PRODUCTIVITY
AND PRESENTEEISM - A
QUESTION OF SLEEPING WELL
Renata da S. Cardoso R. Tavares
Universidade de Taubaté (UNITAU), Brazil
E-mail: renata_cardoso20@hotmail.com
Quésia Postigo Kamimura
Universidade de
Taubaté (UNITAU), Brazil
E-mail: qkamimura@gmail.com
Submission:
01/08/2013
Revision:
26/08/2013
Accept:
24/10/2013
ABSTRACT
Workers are the main assets of the organization, thereby, having a look at some ways that may interfere
with their productivity, represents
a strategic move. Thus, we aimed to investigate the frequency
of certain factors which interfere in the work of the employees, such as: health problems / illnesses, existence of a sick family member, financial problems,
work environment, psychological / emotional and sleep
problems. The research was conducted in a manufacturing industry located in the Valley of Paraiba, where a form was
applied to a sample of 125
employees. The results were that
among the factors surveyed, sleep is what most affects employees’
productivity, followed by working environment, and the factor that
interferes less being the emotional one. It was observed that seniority interferes with the sleep quality. Thus, it is recognized that sleep interferes with workers’ productivity, and it is considered a
factor that impacts on their
productivity.
KEYWORDS: Efficiency; Presenteeism; Sleep; Personnel
Management; Organizational Case Studies.
Contributors and Supporting Agencies: Capes.
1.
INTRODUCTION
In
terms of human
capital management, major business concerns are relate to avoiding accidents,
high health costs, high rates of absenteeism and presentism and
reduced production workers. It is understood that employees represent
the human capital of a company and who
contribute to its success, in other words, the company depends on that human capital’s productivity. Vargas
(2008) argues that human capital is important to the company, regardless of the industry type, and it is the main
factor that management should
put more effort to
manage.
Currently, the
authors underestimate the total cost of workers’
illnesses, which lost a great opportunity to create
competitive advantage between firms
(HEMP, 2004; BURTON;
BRANDT-RAUF, 2008).
Programs targeted to the behavior and habits of workers’ lives are projects that bring increased productivity
and reduce health care costs (EDINGTON,
2009).
No
company can keep
operating in the market without a healthy and productive workforce. Corporate
profits are directly connected with the productivity of their human capital.
Thus, any reason that
may cause the employee to miss work or produce less is of
utmost importance.
According
to O'Toole and
Lawler (2006), an ill employee who
chooses to go to work, costs the
equivalent of U.S. $ 255 per
year in lost productivity,
reaching in total a loss of $ 180 billion
annually to U.S. companies.
Thus, this study sought to search the frequency of the following factors that affect employees’ work: health
problems/ illnesses, existence of a sick family member, financial problems,
working environment, psychological and
emotional problems and sleep.
Therefore, it is expected that the research will contribute to the search for
improvements in the strategies used by companies when it comes to productivity and presenteeism. It is also hoped, that this
research will encourage studies
in corporate environment with respect to productivity, presenteeism and sleep.
2.
PRODUTICTIVITY
AND PRESENTEEISM
Employee
productivity is directly related to the success of a company; therefore, whatever the reason that interferes with that performance will reach the company as
a whole. i.e., both the lack
of work force, as well as the minimization of workers’ performance is problems for the organization.
Thus, it
is understood by absenteeism the absence from the official working day for reasons related to ill health. Fonseca
(2009) clarifies that this absence may be due
to scattered faults, compensation and absence of short and long term disability.
Besides absenteeism, which is an older term and further
explored in the literature, there
is also presenteeism. It is a
latest terminology, which is
characterized by the inability to
produce what should be, or what would be its capacity, due to health problems, but this reason
does not take the employee to be absent from the workplace (FONSECA, 2009). So,
presenteeism is when
people are present in the
workplace, but due to problems of physical or psychological nature, cannot fully comply with their functions (HEMP, 2004
apud FONSECA, 2009).
Hemp and Shamansky
(2004, 2002 apud FONSECA,
2009, p.7) state
that:
Presenteism limits productivity not only in terms of quantity
but also in quality of work and this can be measured by decrease in production, failure to maintain production standard errors and
decreased attention at work, among others.
It
is of paramount importance to clarify that the term presenteeism and studies addressing this issue is recent, so it lacks
quantitative data and even an internationally recognized
protocol that is trustworthy
and fulfilling the task of measurement. About the fragility of studying and measuring presenteeism, Fonseca (2009,
p. 7) studied
Mattke et al.
