17.8-42.5). Work during illness occurred in 92% (95% CI: 91-93) of ARI episodes, absence from work in 38% (95% CI: 36-40).ConclusionInfluenza virus and RSV infections and associated presenteeism and absenteeism were common among HCP. Improving vaccination uptake among HCP, infection control, and encouraging sick HCP to stay home are important strategies to reduce ARI incidence and decrease the risk of in-hospital transmission.

Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones.

Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work absence and productivity losses in a cohort of patients undergoing a trial of passage for ureteral stones. Actively employed patients aged 18 to 64 and discharged from Duke emergency departments without surgical intervention for ureteral stones ≤ 10 mm were contacted by phone four weeks after their presentation. Participants completed the Institute for Medical Technology Assessment Productivity Cost Questionnaire which assesses three domains: absenteeism - missed work; presenteeism -productivity when returning to work; and unpaid work - assistance with household work. Linear regression associated demographic and stone factors with productivity losses.109 patients completed the survey. In total, 67% of patients missed work, 46% had decreased productivity when returning to work, and 55% required assistance with unpaid work. 59% of patients with stones ≤ 5 mm missed work versus 84% with stones > 5 mm (p = 0.009). African American race (coefficient 23.68, 95% confidence interval 2.24-45.11, p = 0.031), first-time stone formers (coefficient 20.28, 95% confidence interval 2.50-38.07, p = 0.026), and patients with stones > 5 mm (coefficient 25.34, 95% CI 5.25-45.44, p = 0.014) were associated with increased productivity losses. The majority of patients miss work while undergoing a trial of passage and many have decreased productivity when returning to work. This information may help counsel patients in emergency departments, especially first-time stone formers, and prevent return visits.

Exploring anesthesiology nurse' presenteeism in China: cross-sectional study.

BACKGROUND: The department of anesthesiology is the main battlefield for the treatment of acute and critical patients, with high work risk and high work pressure. Due to the particularity of the working environment and nature of work, medical staff have become a group with a high incidence of occupational exhaustion and presenteeism. OBJECTIVE: To investigate the current status of presenteeism among anesthesiology nurses in China and to analyze the related influencing factors. METHODS: Three hundred twelve anesthesiology nurses in Sichuan Province were surveyed by means of general data questionnaire, presenteeism scale, work-family conflict scale, perceived social support scale, occupational commitment scale and stress resistance scale from September to November 2023 by convenience sampling method. RESULTS: The total score of presenteeism was (14.67 ± 3.92), the score of work-family conflict was (45.44 ± 15.90), the score of professional commitment was (87.28 ± 14.30), and the score of perceived social support was (66.04 ± 12.78). The evaluation score of stress resistance was (73.35 ± 11.54). The results of multivariate analysis showed that age, education, mode of employment, position, overtime hours per week, work-family conflict, perceived social support and stress resistance were the factors that affected the presenteeism of anesthesiology nurses, which could explain 44.1% of the total variation. The position ( ß = 0.296, P < 0.001), overtime hours per week (h) ( ß = 0.271, P < 0.001), perceived social support ( ß = -0.279, P < 0.001) turned out as the stronger predictors of presenteeism. CONCLUSION: The presenteeism of anesthesiology nurses is at a high level and needs to be further improved. Clinical nursing managers should pay attention to the physical and mental health and special needs of anesthesiology nurses. Interventions are made according to the main influencing factors, so as to reduce the incidence of presenteeism and improve the quality and safety of surgery.

Association between Presenteeism, Associated Factors, and Outcomes among Intern Physicians in Public Hospitals during the COVID-19 Pandemic: A Cross-Sectional Study.

