NURSES COMING TO WORK DESPITE ILLNESS: THE ROLE OF ETHICAL LEADERSHIP BY NURSE MANAGERS

Yıl 2025, Cilt: 23 Sayı: 55, 457 - 475, 25.01.2025

Fadime Ulupınar , Furkan Bozdoğan

https://doi.org/10.35408/comuybd.1546810

Öz

Presenteeism, the act of coming to work while ill, is a prevalent issue among nurses, potentially affecting both nurse health and the quality of patient care. Ethical leadership by nurse managers may play a critical role in reducing presenteeism among nurses. However, studies investigating the impact of ethical leadership on presenteeism are limited, and there is a lack of clear understanding of this relationship in the existing literature. This study aimed to determine the extent to which nurses' perceptions of their managers' ethical leadership influence presenteeism behavior among nurses. Additionally, the study explored how these two concepts are affected by socio-demographic characteristics. A cross-sectional research design was employed, and 307 nurses from a public hospital participated in the study. Data were collected using a descriptive form, the Ethical Leadership Scale, and the Sickness Presenteeism Scale. Hierarchical regression analysis was conducted to determine the impact of ethical leadership on presenteeism. The findings indicated that ethical leadership was the only significant predictor of presenteeism, with higher levels of ethical leadership associated with lower levels of presenteeism. The study also found that other socio-demographic variables (gender, age, marital status, education level, years of service, working unit) did not have a significant impact on presenteeism. This study demonstrated that ethical leadership significantly reduces presenteeism among nurses. This finding contributes to a better understanding of the impact of ethical leadership on presenteeism, which has been underexplored in the literature. It is recommended that healthcare organizations consider ethical leadership practices to support nurse health and performance. Future research should examine the effects of ethical leadership in different healthcare settings and among various professional groups to validate these findings.

Anahtar Kelimeler

Ethical Leadership, Nurse Health, Nursing, Patient Care Quality, Presenteeism

HASTALIKLARINA RAĞMEN İŞE GELEN HEMŞİRELER: HEMŞİRE YÖNETİCİLERİN ETİK LİDERLİĞİNİN ROLÜ

Öz

Hemşireler arasında yaygın bir sorun olan hasta olarak işe gitme durumu (presenteeism), hem hemşire sağlığını hem de hasta bakım kalitesini olumsuz etkileyebilir. Hemşire yöneticilerinin etik liderliği, hemşireler arasında presenteeizmi azaltmada kritik bir rol oynayabilir. Ancak, etik liderliğin presenteeizm üzerindeki etkilerini araştıran çalışmalar sınırlıdır ve mevcut literatürde bu ilişkiye dair net bir anlayış eksiktir. Bu çalışmada hemşirelerin, yöneticilerine ilişkin etik liderlik algılarının hemşireler arasındaki hastalık presenteeizmi davranışı üzerinde ne kadar etkili olduğunu belirlemek amaçlanmıştır. Aynı zamanda bu iki kavramın sosyo-demografik özelliklerden nasıl etkilendiği araştırılmıştır. Bu çalışmada kesitsel bir araştırma tasarımı kullanılmış ve çalışmaya bir kamu hastanesinden 307 hemşire katılmıştır. Veriler tanımlayıcı bir form, Etik Liderlik Ölçeği ve Hastalık Presenteeizm Ölçeği kullanılarak toplanmıştır. Etik liderliğin presenteeizm üzerindeki etkisini belirlemek amacıyla hiyerarşik regresyon analizi yapılmıştır. Bulgular, etik liderliğin presenteeizmi azaltmada tek anlamlı belirleyici olduğunu ve daha yüksek etik liderlik seviyelerinin daha düşük presenteeizm seviyeleri ile ilişkili olduğunu göstermiştir. Çalışmada ayrıca, diğer sosyo-demografik değişkenlerin (cinsiyet, yaş, medeni durum, eğitim seviyesi, hizmet yılı, çalışma birimi) presenteeizm üzerinde anlamlı bir etkisinin olmadığı saptanmıştır. Bu çalışma, etik liderliğin hemşireler arasında presenteeizmi önemli ölçüde azalttığını ortaya koymuştur. Bu bulgu, literatürde eksik olan etik liderliğin presenteeizm üzerindeki etkisinin daha iyi anlaşılmasına yardımcı olmaktadır. Sonuç olarak, sağlık kuruluşlarının hemşire sağlığını ve performansını desteklemek için etik liderlik uygulamalarını dikkate alması gerektiği önerilmektedir. Gelecekteki araştırmaların etik liderliğin etkilerini daha farklı sağlık ortamlarında ve farklı meslek gruplarında inceleyerek bu bulguları doğrulamalarının faydalı olacağı düşünülmektedir.