(2007) analyzed that:
The
quantification of presenteeism is
still under development. According
to a recent literature review related
to instruments used to measure self-reported presenteeism, lacking well-established and validated methods to
convert the lost productivity in
monetary estimates, and concludes
that the challenges to measure presenteeism far exceeds the measure of absenteeism, especially because many professions do not have their results easily measurable.
3.
FACTORS
THAT AFFECT PRODUCTIVITY
According to Whitaker (2001, p. 423), among the factors that affect health and
quality of life and, consequently,
the performance of
an employee at work, are:
·
Social insurance systems, benefit payments and medical
certification practices, which influence work participation;
·
Occupational safety, availability of alternative
employment and attendance, which affect economic climate;
·
Organizational factors, such as firm size, personnel
policies and procedures affecting service management;
·
Job satisfaction, job stress and psychosocial work environment,
which affect service;
·
Individual factors such as personality, social
support, marital status and health problems affecting attendance.
Health
is when the body is in homeostasis, i.e., in a harmonious balance, well-being
between the physical, social and mental aspects of a human being. Health is not
limited to the absence of disease; it also involves quality of life: "The
World Health Organization (2010) scales health, welfare and safety as
fundamental aspects for productivity, competitiveness and the sustainability of
enterprises." (BAPTISTA, 2010, p.3)
Fonseca
(2009) refers to Aldana (2001) saying that "the result is used to describe
financial expenses related to the employee and they can be included in two main
categories: cost of health care and productivity." The author further
states that:
The
loss of worker productivity resulting from health problems is an indirect measure of
the cost of health care for
businesses, and is usually
assessed by absenteeism
and job performance measures, commonly described
as being difficult to quantify
(FONSECA, 2009).
Based in Burton et al.
(1999), Fonseca (2009)
mentions the cost of employee health, saying:
Productivity
measurement is not largely assessed by corporations;
when evaluating the impact of health care costs, the figures used are usually those raised directly by the demand for health care, which are much easier to quantify and investigate than indirect ones.
It is
known that psychological disorders such as stress and depression impact on
employee productivity and are considered factors that influence the occurrence
of work accidents and occupational disease. Dewe and Cooper (2008) and Stewart
et al. (2003) confirmed the existence of this causality in their research.
According to a study by Tavares, Kamimura and Innocent (2010), the changes in
the working world of the XXI century attach great emotional pressure on workers
and, therefore, have annually increased psychological disorders resulting from
work. Thus, the authors analyzed the data available in source Dataprev and
concluded that stress was the disorder that has increased over 2005-2008 among
psychological disorders and occupational diseases and this list
already includes sleep disturbance.
Marques
and Moraes (2004) suggested that individuals are becoming more vulnerable to
psychosomatic illness due to pressures generated in the workplace. The Ministry
of Health in Brazil and the Pan American Health Organization (BRAZIL, 2001),
according to Decree No. 1,339, of November 18, 1999, recognized and presented a
list of 12 mental and behavioral disorders related to work which may affect
workers: a) Dementia in other diseases classified elsewhere b) delirium
superimposed on dementia is not as described, c) mild cognitive impairment, d)
organic personality disorder e) organic mental disorder or unspecified symptomatic
disorder f) chronic alcoholism; g) depressive episodes; h) state of
post-traumatic stress; i) neurasthenia; j) other specified neurotic disorders
k) disorder of the sleep-wake cycle due to non-organic factors) burnout or
burnout syndrome.
The
main symptoms of stress are: nervousness, anxiety, depression, irritability,
fatigue, anger, stomach pain, change in sleep, pain in the chest and neck
muscles (COUTO, 1987).
Alday
(2000, p. 13) further exemplifies, saying that "it is a dynamic puzzle,
whose pieces are embedded every day, every month and year, not mounted at once,
in the development of so-called plan ", i.e., involves long sense of
well-being and comfort and satisfaction of a balance between family life,
loving, social, environmental aesthetics to the very existential. (MINAYO;
HARTZ; BUSS, 2000).
4.