Background and Objectives: Presenteeism, when employees continue to work despite being sick, may have increased among intern physicians during the COVID-19 pandemic due to the necessity of performing unfamiliar tasks. This study aimed to investigate the prevalence of presenteeism among intern physicians (IPs) in Thailand, its associated factors, and outcomes. Material and Methods: A total of 254 IPs participated in this cross-sectional study conducted from June to July 2022. Participants completed a nationwide online questionnaire including demographics, financial status, underlying diseases, hospital location and affiliation, department, resource problems, manpower shortage, workload intensity, presenteeism, and its outcomes. IPs were recruited via various social media platforms. Statistical analysis was performed using multivariable zero-inflated Poisson regression and multivariable linear regression. Results: The average age of IPs was 25.5 years (SD 1.9), and 57.5% were female. The majority of IPs reported dealing with resource problems (74.8%), insufficient manpower (94.9%), and intense workload (83.5%). Presenteeism was prevalent among 63.8% of IPs, with the most common of the diseases being allergic rhinitis (31.3%). IPs with underlying diseases had an increased rate of presenteeism (adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) 1.33-4.55). IPs working in community hospitals during their rotations exhibited a lower rate of presenteeism (aOR 0.39, 95% CI 0.16-0.94) compared to other departments within general or regional hospitals. The IPs frequently exposed to insufficient manpower had an increased rate of presenteeism (aOR 4.35, 95% CI 1.02-20.00) compared to those not exposed. Additionally, IPs with presenteeism had more exhaustion (ß 1.40, 95% CI 0.33 to 2.46), lower perceived well-being (ß -0.65, 95% CI -1.26 to -0.03), and job satisfaction (ß -0.33, 95% CI -0.63 to -0.03). Conclusions: During COVID-19, intern physicians in Thailand often exhibit presenteeism due to physical conditions, resource scarcity, and personnel shortages, impacting exhaustion, well-being, and job satisfaction. Recommendations include assessing healthcare workforces, allocating resources more effectively, enforcing policies to promote responsible use of sick leave, and implementing sick leave systems.

Relationship between occupational stress and presenteeism status among workers in small and medium-sized enterprises.

This study aimed to identify characteristics of workers experiencing health problems without a decline in labor productivity to address presenteeism. A cross-sectional analysis was conducted on 554 workers in Japan, with a median age of 43 years. Participants reported any health problems in the past month, along with job stressors, stress responses, social support, and job and life satisfaction using the Brief Job Stress Questionnaire. They were categorized into three groups: "no symptoms," "pre-presenteeism" (health problems without work impact), and "presenteeism" (health problems with work impact). Results showed that 30.1% were in "prepresenteeism" and 52.0% in "presenteeism." Stress responses and social support were linked to both "pre-presenteeism" and "presenteeism," while job stressors and job and life satisfaction were only associated with "presenteeism." These findings offer insights for preventing presenteeism.

Utility of an online well-being assessment in targeting employee well-being programmes: a cross-sectional survey study in Finland.

OBJECTIVES: Occupational health challenges are changing, emphasising the need for a more comprehensive approach. This study examines how a subjective well-being assessment can be used to identify target groups for work well-being interventions and brings insight into how survey-based well-being evaluations are linked to clinical health indicators (ie, anthropometric measurements and blood tests). DESIGN: A cross-sectional survey study using results from the Virta1 randomised controlled trial and a third-party well-being questionnaire database. SETTING AND PARTICIPANTS: Online well-being survey data from 2990 respondents was used to identify target groups for work well-being interventions and clinical health indicator data from 713 respondents was used to examine how subjective evaluations are linked to physical health. RESULTS: We identified five groups of employees with different well-being challenges and presenteeism levels: Good well-being, Hard on oneself, Lifestyle challenges, Recovery challenges and Multiple challenges. The subjective evaluations correlated with clinical health indicators, showing that the well-being groups differed significantly in their average clinical health profiles. Especially people in the Multiple challenges group had multiple physical health challenges, while people in the Good well-being and Hard on oneself groups did not. CONCLUSIONS: Our results show that a subjective well-being assessment can identify different groups with distinct characteristics and health risks and that subjective evaluations of well-being correlate strongly with physical health. Online well-being assessment offers potentially a cost-effective way for occupational health providers to screen large populations to target physical health examinations to groups that need them the most and simultaneously get a better understanding of their well-being needs.

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea.

The available evidence suggests positive health outcomes associated with early treatment intensification in Type 2 diabetes mellitus (T2DM). Our study estimated the productivity effects arising from improved health correlated with early intensified treatment in T2DM in Korea. Using a recently published methodology and model, we investigated the association between early intensified treatment and the probability of experiencing fewer diabetes-related complication events. Treatment strategies leading to better health outcomes are expected to be associated with social value through increased participation in paid and unpaid work activities. Therefore, we translated the lower incidence of complications into monetary terms related to productivity for the Korean population. We quantified productivity by considering (a) absenteeism, (b) presenteeism, (c) permanent loss of labor force, and (d) activity restriction. Deterministic and probabilistic sensitivity analyses in the base case parameter were performed. Approximately, 1.7 thousand (standard deviation [SD] ±580 events) micro- and macrovascular complication events could potentially be avoided by early treatment intensification. This led to a societal gain attributed to increased productivity of 23 million USD (SD ± $8.2 million). This article demonstrates the likelihood of achieving better health and productivity through early intensified treatment in diabetes.

