Abstract
Aim. This paper is a report of a cohort study of healthcare workers’ work attendance,and its long-term consequences’ on health, burnout, work ability and performance.Background. Concepts and measures of work attendance have varied in the scientificliterature. Attending work in spite of being sick can have serious consequences onhealth. There is little knowledge on which individual and work-related conditionsthat increase work attendance and the long-term impact on health and performance.Method. Prospective analyses of three measures of work attendance i.e. sicknessattendance, uninterrupted long-term attendance and balanced attendance (£7 days ofsick leave per year and no sickness attendance) were done using questionnaire datafrom a 2-year cohort study (2004–2006) of randomly selected healthcare workers(n = 2624). Incentives (e.g. effort-reward balance, social support, meaningfulness)and requirements (e.g. time-pressure, dutifulness, high responsibility) to attend workas well as general health, burnout, sick leave, work ability and performance wereassessed.Results. There was a positive relation between balanced work attendance andincentives, whereas high sickness attendance was associated with requirements.Follow up after 2 years showed that balanced attendance was associated with sus-tained health and performance while sickness attendance was associated with poorhealth, burnout, sick-leave and decreased performance.Conclusion. It is important to distinguish between measures of work attendance asthey differ in relation to incentives, and health- and performance-related conse-quences. Sickness attendance seems to be an important risk indicator. A balancedwork attendance should be promoted for sustained health and performance inhealthcare organisations.Keywords: burnout, nurses, nursing workforce, presenteeism, psychosocial factors,sick-leave, stress, work ability