The health-performance framework of presenteeism: Towards understanding an adaptive behaviour

Abstract

The substantial health and financial costs of presenteeism are well-documented. Paradoxically, presenteeism also has a positive side, which has been largely overlooked. Emerging evidence shows that presenteeism can be a choice that offers a range of positive benefits to the ‘presentee’ (an employee who works through illness). In this conceptual article, we view presenteeism as purposeful and adaptive behaviour: a dynamic process that serves the purpose of balancing health constraints and performance demands in tandem. We propose a 2×2 framework of presenteeism (therapeutic, functional, overachieving, and dysfunctional) and suggest that the success of the presenteeism adaptation process depends on the availability of internal capacities and flexible work resources. When the workplace is supportive and provides adequate resources to aid adaptation, presenteeism can be a sustainable choice for maintaining performance under impaired health. We examine the role of resources for functional presenteeism by drawing on conservation of resources theory and self-determination theory. This framework can contribute to a better understanding of presenteeism by viewing it as an adaptive process, considering presentees as heterogeneous groups, and exploring the importance of internal and work resources for balancing health and performance demands. It sketches new avenues for research and practice and the effective management of presenteeism, health, and performance.