An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - an assessment of sick leave, presenteeism, and health care utilization.

BACKGROUND: Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop- concept. Here, we aimed to evaluate effects of this concept on sick leave, presenteeism, and health care utilization. METHODS: In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding economic outcome parameters assessed over 6 months. Multivariate binary logistic regression models were used to adjust for confounders. RESULTS: Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, the IC group showed significantly fewer days with sick leave or presenteeism (-5 days/month), fewer unscheduled contacts for IIH-specific problems (-2.3/month), and fewer physician or hospital contacts in general (-4.1 contacts/month). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of the IC concept in these groups. CONCLUSIONS: Interdisciplinary integrated management significantly improves the burden of IIH in terms of sick leave, presenteeism and healthcare consultations - particularly in socioeconomically underprivileged patient groups.

The Burden of Work Productivity and Activity Impairment in Patients with Psoriasis, Psoriatic Arthritis, Ulcerative Colitis, and Crohn's Disease.

BACKGROUND: Comparisons among autoimmune diseases enable understanding of the burden and factors associated with work productivity loss and impairment. AIMS: The objective was to compare work productivity and activity and associated factors among patients with inflammatory bowel diseases and other autoimmune conditions. METHODS: This cross-sectional study included employed, adult patients (age 20-64 years) in the CorEvitas Inflammatory Bowel Disease, Psoriasis, and Psoriatic Arthritis/Spondyloarthritis Registries between 5/2017 and 6/2020. Any patient-reported impairment on four domains of the Work Productivity and Activity Index (WPAI) was collected across registries. Prevalence for each autoimmune disease was reported and stratified by disease activity using direct age-sex-standardization. Factors associated with the presence of any WPAI were identified in logistic regression models. RESULTS: A total of 7,169 patients with psoriasis (n = 4,768, 67%), psoriatic arthritis (n = 1,208, 17%), Crohn's disease (CD, n = 621, 9%), and ulcerative colitis (UC, n = 572, 8%) met inclusion criteria. Among patients not in remission across all disease cohorts, the age-sex-standardized prevalence of any presenteeism, work productivity loss, and activity impairment ranged from 54 to 97%. Patients with CD in remission had higher standardized prevalence of presenteeism (53% [48-57%]) and work productivity loss (54% [49-59%]), compared to those from other cohorts (presenteeism [range: 33-39%] and work productivity loss [range: 37-41%]). For all WPAI domains, the strongest adjusted associations were for moderate to severe disease activity and psychosocial symptoms. CONCLUSIONS: Patients with moderate to severe disease activity reported the highest WPAI burden. However, patients in remission or mild disease activity also report some WPAI burden, emphasizing a multidisciplinary treatment approach to improve work productivity loss and impairment.

Exercise and health-related quality of life and work-related outcomes in primary care patients with anxiety disorders - A randomized controlled study.

BACKGROUND: Exercise interventions show promise in the treatment of anxiety disorders, but effects on health-related quality of life (HR-QoL), work ability, and sick leave are little studied. We investigated these outcomes in a 12-week randomized controlled trial with a 1-year follow-up. METHODS: Patients aged 18-65 (n = 222) with anxiety disorders from primary care centers in Gothenburg were randomized to a control group or one of two 12-week exercise intervention groups (low-intensity, [LI] and moderate/high-intensity, [HI]); 148 were evaluated at 12-weeks and 113 completed the 1-year follow-up. The EuroQol 5D (EQ5D; index and the visual analogue scale [VAS]), work ability score (WAS), presenteeism, and self-reported sick leave were assessed at baseline, 12 weeks, and 1 year. Improvements were defined by binary cut-offs for each scale. Binary logistic regression with odds ratios (OR) and 95 % confidence intervals (CI) were reported. RESULTS: There were improved scores for EQ5D and WAS in the HI group compared to controls after 12 weeks (EQ5D index: 4.74 [1.91-11.7], EQ5D-VAS 4.00, [1.65-9.72], WAS 3.41 [1.24-7.37]) and 1 year (EQ5D index: 3.05 [1.05-8.81], EQ5D-VAS 3.20 [1.16-8.84], WAS 5.50 [1.85-16.3]). Post-hoc analysis showed higher ORs in participants on antidepressants (n = 75) (12-week EQ5D index: OR 9.95 [2.85-34.8]) and significant improvements in EQ5D scores for both intervention groups after 1 year. There were no between-group differences for presenteeism or sick leave. LIMITATIONS: Discontinuation was high, mostly early after randomization (n = 74), as is common for anxiety interventions. CONCLUSIONS: HI Exercise improves HR-QoL and work ability in anxiety patients, especially when combined with antidepressants.

