Abstract
Research on presenteeism, defined as working when feeling unwell, has identified its many antecedents and consequences, but the decision-making process underlying this behavior remains a black box. This study employs an experience sampling approach to explore the presenteeism decision-making process, specifically, the potential influence of biases in the identification and evaluation of options in the presenteeism decision-making process (Whysall, Karanika-Murray & Chen, 2023). Participants completed daily diaries every working day for 2 to 6 weeks, of which 121 experienced ill-health symptoms on a workday, during which time 476 ill-health incidences were captured. Participants rated their symptom severity, reflected on their health and work status, how they made their decision, and its consequences. Findings revealed that, despite the increased flexibility offered by post-pandemic hybrid working, the work-related factors appear to dominate presenteeism decision-making, priming options that facilitate work-related goals, even restricting the range of options that individuals perceive as feasible in the first instance. Beliefs regarding the availability of flexible working options and other potential work adaptations play a central role in framing options, highlighting the importance of organisations not only doing what they can to make work adaptations according to health needs but also making the possibility of flexible work salient to employees, to reduce sickness absence and potentially help to shift dysfunctional presenteeism to functional presenteeism. In addition, the findings suggest that when asked to evaluate whether they made the right decision between presenteeism and absenteeism options, individuals’ reflection is based mainly on considerations related to the impact on work rather than health. As a goal-orientated behavior aimed at balancing work and health needs (Karanika-Murray & Biron, 2020), this evidence of either no reflection, or one-sided reflection biased towards consideration of the extent to which the decision and subsequent enacted behavior has met work-related rather than health-related needs, has significant implications for understanding and optimising decision-making in attendance behavior. Thus, there is an opportunity to encourage individuals to more consciously and deliberately evaluate whether the chosen behaviour is helping them to achieve their goals, reflecting on the consequences for both recovery and work-performance.