[2026-06-05] Strained but Staying: Job Strain, Presenteeism, and Sickness Absenteeism Among Academic Staff in a Thai Teaching Hospital

Jirun Pongsawatmanit; Chathaya Wongrathanandha; Wichai Aekplakorn; Lakkana Hengboriboon; Oraluck Pattanaprateep; Warisa Soonthornvinit

doi:10.33165/rmj.2027.e279299

Authors

Jirun Pongsawatmanit Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0009-0002-0028-1204
Chathaya Wongrathanandha Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0000-0002-3565-7446
Wichai Aekplakorn Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0000-0002-3292-510X
Lakkana Hengboriboon Business Division, Khon Kaen University International College, Khon Kaen University, Khon Kaen, Thailand https://orcid.org/0000-0002-0659-2225
Oraluck Pattanaprateep Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0000-0001-9570-2635
Warisa Soonthornvinit Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0009-0002-5831-9375

DOI:

https://doi.org/10.33165/rmj.2027.e279299

Keywords:

Job strain, Presenteeism, Sickness absenteeism, Academic staff, Teaching hospital, Job demand-control model

Abstract

Background: Academic staff in teaching hospitals face complex workplace challenges that may contribute to job strain, affecting health and productivity. Despite crucial roles in healthcare and education, research specifically examining job strain among academic staff in teaching hospitals remains remarkably limited.

Objectives: To examine job strain prevalence and its associations with sickness absenteeism and presenteeism among academic staff at a teaching hospital in Thailand.

Methods: This analytical cross-sectional study included 189 academic staff who completed validated questionnaires assessing job demands, job control, social support, and financial well-being. Job strain was assessed using the Karasek job demand-control model and extended with the social support dimension model. Participants were classified as high-strain, active, passive, or low-strain based on median splits of job demand and job control, with social support assessed as an additional psychosocial dimension and included as a covariate in the multivariable models. Negative binomial regression was used to examine associations between job strain and productivity outcomes.

Results: High job strain prevalence was 23.3%, with active strain most common (30.7%). Presenteeism was substantially more prevalent than sickness absenteeism (48.1% vs 24.3%). Active strain (adjusted relative risk [RR], 2.74; 95% CI, 1.45-5.17) and high strain (adjusted RR, 3.04; 95% CI, 1.55-5.95) were significantly associated with presenteeism when compared with low strain. Financial well-being showed the strongest association for both outcomes, with low financial well-being associated with increased sickness absenteeism (adjusted RR, 4.97; 95% CI, 1.60-15.50) and presenteeism (adjusted RR, 2.92; 95% CI, 1.40-6.12). Job strain was not significantly associated with sickness absenteeism

Conclusions: Job strain was significantly associated with presenteeism but not with sickness absenteeism among academic staff in teaching hospitals. The high prevalence of presenteeism raises concerns about work quality and patient safety. Comprehensive interventions addressing job strain and financial well-being may improve staff well-being and productivity in academic healthcare settings.

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