The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Original Research: Nurses' Presenteeism and Its Effects on Self-Reported Quality of Care and Costs
Abstract
OBJECTIVE: Although research has been conducted on how nurse staffing levels affect outcomes, there has been little investigation into how the health-related productivity of nurses is related to quality of care. Two major causes of worker presenteeism (reduced on-the-job productivity as a result of health problems) are musculoskeletal pain and mental health issues, particularly depression. This study sought to investigate the extent to which musculoskeletal pain or depression (or both) in RNs affects their work productivity and self-reported quality of care and considered the associated costs. METHODS: Using a cross-sectional survey design, a random sample of 2,500 hospital-employed RNs licensed in North Carolina were surveyed using a survey instrument sent by postal mail. Specific measures included questions on individual and workplace characteristics, self-reported quality of care, and patient safety; a numeric pain rating scale, a depression tool (the Patient Health Questionnaire), and a presenteeism tool (the Work Productivity and Activity Impairment Questionnaire: General Health) were also incorporated. A total of 1,171 completed surveys were returned and used for analysis. RESULTS: Among respondents, the prevalence of musculoskeletal pain was 71%; that of depression was 18%. The majority of respondents (62%) reported a presenteeism score of at least 1 on a 0-to-10 scale, indicating that health problems had affected work productivity at least "a little." Pain and depression were significantly associated with presenteeism. Presenteeism was significantly associated with a higher number of patient falls, a higher number of medication errors, and lower quality-of-care scores. Baseline cost estimates indicate that the increased falls and medication errors caused by presenteeism are expected to cost $1,346 per North Carolina RN and just under $2 billion for the United States annually. Upper-boundary estimates exceed $9,000 per North Carolina RN and $13 billion for the nation annually. CONCLUSION: More attention must be paid to the health of the nursing workforce to positively influence the quality of patient care and patient safety and to control costs.
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“These symptoms have been found to be associated with poor job satisfaction, nursing quality, work performance, and increased absenteeism and turnover among nurses [4-6].”
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“and in decreased work performance, especially quality of care provided by nurses9–13.”
From Effect of smartphone-based stress management programs on depression and anxiety of hospital nurses in Vietnam: a three-arm randomized controlled trial (2021) · cites this paper as [12]
In the citing paper
“It is known that psychological distress (i.e., depression and anxiety) among workers results in substantial deterioration in workers’ quality of life and economic loss in the workplace, and in decreased work performance, especially quality of care provided by nurses9–13.”
From Effect of smartphone-based stress management programs on depression and anxiety of hospital nurses in Vietnam: a three-arm randomized controlled trial (2021) · cites this paper as [12]
Citations
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
Mail and Telephone Surveys: The Total Design Method.
Babbie, E. R., & Dillman, D. A. (1982) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2068433 · Cited by 6,859
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Aiken, L. H. (2002) · JAMA · doi:10.1001/jama.288.16.1987 · Cited by 5,226
Lost productive time and cost due to common pain conditions in the US workforce
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.290.18.2443 · Cited by 1,570
Responsiveness of the Numeric Pain Rating Scale in Patients with Low Back Pain
Childs, J. D., Piva, S. R., & Fritz, J. M. (2005) · Spine · doi:10.1097/01.brs.0000164099.92112.29 · Cited by 1,481
Cost of Lost Productive Work Time Among US Workers With Depression
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.289.23.3135 · Cited by 1,421
Sick but yet at work. An empirical study of sickness presenteeism
Aronsson, G., Gustafsson, K., & Dallner, M. (2000) · Journal of Epidemiology & Community Health · doi:10.1136/jech.54.7.502 · Cited by 1,250
Hospital staffing, organization, and quality of care: cross-national findings
Aiken, L. H. (2002) · International Journal for Quality in Health Care · doi:10.1093/intqhc/14.1.5 · Cited by 728
Work stress precipitates depression and anxiety in young, working women and men
MELCHIOR, M., CASPI, A., MILNE, B. J., DANESE, A., POULTON, R., & MOFFITT, T. E. (2007) · Psychological Medicine · doi:10.1017/s0033291707000414 · Cited by 691
Implications of an Aging Registered Nurse Workforce
Buerhaus, P. I. (2000) · JAMA · doi:10.1001/jama.283.22.2948 · Cited by 593
Research works printed but not linked: 4
- 2011, An estimated 1 in 10 U.S., adults report depression
- 2011, About medication errors: what is a medication error
- 1999, ANA indicator history
- 2010, S. Census Bureau. Table 638. Employer costs of employee compensation per hour worked: 2008 Section 12. Labor force, employment, and earnings. Washington, DC: U.S., Department of Commerce
Cited by
Sorted by citations
Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study
Cheung, T. C. C., & Yip, P. S. F. (2015) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph120911072 · Cited by 405
“In consequence, nurses are at a high risk of developing work-related stress and associated forms of psychiatric morbidity, including depression [10,25,31,32].”
BackgroundDyrbye, L. N., Shanafelt, T. D., Johnson, P. O., Johnson, L. M., Satele, D., & West, C. P. (2019) · BMC Nursing · doi:10.1186/s12912-019-0382-7 · Cited by 391
Nurses and Health‐Promoting Behaviors: Knowledge May Not Translate Into Self‐Care
Ross, A. C., Bevans, M. F., Brooks, A. T., Gibbons, S. W., & Wallen, G. R. (2017) · AORN Journal · doi:10.1016/j.aorn.2016.12.018 · Cited by 255
“of 1,171 staff nurses revealed a musculoskeletal pain prevalence rate of 71%, with the majority of these nurses (62%) indicating that pain (and depression) led to decreased productivity at work.(49) Staff member absences as a result of an”
BackgroundEffectiveness of lifestyle health promotion interventions for nurses: a systematic review
Stanulewicz, N., Knox, E., Narayanasamy, M., Shivji, N., Khunti, K., & Blake, H. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010017 · Cited by 206
“Nurses’ ill-health impacts on productivity [31], care quality [31,32], absenteeism and turnover [33], continuity of care [34] and patient safety (e.”
BackgroundSickness presenteeism at work: prevalence, costs and management
Kinman, G. (2018) · British Medical Bulletin · doi:10.1093/bmb/ldy043 · Cited by 175
Metadata
- Authors
- Letvak, S. A., Ruhm, C. J., & Gupta, S. N.
- Affiliations
- University of North Carolina at Greensboro (US)
- Venue
- AJN, American Journal of Nursing
- Published
- 2012-02
- Volume
- 112
- Issue
- 2
- Pages
- 30-38
- ISSN
- 0002-936X (ISSN-L)
- OpenAlex
- W1531597194
- Cited by
- 322
- References
- 58
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 26 · 2023: 24 · 2022: 29 · 2021: 39 · 2020: 34 · 2019: 30 · 2018: 27 · 2017: 21 · 2016: 16 · 2015: 14 · 2014: 9 · 2013: 13 · 2012: 2
- FWCI
- 21.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- AJN American Journal of Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- musculoskeletal pain, depression, quality of care, patient safety, patient falls, medication errors, nursing workforce health, cost estimation, registered nurses
- MeSH terms
- Accidental Falls, Adult, Aged, Cross-Sectional Studies, Depressive Disorder, Efficiency, Female, Humans, Male, Medication Errors, Middle Aged, North Carolina, Nursing Staff, Hospital, Quality of Health Care, Prevalence, Health Care Costs, Musculoskeletal Pain, Patient Safety
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