Presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention among nurses: a structural equation modeling study
- 1School of Nursing, Suzhou Medical College, Soochow University , ,
- 2Department of Nursing, First Affiliated Hospital of Dali University , ,
Abstract
Background: The interrelationships between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention remain insufficiently understood in nursing populations.
Objective: This study examined the associations between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention.
Methods: A cross-sectional survey was conducted involving 511 nurses. Composite scores from the Work Productivity and Activity Impairment (WPAI) questionnaire, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), the Quality of Nursing Care Tool, and the Nurse Retention Intention Scale were analyzed using an observed-composite path structural equation modeling (SEM) approach. Indirect effects were estimated using 5,000 bootstrap resamples with percentile-based 95% confidence intervals.
Results: Presenteeism was positively associated with burnout (β = 0.262, p < 0.001) and negatively associated with the quality of nursing care (β = −0.250, p < 0.001) and retention intention (β = −0.334, p < 0.001). Burnout was negatively associated with the quality of nursing care (β = −0.177, p < 0.001) and retention intention (β = −0.179, p < 0.001). Bootstrap analyses indicated indirect associations between presenteeism and productivity loss and both outcomes through burnout. The model showed an acceptable but imperfect fit: χ ² (4) = 13.151, CFI = 0.959, TLI = 0.877, RMSEA = 0.067, and SRMR = 0.043.
Conclusion: Higher presenteeism was statistically associated with lower retention intention and poorer nursing care quality, both directly and indirectly, through burnout. Health-related productivity loss showed indirect associations with both outcomes through burnout.
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BibTeX
@article{peng2026presenteeism,
title = {{Presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention among nurses: a structural equation modeling study}},
author = {Mengyun Peng and Jiqin Ma and Wenyu Shi and Suyan Chen and Zixuan Zhang and Xiaoling Zhu},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1962028},
url = {https://europepmc.org/article/PMC/PMC13663174},
note = {CC BY},
}
RIS
TY - JOUR
TI - Presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention among nurses: a structural equation modeling study
AU - Mengyun Peng
AU - Jiqin Ma
AU - Wenyu Shi
AU - Suyan Chen
AU - Zixuan Zhang
AU - Xiaoling Zhu
PY - 2026
DA - 2026/10/14
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1962028
UR - https://europepmc.org/article/PMC/PMC13663174
AB - Background: The interrelationships between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention remain insufficiently understood in nursing populations. Objective: This study examined the associations between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention. Methods: A cross-sectional survey was conducted involving 511 nurses. Composite scores from the Work Productivity and Activity Impairment (WPAI) questionnaire, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), the Quality of Nursing Care Tool, and the Nurse Retention Intention Scale were analyzed using an observed-composite path structural equation modeling (SEM) approach. Indirect effects were estimated using 5,000 bootstrap resamples with percentile-based 95% confidence intervals. Results: Presenteeism was positively associated with burnout (β = 0.262, p < 0.001) and negatively associated with the quality of nursing care (β = −0.250, p < 0.001) and retention intention (β = −0.334, p < 0.001). Burnout was negatively associated with the quality of nursing care (β = −0.177, p < 0.001) and retention intention (β = −0.179, p < 0.001). Bootstrap analyses indicated indirect associations between presenteeism and productivity loss and both outcomes through burnout. The model showed an acceptable but imperfect fit: χ ² (4) = 13.151, CFI = 0.959, TLI = 0.877, RMSEA = 0.067, and SRMR = 0.043. Conclusion: Higher presenteeism was statistically associated with lower retention intention and poorer nursing care quality, both directly and indirectly, through burnout. Health-related productivity loss showed indirect associations with both outcomes through burnout.
SN - 2296-2565
ER -