Association between sickness presenteeism and depressive symptoms: a cross-sectional study using the 6th Korean working conditions survey.

PURPOSE: This study aimed to reveal the relationship of the days of experiencing sickness presentism and depressive symptoms among Korean workers. Sickness presenteeism which defined as the act of going to work despite being feeling unhealthy triggers various adverse effects on mental health, including increased risks of depression. Furthermore, Sickness presenteeism is a major social issue causing substantial socioeconomic costs. METHODS: The data of 25120 participants from sixth Korean Working Condition Survey was utilized in this cross-sectional study. Sickness presenteeism was defined using a self-reported questionnaire and depressive symptoms were assessed by WHO well-being index. Multivariate logistic regression analysis was conducted to calculate the odd ratios for depressive symptoms regarding the number of days experiencing sickness presenteeism. We calculated odds ratios (ORs) and 95% confidence interval (95% CI) for depressive symptoms after categorizing participants into three groups based on the duration of experiencing sickness presenteeism, using cut-off values of 3 and 5 days. RESULTS: Workers who have experienced sickness presenteeism for more than 5 days were at highest risk for depressive symptoms than referent group (OR 2.87; 95% CI 2.17-3.76 in male, OR 3.86; 95% CI 3.02-4.91 in female). Furthermore, there was a trend of increasing risk for depressive symptom as the duration of experiencing sickness presenteeism extended. CONCLUSION: This study presents the association between experiencing sickness presenteeism in the previous 12 months and depressive symptoms. Based on the results, we provide individual and organizational strategies of reducing sickness presenteeism. Also, screening for workers who have experienced sickness presenteeism are needed to ensure good mental health.

Presenteeism and sleep duration on workdays and days off.

BACKGROUND: Presenteeism refers to being present at work but experiencing reduced productivity due to health problems, and has been known to be related to sleep loss. Workers commonly sleep longer on days off than on workdays, and presenteeism may be reduced with extended sleep on days off. AIMS: This study aimed to determine the association between sleep duration both on workdays and days off and presenteeism. METHODS: The participants were 1967 workers who engaged in work for 5 days and rested for 2 days weekly. Sleep duration was classified into less than 6 hours (short; S), 6-8 hours (medium; M), and 9 hours or longer (long; L), for workdays and days off, respectively. Presenteeism was assessed using the World Health Organization Health and Work Performance Questionnaire. RESULTS: On both workdays and days off, compared to medium sleep duration, short sleep duration was significantly associated with increased odds of presenteeism. The odds of presenteeism were significantly increased for S-S (odds ratio [OR] 2.17, 95% confidence interval [CI]1.40-3.37), S-M (OR 1.59, 95% CI 1.14-2.22), S-L (OR 2.71, 95% CI 1.05-7.00), and M-S (OR 6.82, 95% CI 2.71-17.17) combined sleep duration for workdays and days off, respectively, compared to an M-M (reference). CONCLUSIONS: Sleep loss on workdays cannot be compensated for with longer sleep on days off. This study suggests that sufficient sleep duration on both workdays and days off is important for reducing presenteeism.

Effect of COVID-19 Infection on Presenteeism: A Cohort Study Using Large Health Insurance-Based Data in Japan.

OBJECTIVE: Presenteeism occurs when employees attend work despite experiencing problems and ill-health that require sick leave. This study examined whether presenteeism worsened following COVID-19 infection. METHODS: We used the DeSC, a large health insurance claims database. Participants were 9241 individuals who responded to questionnaires at baseline (June 2020) and 6 months later, had been continuously insured for at least 6 months prior to baseline, and reported being employed. Propensity score matching was performed. Adjusted multiple logistic regression was used to estimate odds ratios and 95% confidence intervals of worsening presenteeism from baseline according to COVID-19 infection compared with noninfection. RESULTS: Conditional logistic regression analysis showed that the adjusted OR for presenteeism in the COVID-19-infected group was 1.555 (95% confidence interval, 1.086-2.225). CONCLUSIONS: The findings suggest that COVID-19 infection affected worsening of presenteeism.