Anahtar Kelimeler

Etik Liderlik, Hasta Bakım Kalitesi, Hemşire Sağlığı, Hemşirelik, Presenteeizm

Etik Beyan

No potential conflicts of interest were declared by the authors. This study was supported by the TÜBİTAK–2209-A University Students Research Projects Support Program during the 2023/2 funding period. Approval for the study was obtained from the Research Ethics Committee of Erzurum Technical University (approved on April 4, 2024, during the 4th meeting, with decision number 19). Institutional permissions were also sought to conduct the study (approved on April 24, 2024, with reference number E-76614443-604.01-242877067). After completing the institutional permission processes, written and/or verbal informed consent was obtained from the participants before data collection.

Destekleyen Kurum

TÜBİTAK–2209-A University Students Research Projects Support Program

Kaynakça

• Abdul Halim, N. S. S., Mohd Ripin, Z., and Ridzwan, M. I. Z. (2023). Efficacy of interventions in reducing the risks of work-related musculoskeletal disorders among healthcare workers: a systematic review and meta-analysis. Workplace health and safety, 71(12), 557-576. https://doi.org/10.1177/21650799231185335.
• Abou-ElWafa, H. S., El-Metwaly, A. A., and El-Gilany, A.-H. (2020). Lower limb varicose veins among nurses: a single center cross-sectional study in Mansoura, Egypt. Indian Journal of Occupational and Environmental Medicine, 24(3), 172-177. DOI: 10.4103/ijoem.IJOEM_264_19.
• Aloustani, S., Atashzadeh-Shoorideh, F., Zagheri-Tafreshi, M., Nasiri, M., Barkhordari-Sharifabad, M., and Skerrett, V. (2020). Association between ethical leadership, ethical climate and organizational citizenship behavior from nurses’ perspective: a descriptive correlational study. BMC nursing, 19, 1-8. https://doi.org/10.1186/s12912-020-0408-1.
• AlShehhi, H., Alshurideh, M., Kurdi, B. A., and Salloum, S. A. (2020). The impact of ethical leadership on employees performance: A systematic review. Paper presented at the International conference on advanced intelligent systems and informatics. https://doi.org/10.1007/978-3-030-58669-0_38.
• Aronsson, G., Gustafsson, K., and Dallner, M. (2000). Sick but yet at work. An empirical study of sickness presenteeism. Journal of Epidemiology and Community Health, 54(7), 502-509. https://doi.org/10.1136/jech.54.7.502.
• Aslan, M., and Ulupinar, F. (2020). A danger for care quality and patient safety in nursing: presenteeism/Hemşirelikte bakım kalitesi ve hasta güvenliği için bir tehlike: İşte var olamama. Journal of Education and Research in Nursing, 17(3), 267-273. doi:10.5222/KUHEAD.2020.56873.
• Avolio, B. J., and Gardner, W. L. (2005). Authentic leadership development: Getting to the root of positive forms of leadership. The leadership quarterly, 16(3), 315-338. https://doi.org/10.1016/j.leaqua.2005.03.001.
• Baris, V. K., Intepeler, S. S., and Unal, A. (2023). Development and psychometric validation of the Sickness Presenteeism Scale‐Nurse. International Journal of Nursing Practice, 29(5), e13168. https://doi.org/10.1111/ijn.13168.
• Bergström, G., Bodin, L., Hagberg, J., Aronsson, G., and Josephson, M. (2009). Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. Journal of occupational and environmental medicine, 51(6), 629-638. DOI: 10.1097/JOM.0b013e3181a8281b.
• Brown, M. E., and Treviño, L. K. (2006). Ethical leadership: A review and future directions. The leadership quarterly, 17(6), 595-616. https://doi.org/10.1016/j.leaqua.2006.10.004.
• Brown, M. E., Treviño, L. K., and Harrison, D. A. (2005). Ethical leadership: A social learning perspective for construct development and testing. Organizational behavior and human decision processes, 97(2), 117-134. https://doi.org/10.1016/j.obhdp.2005.03.002.
• Cochran, W. G. (1942). Sampling theory when the sampling-units are of unequal sizes. Journal of the American Statistical Association, 37(218), 199-212. https://doi.org/10.1080/01621459.1942.10500626.
• Demerouti, E., Le Blanc, P. M., Bakker, A. B., Schaufeli, W. B., and Hox, J. (2009). Present but sick: a three‐wave study on job demands, presenteeism and burnout. Career Development International, 14(1), 50-68. DOI 10.1108/13620430910933574.
• Den Hartog, D. N., and Belschak, F. D. (2012). Work engagement and Machiavellianism in the ethical leadership process. Journal of business ethics, 107, 35-47. DOI 10.1007/s10551-012-1296-4.
