Job stress, sickness absence and sickness presenteeism in Nordic elderly care

Aims: Nordic elderly care has been restructured to obtain more efficiency. Among workers caring for the elderly, levels of perceived job stress could vary, due to understaffing and resource scarcity. This study examines how sickness absence and sickness presenteeism are associated with perceived job stress. Methods: Data were obtained by posting questionnaires to lower-level care staff in Sweden (n=483), Denmark (n=704), Finland (n=597), and Norway (n=663). Self-reports about job stress (four items), sickness absence and sickness presenteeism were analysed by cross-tabulations and logistic regression. Results: Each item of job stress was associated with sickness absence and sickness presenteeism in the samples from all four countries. With low levels of job stress, levels of reported sickness absence and sickness presenteeism were relatively moderate. With increasing levels of job stress, the level of sickness presenteeism rose more sharply than that of sickness absence. Conclusions: The results can be interpreted in the light of features inherent in care work. Owing to professional norms and moral obligations, care workers could lower their thresholds for taking sick leave when care organizations are understaffed, because absences will be particularly critical for care recipients in such circumstances. Thus, while increasing job stress tends to be accompanied both by more sickness absence and by more sickness presenteeism, sickness presenteeism rises particularly in cases of high levels of job stress. Owing to cross-sectional data and self-reported information, conclusions arc tentative.