Association Between Workaholism and Headaches Causing Presenteeism: A Cross-sectional Study in Japan.

OBJECTIVES: This study investigates the association between workaholism and headaches causing presenteeism among Japanese employees. METHODS: Used data from self-reporting questionnaire and annual health checkups. Workaholism was assessed using the Dutch Workaholic Scale and headaches causing presenteeism were identified as the symptom hindering work. We performed a logistic regression analysis adjusted for covariates. RESULTS: Among 5802 respondents, 3.7% cited headaches as the symptom hindering work. We found an association between workaholism and such headaches (odds ratios [OR]: 1.05, 95% confidence intervals [CI]: 1.03-1.08). Both working excessively (OR: 1.08, 95% CI: 1.04-1.12) and working compulsively (OR: 1.10, 95% CI: 1.05-1.15) subscales were also related. CONCLUSIONS: Workaholism may lead to productivity loss due to headaches, and addressing workaholism can prevent this loss. Combining health examination data with work hours data may enable the early detection of workaholism.

Improvement in work productivity among psoriatic arthritis patients treated with biologic or targeted synthetic drugs: a systematic literature review and meta-analysis.

BACKGROUND: Capacity to work is impacted by psoriatic arthritis (PsA). Our objective was to describe the course of work productivity and leisure activity in patients with PsA treated with biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs). METHODS: A systematic literature review identified all trials and observational studies published January 1, 2010-October 22, 2021, reporting work productivity using the Work Productivity and Activity Impairment Questionnaire (WPAI) in patients with PsA treated with b/tsDMARDs. Outcomes for WPAI domains (absenteeism, presenteeism, total work productivity, and activity impairment) were collected at baseline and time point closest to 24 weeks of treatment. A random effects meta-analysis of single means was conducted to calculate an overall absolute mean change from baseline for each WPAI domain. RESULTS: Twelve studies (ten randomized controlled and two observational) assessing patients treated with adalimumab, bimekizumab, guselkumab, ixekizumab, risankizumab, secukinumab, or upadacitinib were analysed. Among 3741 employed patients, overall mean baseline scores were 11.4%, 38.7%, 42.7%, and 48.9% for absenteeism, presenteeism, total work productivity impairment, and activity impairment, respectively. Estimated absolute mean improvements (95% confidence interval) to week 24 were 2.4 percentage points (%p) (0.6, 4.1), 17.8%p (16.2,19.3), 17.6%p (15.9,19.4), and 19.3%p (17.6, 21.0) respectively, leading to a mean relative improvement of 41% for total work productivity. The change in work outcomes in the b/tsDMARDs appeared similar. CONCLUSIONS: This systematic literature review and meta-analysis confirmed that patients with active PsA have a substantially reduced capacity to work and participate in leisure activities. Substantial improvements across various WPAI domains were noted after 24 weeks of b/tsDMARD treatment, especially in presenteeism, total work productivity, and activity impairment. These findings may be useful for reimbursement purposes and in the context of shared decision-making. This systematic literature review (SLR) of randomized clinical trials and observational studies of biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs b/tsDMARDs in patients with PsA found that at treatment introduction, patients presented with a 42.7% mean productivity loss per week as assessed by the Work Productivity and Activity Impairment (WPAI) Questionnaire. Through a meta-analysis comparing before/after values without adjustment for placebo response, we found that after 24 weeks of treatment with b/tsDMARDs, there was a mean absolute improvement of 17.6 percentage points and a mean relative improvement of 41% in total work productivity, with similar magnitudes of improvement in time spent at work and regular activities outside of work. These results provide clinical-, regulatory- and reimbursement decision-makers with data on the potential societal and socio-economic benefits of b/tsDMARDs in PsA.

Psoriatic arthritis (PsA) has a major impact on patients' lives, including their ability to work by causing absence and reducing productivity. By pooling together published studies (12 studies, corresponding to 3741 patients) and comparing what patients reported before starting treatment to during treatment, we found that over the course of treatment with biologic (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs), patients with PsA had an average of 18% higher total work productivity, translating to a 41% reduced impact of PsA at the group level (without looking at comparisons to a placebo response). It is important for health professionals and patients to know that work outcomes affected by PsA are improved when patients take b/tsDMARDS.