• Dey, M., Bhattacharjee, S., Mahmood, M., Uddin, M. A., and Biswas, S. R. (2022). Ethical leadership for better sustainable performance: Role of employee values, behavior and ethical climate. Journal of Cleaner Production, 337, 130527. https://doi.org/10.1016/j.jclepro.2022.130527.
• Huhtala, M., Kangas, M., Lämsä, A. M., and Feldt, T. (2013). Ethical managers in ethical organisations? The leadership‐culture connection among Finnish managers. Leadership and Organization Development Journal, 34(3), 250-270. DOI 10.1108/01437731311326684.
• Jia, K., Zhu, T., Zhang, W., Rasool, S. F., Asghar, A., and Chin, T. (2022). The linkage between ethical leadership, well-being, work engagement, and innovative work behavior: the empirical evidence from the higher education sector of China. International journal of environmental research and public health, 19(9), 5414. https://doi.org/10.3390/ijerph19095414.
• Johns, G. (2010). Presenteeism in the workplace: A review and research agenda. Journal of organizational behavior, 31(4), 519-542. https://doi.org/10.1002/job.630.
• Karanika-Murray, M., Biron, C., Hervieux, V., Whysall, Z., and Chen, H. (2021). Managing presenteeism to optimise health and performance. In The SAGE Handbook of organizational wellbeing (pp. 232-247). London: Sage.
• Letvak, S. A., Ruhm, C. J., and Gupta, S. N. (2012). Nurses' presenteeism and its effects on self-reported quality of care and costs. AJN The American Journal of Nursing, 112(2), 30-38. DOI: 10.1097/01.NAJ.0000411176.15696.f9.
• Rainbow, J. G., Gilbreath, B., and Steege, L. M. (2019). How to know if you’re really there: An evaluation of measures for presenteeism in nursing. Journal of occupational and environmental medicine, 61(2), e25-e32. DOI: 10.1097/JOM.0000000000001506.
• Rainbow, J. G., and Steege, L. M. (2017). Presenteeism in nursing: An evolutionary concept analysis. Nursing Outlook, 65(5), 615-623. https://doi.org/10.1016/j.outlook.2017.03.005.
• Shan, G., Wang, S., Wang, W., Guo, S., and Li, Y. (2021). Presenteeism in nurses: prevalence, consequences, and causes from the perspectives of nurses and chief nurses. Frontiers in psychiatry, 11, 584040. https://doi.org/10.3389/fpsyt.2020.584040.
• Skagen, K., and Collins, A. M. (2016). The consequences of sickness presenteeism on health and wellbeing over time: a systematic review. Social Science and Medicine, 161, 169-177. https://doi.org/10.1016/j.socscimed.2016.06.005.
• Sun, W., Yin, L., Zhang, T., Zhang, H., Zhang, R., and Cai, W. (2023). Prevalence of work-related musculoskeletal disorders among nurses: a meta-analysis. Iranian journal of public health, 52(3), 463. doi: 10.18502/ijph.v52i3.12130.
• Treviño, L. K., Brown, M., and Hartman, L. P. (2003). A qualitative investigation of perceived executive ethical leadership: Perceptions from inside and outside the executive suite. Human relations, 56(1), 5-37. https://doi.org/10.1177/00187267030560014.
• Tuna, M., Bircan, H., ve Yeşiltaş, M. (2012). Etik liderlik ölçeği’nin geçerlilik ve güvenilirlik çalişmasi: antalya örneği. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 26(2), 143-155.
• Tüchsen, F., Hannerz, H., Burr, H., and Krause, N. (2005). Prolonged standing at work and hospitalisation due to varicose veins: a 12 year prospective study of the Danish population. Occupational and environmental medicine, 62(12), 847-850. https://doi.org/10.1136/oem.2005.020537.
• Walumbwa, F. O., Morrison, E. W., and Christensen, A. L. (2012). Ethical leadership and group in-role performance: The mediating roles of group conscientiousness and group voice. The leadership quarterly, 23(5), 953-964. https://doi.org/10.1016/j.leaqua.2012.06.004.
• Wang, Y.-X., Mínguez-Alarcón, L., Gaskins, A. J., Wang, L., Ding, M., Missmer, S. A., . . . Chavarro, J. E. (2022). Pregnancy loss and risk of cardiovascular disease: the Nurses’ Health Study II. European Heart Journal, 43(3), 190-199. https://doi.org/10.1093/eurheartj/ehab737.
• Wong, C. A., and Cummings, G. G. (2007). The relationship between nursing leadership and patient outcomes: a systematic review. Journal of nursing management, 15(5), 508-521. https://doi.org/10.1111/j.1365-2834.2007.00723.x.
• Yip, Y. b. (2001). A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong. Journal of advanced nursing, 36(6), 794-804. https://doi.org/10.1046/j.1365-2648.2001.02037.x.