Multifaceted analysis of presenteeism: contributions of pain, psychological factors and daily functioning - a cross-sectional study in Japan

Abstract

Objective: Presenteeism, defined as reduced work efficiency due to health issues despite attending work, accounts for a substantial proportion of labour productivity loss. Although pain significantly impacts presenteeism, the relationship between pain and presenteeism remains poorly understood due to the multifaceted nature of pain, encompassing psychosocial factors and daily functioning. This study aimed to identify which of these factors are significantly associated with presenteeism among employees.

Design: Cross-sectional study using self-administered questionnaires and generalised additive model analysis.

Setting: Multiple workplaces (including a university and hospitals) in Japan.

Participants: Employed individuals (n=212, age range: 20-65 years; 59 males and 153 females) participated. They were recruited through workplace bulletin boards, email announcements and direct invitations. Participants with and without chronic pain were included.

Primary and secondary outcome measures: Participants completed self-report measures, including the Health and Work Performance Questionnaire (HPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Pain Catastrophising Scale (PCS), Beck Depression Inventory-second edition (BDI-II), State-Trait Anxiety Inventory (STAI) and WHO Disability Assessment Schedule 2.0 (WHODAS 2.0).

Results: The results indicated that absolute HPQ was significantly associated with BDI-II scores (F=4.51, p=0.035). On the other hand, relative HPQ was influenced by SF-MPQ (F=3.76, p=0.005), PCS (F=4.16, p=0.014), STAI (F=5.62, p=0.019) and limited daily activities (F=13.25, p=0.00035).

Conclusions: These findings suggest that presenteeism is multifactorial, with pain, psychosocial factors and daily functioning playing critical roles. Moreover, the impact of depression on presenteeism differs from that of pain and anxiety. Therefore, tailored intervention approaches may be required for each factor, ultimately improving workplace productivity.

Trial registration number: This study was preregistered at UMIN-CTR (UMIN000054797).

Keywords: Back pain; Health; PSYCHIATRY.

Figure 1. Participant flow through the study.

Figure 2. Partial effects on absolute HPQ. The vertical axis represents the contribution to HPQ (presenteeism tendency), with more negative values indicating an increased contribution to presenteeism. The grey area represents variance, and the effect is significant if it does not include 0. BDI-II, Beck Depression Inventory-second edition; HPQ, Health and Work Performance Questionnaire; PCS, Pain Catastrophising Scale; SF-MPQ, Short-Form McGill Pain Questionnaire; STAI, State-Trait Anxiety Inventory; WHODAS 2.0, WHO Disability Assessment Schedule 2.0.

Figure 3. Partial effects on relative HPQ. The vertical axis represents the contribution to HPQ (presenteeism tendency), with more negative values indicating a more significant contribution to presenteeism. The grey area represents variance, and the effect is significant if it does not include 0. BDI-II, Beck Depression Inventory-second edition; HPQ, Health and Work Performance Questionnaire; PCS, Pain Catastrophising Scale; SF-MPQ, Short-Form McGill Pain Questionnaire; STAI, State-Trait Anxiety Inventory; WHODAS 2.0, WHO Disability Assessment Schedule 2.0.

Figure 4. Relationship between life activities scores and relative HPQ in males and females. Curves were estimated using generalised additive models. Shaded areas indicate 95% CIs. The association between reduced life activities and lower relative HPQ scores was stronger in females than in males. HPQ, Health and Work Performance Questionnaire.