Wu Jijun, Li Yuxin, Liu Xiaoli, Fan Yuting, Dai Ping, Chen Baixia, Liu Zhenfan, Rong Xian, Zhong Xiaoli
Department of Nursing, Deyang People's Hospital, Deyang, China.
School of Nursing, North Sichuan Medical College, Nanchong, China.
Front Public Health. 2025 Mar 3;13:1510147. doi: 10.3389/fpubh.2025.1510147. eCollection 2025.
Presenteeism, also known as impaired health productivity, refers to the condition of impaired productivity of an individual due to physiological or mental health problems. ICU, as a place of intensive care for patients with acute and critical illnesses, nurses have long faced the nature of work with high loads, high pressures, and high intensities, which makes them a high prevalence group of presenteeism. Presenteeism not only affects the physical and mental health and work wellbeing of nurses but also reduces the quality of nursing services and affects the life safety of patients, such as increasing the risk of falls during hospitalization, increasing the risk of medication errors, and prolonging the hospitalization time of patients. Therefore, early identification and targeted interventions are crucial to reduce presenteeism among ICU nurses.
This study aimed to construct and validate a predictive model for presenteeism among ICU nurses.
A cross-sectional study.
1,225 ICU nurses were convened from January to April 2023 from 25 tertiary and secondary hospitals in Sichuan Province, China. ICU nurses were randomly divided into a development set ( = 859) and a validation set ( = 366) according to a 7:3 ratio. Univariate and multifactorial logistic regression analyses were used to determine the influencing factors for presenteeism, and R software was used to construct a column-line graph prediction model. The differentiation and calibration of the predictive model were evaluated by the area under the curve of subjects' work characteristics (ROC) and the Hosmer-Leme-show test, and the clinical decision curve evaluated the clinical validity of the predictive model.
The presenteeism rate of ICU nurses in the development set was 76.8%. Multifactorial logistic regression analysis showed that independent factors affecting ICU nurses' presenteeism included income per month, physical health status, job satisfaction, perceived work stress, perceived social support, transformational leadership, and occupational coping self-efficacy. In the development set and validation set, the area under the ROC curve was 0.821 and 0.786, respectively; the sensitivity and specificity were 80.6, 69.8 and 80.9%, 65.1%, respectively; the Hosmer-Lemeshow goodness-of-fit was = 8.076 ( = 0.426) and = 5.134 ( = 0.743), respectively, and the model had relatively good discrimination and consistency. The clinical decision curve showed that the model had good clinical validity.
The predictive model of presenteeism risk for ICU nurses constructed in this study has good predictive ability. The model can effectively identify ICU nurses with high presenteeism and provide a reference basis for developing targeted interventions to reduce presenteeism among ICU nurses.
出勤主义，也被称为健康生产力受损，是指个体由于生理或心理健康问题导致生产力受损的状况。重症监护病房（ICU）作为急危重症患者的重症护理场所，护士长期面临高负荷、高压力、高强度的工作性质，这使其成为出勤主义的高发群体。出勤主义不仅影响护士的身心健康和工作幸福感，还会降低护理服务质量，影响患者的生命安全，如增加住院期间跌倒风险、增加用药错误风险以及延长患者住院时间等。因此，早期识别和针对性干预对于降低ICU护士的出勤主义至关重要。
本研究旨在构建并验证ICU护士出勤主义的预测模型。
一项横断面研究。
2023年1月至4月，从中国四川省25家三级和二级医院召集了1225名ICU护士。根据7:3的比例将ICU护士随机分为开发集（n = 859）和验证集（n = 366）。采用单因素和多因素逻辑回归分析确定出勤主义的影响因素，并使用R软件构建列线图预测模型。通过受试者工作特征曲线下面积（ROC）和Hosmer-Leme-show检验评估预测模型的区分度和校准度，临床决策曲线评估预测模型的临床有效性。
开发集中ICU护士的出勤主义发生率为76.8%。多因素逻辑回归分析显示，影响ICU护士出勤主义的独立因素包括月收入、身体健康状况、工作满意度、感知工作压力、感知社会支持、变革型领导和职业应对自我效能感。在开发集和验证集中，ROC曲线下面积分别为0.821和0.786；敏感性和特异性分别为80.6%、69.8%和80.9%、65.1%；Hosmer-Lemeshow拟合优度分别为χ² = 8.076（P = 0.426）和χ² = 5.134（P = 0.743），模型具有较好的区分度和一致性。临床决策曲线显示该模型具有良好的临床有效性。
本研究构建的ICU护士出勤主义风险预测模型具有良好的预测能力。该模型能够有效识别出勤主义高的ICU护士，为制定针对性干预措施以降低ICU护士的出勤主义提供参考依据。
