Through sickness and health? A qualitative investigation into the decision to work whilst sick and the consequences for employee well-being

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Presenteeism, the act of working whilst sick, is a global phenomenon of increasing interest to scholars and practitioners alike. This rise in interest stems from evidence of detrimental consequences to both mental and physical well-being, including an increased risk of anxiety and depression. Research has also emphasised the significant impact of presenteeism on employee performance, an issue that is often overlooked by organisations, despite suggestions that the costs outweigh those stemming from absenteeism. Due to COVID-19, presenteeism has become increasingly salient in the public domain. Here we see the tensions between an increasing need to keep sick people at home to curb occupational spread, alongside a rising pressure on organisations to remain profitable, that could result in organisations aiming to reduce the costs associated with sickness absence. With many employees also facing ongoing job insecurity, individuals may continue to work due to a fear of the consequences if they are absent. Due to these risk factors, there is an urgent need to better understand how someone comes to decide to work whilst sick and the consequences to well-being. There is a rich body of research exploring the antecedents and correlates of presenteeism, however, there is a lack of focus on intra-individual processes and dynamics triggering the behaviour. In addition to this, existing evidence of the consequences of presenteeism has produced mixed findings, with the majority of research concentrating on the negative outcomes associated with working whilst unwell. This study will employ a multi-method qualitative design to explore the decision-making processes driving presenteeism and its consequences for well-being. Specifically, the research will combine in-depth semi-structured interviews with qualitative diaries. This will enable a rich and unique insight into the lived experience of this dynamic behaviour, including when working whilst sick may be a sustainable choice. By capturing lived experiences of presenteeism, this research will offer valuable insights into the effects on mental health and crucially how these outcomes can be managed, but equally, offer an enhanced understanding of how and when presenteeism can lead to beneficial outcomes. By acknowledging that COVID-19 may have a significant impact and influence on the decision to work while sick, this research will also provide practical knowledge to organisations on how they can manage presenteeism as we emerge from the pandemic.