This position paper brings together recent and emerging developments in the field of presenteeism. A critical synthesis of the evidence is needed due to persisting conceptual and methodological challenges as well as the increased volume of research in the field. This paper integrates emerging evidence and critical thinking into three areas: (1) concept, (2) measurement and methodological issues, and (3) the context of presenteeism. First, due to the variety of existing definitions, competing understandings, as well as the notion of positive presenteeism, it is important to reconsider the notion of presenteeism. Second, it is important to reflect on the measurement of the act of presenteeism and the productivity loss associated with that. Third, following the call to investigate presenteeism in specific contexts, it is important to explain the social, occupational, cross-cultural aspects, as well as the contemporary workplace changes. Based on this critical synthesis, we conclude by identifying recommendations for future research on presenteeism.

The substantial health and financial costs of presenteeism are well-documented. Paradoxically, presenteeism also has a positive side, which has been largely overlooked. Emerging evidence shows that presenteeism can be a choice that offers a range of positive benefits to the ‘presentee’ (an employee who works through illness). In this conceptual article, we view presenteeism as purposeful and adaptive behaviour: a dynamic process that serves the purpose of balancing health constraints and performance demands in tandem. We propose a 2×2 framework of presenteeism (therapeutic, functional, overachieving, and dysfunctional) and suggest that the success of the presenteeism adaptation process depends on the availability of internal capacities and flexible work resources. When the workplace is supportive and provides adequate resources to aid adaptation, presenteeism can be a sustainable choice for maintaining performance under impaired health. We examine the role of resources for functional presenteeism by drawing on conservation of resources theory and self-determination theory. This framework can contribute to a better understanding of presenteeism by viewing it as an adaptive process, considering presentees as heterogeneous groups, and exploring the importance of internal and work resources for balancing health and performance demands. It sketches new avenues for research and practice and the effective management of presenteeism, health, and performance.

Introduction: The COVID-19 pandemic has led to a significant increase in the proportion of employees for whom teleworking became mandatory. Presenteeism, or the behavior of working while ill, has hardly been studied in the context of telework. The pandemic forced millions of workers to abruptly transition to working from home for a prolonged period of time, leaving employers often unaware of their health status or work capacity of the workers. This change also eroded the work experience itself, the workplace, and their protective impact on both individual health and work outcomes. This study focused on the longitudinal relationships among psychosocial safety climate (PSC), a lead indicator of workplace conditions, psychological demands, an indicator of quality of work, and presenteeism among a representative sample of teleworkers. PSC was expected to have an indirect impact on presenteeism with psychological demands as a mediator of this impact.Method: We collected the data from a representative sample of teleworkers in the first months (T1: April, T2: June, and T3: December 2020) of the pandemic using a three-wave online survey (n = 275). We tested a model of PSC as a determinant of presenteeism in teleworkers with psychological demands as a mediator. A cross-lagged panel model was estimated to test cross-sectional and longitudinal relationships.Findings: As expected, psychological demands increased over time. Contrary to expectations, the prevalence of presenteeism remained unchanged while PSC increased over time. The data fully supported the mediating effect of psychological demands such that a higher evaluation of PSC at T1 led to lower psychological demands at T2, which led to reduced presenteeism at T3. We also found a reciprocal relationship, with higher psychological demands at T2 leading to decreased evaluation of PSC at T3. These results show that the perception of teleworkers on their organization as giving a high priority to their psychological health is an important determinant of their work experience, ultimately influencing their decision to work while ill. The context of the pandemic has highlighted the importance of a positive workplace climate and working conditions for reducing the behaviors that can be harmful to health and productivity. Implications for theory and practice, beyond the pandemic, are discussed.

Healthcare workers (HCWs) on the frontline of the COVID-19 pandemic exhibit a high prevalence of depression and psychological distress. Moral injury (MI) can lead to such mental health problems. MI occurs when perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. Since the start of the pandemic, psychosocial stressors at work (PSWs) might have been exacerbated, which might in turn have led to an increased risk of MI in HCWs. However, research into the associations between PSWs and MI is lacking. Considering these stressors are frequent and most of them are modifiable occupational risk factors, they may constitute promising prevention targets. This study aims to evaluate the associations between a set of PSWs and MI in HCWs during the third wave of the COVID-19 pandemic in Quebec, Canada. Furthermore, our study aims to explore potential differences between urban and non-urban regions. The sample of this study consisted of 572 HCWs and leaders from the Quebec province. Prevalence ratios (PR) of MI and their 95% confidence intervals (CI) were modelled using robust Poisson regressions. Several covariates were considered, including age, sex, gender, socio-economic indicators, and lifestyle factors. Results indicated HCWs exposed to PSWs were 2.22–5.58 times more likely to experience MI. Low ethical culture had the strongest association (PR: 5.58, 95% CI: 1.34–23.27), followed by low reward (PR: 4.43, 95% CI: 2.14–9.16) and high emotional demands (PR: 4.32, 95% CI: 1.89–9.88). Identifying predictors of MI could contribute to the reduction of mental health problems and the implementation of targeted interventions in urban and non-urban areas.