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

出勤主义，即在生病时工作的行为，是一种日益引起学者和实践者兴趣的全球现象。这种兴趣的上升源于有证据表明，对心理和身体健康都有有害的后果，包括焦虑和抑郁的风险增加。研究还强调了出勤对员工绩效的重大影响，这是一个经常被组织忽视的问题，尽管有迹象表明，出勤的成本超过了缺勤造成的成本。由于新冠肺炎的存在，考勤主义在公共领域变得越来越突出。在这里，我们看到了越来越多的需要将病人留在家里以遏制职业传播，以及组织面临的保持盈利的压力之间的紧张关系，这可能导致组织致力于降低与病假相关的成本。由于许多员工还面临着持续的工作不稳定，个人可能会继续工作，因为他们担心自己缺席的后果。由于这些风险因素，迫切需要更好地了解一个人是如何决定在生病期间工作的，以及对健康的影响。有大量的研究探索了出勤症的前因和相关性，然而，缺乏对触发这种行为的个体内部过程和动力的关注。除此之外，现有的关于出勤主义后果的证据也产生了不同的结论，大多数研究集中在与工作相关的负面结果上。本研究将采用多方法的定性设计来探索决策过程驱动出勤主义及其对幸福感的影响。具体地说，研究将深度半结构化访谈与定性日记相结合。这将使人们能够对这种动态行为的生活体验有丰富而独特的洞察，包括在生病时工作可能是一个可持续的选择。通过捕捉出勤主义的真实经历，这项研究将提供对心理健康影响的有价值的见解，关键是如何管理这些结果，但同样，也提供了对出勤主义如何以及何时能够带来有益结果的更好的理解。通过承认新冠肺炎可能会对人们在生病期间工作的决定产生重大影响，这项研究也将为组织提供实用知识，帮助他们在我们摆脱疫情后如何管理出勤。

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.