Presenteísmo na equipe de Enfermagem ambulatorial: o ausente não percebido / Presenteeism in the outpatient Nursing team: the unnoticed absence

A pesquisa apresentou como objeto o presenteísmo na equipe de enfermagem ambulatorial de universidades públicas do município do Rio de Janeiro. Teve como objetivos: analisar a ocorrência de presenteísmo na equipe de enfermagem ambulatorial de Hospitais Universitários do município do Rio de Janeiro e sua relação com a organização prescrita do trabalho e com os danos relacionados ao trabalho; analisar o presenteísmo na enfermagem ambulatorial de Hospitais Universitários do município do Rio de Janeiro; identificar a percepção profissional quanto a organização do trabalho e a sua relação com o presenteísmo na equipe de enfermagem ambulatorial de Hospitais Universitários do município do Rio de Janeiro; levantar e mensurar os danos físicos, psicológicos e sociais da equipe de enfermagem ambulatorial de Hospitais Universitários e sua relação com o presenteísmo; e avaliar a associação da organização do trabalho e danos relacionados ao trabalho na equipe de enfermagem ambulatorial de Hospitais Universitários. Trata-se de um estudo transversal, descritivo, de abordagem quantitativa sobre a ocorrência do presenteísmo na equipe de enfermagem ambulatorial universitária. O estudo foi realizado nas unidades de média e alta complexidade ambulatoriais das universidades públicas no município do Rio de Janeiro. O critério de inclusão ficou definido como todos os profissionais de enfermagem que trabalhavam em unidades ambulatoriais de média e alta complexidade universitária e os critérios de exclusão foram profissionais que atuavam na área administrativa e/ou não prestavam assistência direta ao cliente, além dos profissionais que estavam em licença prolongada (gestação, especial, para capacitação e/ou qualificação) ou não foram abordados. Criou-se um instrumento para coleta dos dados sociodemográficos, laborais e de saúde dos profissionais, a fim de caracterizá-los enquanto população-alvo. Além disso, foram utilizadas a EOT e a EDT do PROART para avaliar a exposição e a SPS-6 para avaliação do presenteísmo. Os resultados desta pesquisa constataram a ocorrência de presenteísmo entre os profissionais de enfermagem dos ambulatórios universitários. Dentre os 388 participantes, 51,0% (n=198) foram considerados presenteístas, porém com níveis de dificuldade de realização das atividades variados. Conclui-se que o presenteísmo tem relação com a organização do trabalho e com os danos relacionados ao trabalho, o que confirma a hipótese. Porém, ele é observado em intensidades diferentes, com grande necessidade de intervenções que possam contribuir de forma significativa no controle do problema, trazendo benefícios às instituições de saúde e principalmente à saúde do trabalhador.

The study presented as object the presenteeism in the outpatient nursing team of public universities in the city of Rio de Janeiro. The objectives were: to analyze the occurrence of presenteeism in the outpatient nursing team of University Hospitals in the city of Rio de Janeiro and its relation with the prescribed organization of work and with the damage related to work; to analyze the presenteeism in the outpatient nursing team in the University Hospitals in the city of Rio de Janeiro; to identify the professional perception of the work organization and its relation with presenteeism in the outpatient nursing team of University Hospitals in the city of Rio de Janeiro; to collect and measure the physical, psychological and social damages in the outpatient nursing team of University Hospitals and its relation with presenteeism; and to evaluate the association between the work organization and the damage related to work in the outpatient nursing team of University Hospitals. It was a transversal and descriptive study, with a quantitative approach about the occurrence of presenteeism in the university outpatient nursing team. The study was carried out in the medium and high complexity outpatient units in the public universities in the city of Rio de Janeiro. The criteria for inclusion in this study was defined as all nursing professionals that worked at medium and high complexity outpatient units and the criteria for exclusion were nursing professionals that worked at the administrative area and/or did not assist the client directly, in addition to those that were in extended leave (maternity, special, training and/or qualification) or were not approached. An instrument for the professionals' sociodemographic, work and health data collection were created, with the aim of characterize them as the target population. In addition, the Work Organization Scale (EOT) and the Damage at Work Scale (EDT) from PROART were used to evaluate the exposition to presenteeism and the SPS-6 were used to evaluate the presenteeism itself. The results of this study found the occurrence of presenteeism among the nursing professionals of the university outpatient units. Among the 388 participants, 51,0% (n=198) were considered presentists, but with different levels of difficulties to accomplish varied activities. It was concluded that the presenteeism is related to the organization of work and with the damages related with work, which confirms the original hypothesis. Nevertheless, it is found in different intensities, with high necessity of interventions that can contribute significantly to the problem control, allowing improvements in the health institutions and, most importantly, in the worker's health.

