Exploring nurses’ presenteeism from the effort-reward imbalance perspective in the Chinese context: a latent profile analysis

BMC Nursing https://doi.org/10.1186/s12912-026-04786-7 Article in Press Exploring nurses’ presenteeism from the effortreward imbalance perspective in the Chinese context: a latent profile analysis Siqi Wang, Chaonan Kong, Mo Li, Zhiyu Zhang, Li Gai, Xinying Yu, Yanan Guo, Ling Fan & Fan Yang Received: 15 August 2025 Accepted: 14 May 2026 Cite this article as: Wang S., Kong C., Li M. et al. Exploring nurses’ presenteeism from the effort-reward imbalance perspective in the Chinese context: a latent profile analysis. BMC Nurs (2026). https://doi.org/10.1186/ s12912-026-04786-7 A S S We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply. E R P If this paper is publishing under a Transparent Peer Review model then Peer Review reports will publish with the final article. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Exploring nurses’ presenteeism from the effort-reward imbalance perspective in the Chinese Context: A latent profile analysis Siqi Wang1,2,#, Chaonan Kong1,2,#, Mo Li1,2, Zhiyu Zhang1,2, Li Gai1,2,Xinying Yu1,2, Yanan Guo1,2, Ling Fan3,* and Fan Yang1,2,* Corresponding author *Fan Yang, Shengjing Hospital of China Medical University, Building 2, Nanhu district of hospital, Shenyang, Liaoning, China. Email: S S E R P *Ling Fan, Shengjing Hospital of China Medical University, Building 6, Nanhu district of hospital, Shenyang, Liaoning, China. Email: E L C I T R A IN Other author footnotes #Siqi Wang and Chaonan Kong made equal contributions to this manuscript and should be considered joint first authorship. *Fan Yang and Ling Fan made equal contributions to this manuscript and should be considered joint corresponding authorship. Affiliations 1Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China 2Department of Nursing, Shengjing Hospital of China Medical University, Shenyang, China ACCEPTED ARTICLEMANUSCRIPT IN PRESS 3Clinical Skills Practice Teaching Center, Shengjing Hospital of China Medical University, Shenyang, China Abstract Background: Due to the unique challenges of their work environment and job demands, nurses often work even when ill. Nurses’ presenteeism, defined as working while illness impairs performance or engagement, poses a significant threat to both the quality of care and patient safety. Previous studies have primarily measured nurses’ presenteeism using scale scores or thresholds, an approach that focuses solely on the study variable while S S E R P neglecting inter-individual differences. Recognising individual differences is the key to conducting personalised analyses and subsequently developing targeted intervention strategies. E L C I T R A IN Aim: This study aimed to employ latent profile analysis to identify distinct subgroups and characteristics of nurses’ presenteeism within the Chinese cultural context, and incorporate the effort-reward imbalance model to explore factors associated with presenteeism. Methods: A cross-sectional online study involving 2,871 eligible nurses conducted through the questionnaire platform named “Wen Juan Xing”. The general information questionnaire, the McCloskey/Mueller Satisfaction Scale, the Stanford Presenteeism Scale and the Effort-Reward Imbalance Questionnaire were used as the measurement instruments. SPSS (version 25.0) was used for the descriptive statistics and multicollinearity analysis. ACCEPTED ARTICLEMANUSCRIPT IN PRESS Mplus (version 8.0) was used to conduct the common method bias test, latent profile analysis and covariate analysis. Results: Nurses’ presenteeism was classified into three profiles, namely, the “Low presenteeism-Dual Stability Group” (29.5%), the “Medium Presenteeism-Restricted Concentration Group” (20.5%), and the “High Presenteeism-Impaired Task Execution Group” (50.0%). These subgroups demonstrated divergent patterns across the effort-reward imbalance perspective (effort, reward, and overcommitment), individual characteristics (age and gender), and occupational information (years of working experience and job satisfaction). S S E R P Conclusions: The three subgroups of nurses’ presenteeism in this study IN exhibited significant heterogeneity. Different subgroups exhibited distinct E L C I T R A characteristics. The significant heterogeneity in the three potential profiles can help nursing managers develop individualised and targeted interventions. This study provides a new direction for reducing nurse presenteeism from an effort-reward imbalance perspective. Clinical trial number: Not applicable Keywords：Effort-reward imbalance; Latent profile analysis; Nurses; Overcommitment; Presenteeism Background As nurses are guardians of health, disseminators of health knowledge, and promoters of health behaviours, their health status is crucial to the healthcare system. However, the physical and mental health of nurses is not ACCEPTED ARTICLEMANUSCRIPT IN PRESS satisfactory, as they are in a high-stress, high-demand, and high-load work environment for long periods [1]. The surge in patient volume, prevention, and control work, particularly during epidemics and infectious disease outbreaks, and the considerably high risk of infection increase the workload of nurses and their work pressure and burnout, which seriously threaten their physical and mental health [2-4]. A study revealed that 40.99% of nurses in the sample exhibited mental health issues, while 54.25% reported poor physical health [1]. However, due to staff shortages and social responsibilities, nurses persist in working even when their physical and mental wellbeing is compromised [5]. S S E R P Nurses, who comprise the largest group in a healthcare team, have a real stake in (...truncated)