La investigación tuvo como objeto el presentismo en el equipo de enfermería en ambulatorio de universidades públicas de la ciudad de Rio de Janeiro. Los objetivos fueron: analizar la ocurrencia de presentismo en el equipo de enfermería ambulatoria de Hospitales Universitarios de la ciudad de Rio de Janeiro y su relación con la organización prescrita del trabajo y con los daños relacionados al trabajo; analizar el presentismo en la enfermería ambulatoria de Hospitales Universitarios de la ciudad de Rio de Janeiro; identificar la percepción profesional frente la organización del trabajo y su relación con el presentismo en el equipo de enfermería ambulatoria de Hospitales Universitarios de la ciudad de Rio de Janeiro; identificar y mensurar los daños físicos, psicológicos y sociales del equipo de enfermería ambulatoria de Hospitales Universitarios y su relación con el presentismo; y evaluar la asociación de la organización del trabajo y daños relacionados al trabajo en el equipo de enfermería ambulatoria de Hospitales Universitarios. Se trata de un estudio transversal, descriptivo, de enfoque cuantitativo sobre la ocurrencia del presentismo en el equipo de enfermería ambulatoria universitaria. Se realizó el estudio en las unidades de media y alta complejidad ambulatorias de las universidades públicas en la ciudad de Rio de Janeiro. Se estableció como el criterio de inclusión todos los profesionales de enfermería que trabajaban en unidades ambulatorias de media y alta complejidad universitaria y como criterio de exclusión, profesionales que actuaban en el área administrativa y/o no asistían directamente al cliente, además de los profesionales que tenían permiso prolongado (embarazo, especial, para capacitación y/o especialización) o no fueron abordados. Se creó un instrumento para recolectar datos sociodemográficos, laborales y de salud de los profesionales, a fin de caracterizarlos conforme población objetivo. Además, se utilizaron la EOT y la EDT del Protocolo de Evaluación de Riesgos Psicosociales de Trabajo (PROART) para evaluar la exposición y la SPS-6 para la evaluación del presentismo. Los resultados obtenidos de esta investigación constataron la ocurrencia del presentismo entre los profesionales de enfermería de los ambulatorios universitarios. Sobre 388 participantes, se consideró el 51,0% (n=198) como presentistas, pero con niveles de dificultad de ejecución de las actividades variados. Se concluyó que el presentismo tiene relación con la organización del trabajo y con los daños relacionados al trabajo, lo que comprueba la hipótesis. Sin embargo, se lo observa en intensidades diferentes, con gran necesidad de intervenciones que puedan contribuir de manera significativa en el control del problema, trayendo beneficios a las instituciones de salud y, principalmente, a la salud del trabajador.

Presenteeism in multiprofessional team workers in the Adult Intensive Care Unit / Presentismo en trabajadores del equipo multiprofesional de Unidad de Terapia Intensiva Adulta / Presenteísmo em trabalhadores da equipe multiprofissional de Unidade de Terapia Intensiva Adulta

ABSTRACT Objective: To analyze the occurrence of presenteeism in multiprofessional team workers of an Adult Intensive Care Unit, relating it to sociodemographic and labor characteristics. Method: It is an analytical cross-sectional qualitative study, which used a questionnaire for sociodemographic data collection, and Stanford Presenteeism Scale(SPS-6) to assess presenteeism. Results: There was predominance of women (75.9%), nursing workers (66.7%), mean age of 39.81 years, and 6 to 10 years (31.6%) of experience in the labor market. Regarding presenteeism, 48.7% presented work impairment and 31.8% presentedperformance and completion of tasks altered by this phenomenon. Conclusion: Expressive numbers of general presenteeism were identified, with results indicating impairment in completing work. When connecting presenteeism to sociodemographic and labor characteristics, the variables sex, dependent children and absence from work presented values with statistical significance among the studied workers.

RESUMEN Objetivo: Analizar la ocurrencia del presentismo en trabajadores del equipo multiprofesional de una Unidad de Terapia Intensiva Adulta y relacionar con las características sociodemográficas y laborales. Método: Estudio analítico, transversal y cuantitativo, que utilizó para la recolección de datos un cuestionario para la obtención de los datos sociodemográficos y la Stanford Presenteeism Scale SPS-6 para evaluar el presentismo. Resultados: La mayoría fue de mujeres (75,9%), trabajadoras de enfermería (66,7%), con una media de edad de 39,81 años y con 6 a 10 años (31,6%) de trabajo. Acerca del presentismo, el 48,7% presentó compromiso en el trabajo, y el 31,8% tuvo la realización y finalización de las tareas alteradas por este fenómeno. Conclusión: Se identificaron números expresivos de presentismo general, con resultados que indican compromiso en la finalización del trabajo. Al relacionar el presentismo con las características sociodemográficas y laborales, las variables género, tener hijos dependientes y haber se alejado del trabajo presentar on valores consignificación estadística entre los trabajadores estudiados.

RESUMO Objetivo: Analisar a ocorrência do presenteísmo em trabalhadores da equipe multiprofissional de uma Unidade de Terapia Intensiva Adulta e relacionar com as características sociodemográficas e laborais. Método: Estudo analítico, transversal e quantitativo, que utilizou para a coleta de dados um questionário para a obtenção dos dados sociodemográficos e a Stanford Presenteeism Scale SPS-6 para avaliar o presenteísmo. Resultados: Predominaram mulheres (75,9%), trabalhadoras de enfermagem (66,7%), com média de idade de 39,81 anos e com 6 a 10 anos (31,6%) de trabalho. Quanto ao presenteísmo, 48,7% apresentaram comprometimento no trabalho e 31,8% tiveram a realização e finalização das tarefas alteradas por este fenômeno. Conclusão: Foram identificados números expressivos de presenteísmo geral, com resultados que indicam comprometimento na finalização do trabalho. Relacionando o presenteísmo com as características sociodemográficas e laborais, as variáveis sexo, ter filhos dependentes e ter-se afastado do trabalho apresentaram valores com significância estatística entre os trabalhadores estudados.

Burden of rheumatoid arthritis on patients' work productivity and quality of life

Abstract Background: To determine the burden of Rheumatoid Arthritis (RA) on patients' work productivity and health related quality of life (HRQoL), and examine the influence of several exposure variables; to analyze the progression of RA over 1 year and its impact on work productivity and HRQoL. Methods: International multicenter prospective survey including patients in 18 centers in Argentina, Brazil, Colombia and Mexico with diagnosis of RA and aged between 21-55 years. The following standard questionnaires were completed at baseline and throughout a 1-year follow-up: WPAI:RA, WALS, WLQ-25, EQ-5D-3 L and SF-36. Clinical and demographic variables were also collected through interview. Results: The study enrolled 290 patients on baseline visit. Overall mean scores at baseline visit were: WPAI:RA (presenteeism) = 29.5% (SD = 28.8%); WPAI:RA (absenteeism) = 9.0% (SD = 23.2%); WPAI:RA (absenteeism and presenteeism) = 8.6% (SD = 22.6%); WALS = 9.0 (SD = 6.1); WLQ-25 = 7.0% (SD = 5.1%); SF-36 Physical Scale = 39.1 (SD = 10.3) and Mental Scale = 45.4 (SD = 11.3); EQ-5D-3 L VAS = 69.8 (SD = 20.4) and EQ-5D-3 L index = 0.67 (SD = 0.23). Higher educational levels were associated with better results in WLQ-25, while previous orthopedic surgeries reduced absenteeism results of WPAI:RA and work limitations in WLQ-25. Higher disease duration was associated with decreased HRQoL. Intensification of disease activity was associated with decreased work productivity and HRQoL, except in WLQ-25. In the longitudinal analysis, worsening in disease activity was associated with a decrease in both work productivity and HRQoL. Conclusions: RA patients are dealing with workplace disabilities and limitations and loss in HRQoL, and multiple factors seems to be associated with this. Worsening of disease activity further decreased work productivity and HRQoL, stressing the importance of disease tight control.