BEHAVIORAL
DEFINITION OF SLEEP
Sleep
is a temporary physiological
state that can be recognized by
monitoring and suppression of decrease in metabolic rate. According to Fernandes (2006,
p. 157), sleep is a "special physiological state that occurs cyclically in
a wide variety of living beings
in the animal kingdom, having
been observed behaviors of rest and activity." Still, according to the author, there are four criteria for defining sleep behavior: decreased movement,
decreased responsiveness to stimulus
of low intensity, typical posture
and reversibility between states of wakefulness
and sleep.
Sleep
disorders can occur for
increase, decrease or change of pace from the normal
pattern of sleep and wakefulness. Sleep disorders from work relate to working conditions to which the worker is exposed and altering its cycle
of sleep and wakefulness. Among the
most common reasons include exposure
to work situations that affect the emotional, psychological and physical, which could cause a sleep disorder. It is also known that exposure to certain chemicals that cause irritation
to the airways, or causing bouts of chronic allergies, also interferes with sleep
and is the main cause of sleep disorders and is the result of the work shift
changes, in other words, the
turnover time of
the working day, considered the main
culprit when it comes to sleep
disorders.
The onset of sleep disorders, including insomnia, excessive sleepiness, sleep apnea, narcolepsy and restless legs syndrome, are common indicators of the performance
of labor and night shift because they
affect health and
thus the quality of life and work performance.
5.
RECENT
STUDIES OF CORPORATE HEALTH MANAGEMENT
Recent
studies of corporate health management show the impact of health on
productivity and the financial consequences of this link. As this subject is
very new in Brazil, there are not many completed surveys. Thus, the research
presented has been developed in other countries.
Cooper
and Dewe (2008), using the statistical source Health & Safety Executive, in
his research showed that in 2006/07, almost 30 million days were lost due to
work-related diseases, stress, depression or anxiety accounted for 13.8 million
days lost.
Musich
et al. (2006) sought to investigate the impact of factors related to the
corporate environment, the risks to health and medical conditions on
productivity, from the historical perspective of 8000 employees in ten
different Australian companies. The research revealed that poor working
conditions, ineffective management, leadership with low life quality influence the rate of
presenteeism.
The
study by Stewart et al. (2003) demonstrated that 85% of the costs of reduced
productivity are explained by reduced performance while at work and that
depression is responsible for 48% of this reduction in productivity. The
authors also comment that this reduced productivity caused by the depression of
employees, costs Americans a value of $ 44 billion a year.
Boles,
Peltier and Lynch (2004) conducted a study with a sample of 2264 employees of
the same company, seeking to provide evidence for the relationship between
health risks and productivity of these workers. The authors concluded that
people with more risk factors reported greater loss of productivity, indicating
a greater reduction in individuals with diabetes (absenteeism) and stress
(presenteeism).
Burton
et al. (2005) used a brief version of the Work Limitations Questionnaire along
with an assessment of risk to health in a sample of 28,375 employees of a
company. The objective of the research was to study the impact of risk factors
for the health of workers and their reduced productivity (presenteeism). The
result showed that dissatisfaction with life, job dissatisfaction, poor health
and stress have a greater association with presenteeism, and each additional
risk factor was associated with a reduction in productivity of 2.4%.
Individuals who had medium and high risk were 6.2% and 12.2%, respectively,
less productive than low risk. The estimated cost of this lost productivity was
$ 99 million for medium risk and 185 million dollars for the high-risk, or U.S.
$ 1,392 and U.S. $ 2,592 per employee. Another finding of the survey was that
anyone who has risk factors for moderate (low level of physical activity and
overweight) has decreased productivity by around 6%, while employees with high
risk factors (physical inactivity, hypertension, smoking, high cholesterol) are
down 12%.
Another
study by Burton and others (2006), using the same survey instrument, but in a
sample of 7,026 employees of a financial services company, has come to the
conclusion that each risk factor implies a reduction in productivity 1.9% over
time and estimated $ 950 annual per risk.
A
study of more than 12,000 employees of the Dow Chemical Company revealed that
emotional problems were the major source of productivity loss compared to a
range of other chronic conditions, reducing worker performance by approximately
36% (PROCHASKA et al. 2011).
Another
research conducted at the Dow Chemical Company in the United States, which used
the Stanford presenteeism scale and employee data such as demographics, medical
and pharmacy claims, smoking, risk factors biometric health records payroll and
type of work, revealed that almost 65% of respondents reported having one or
more chronic conditions surveyed. The most common were allergies, arthritis /
joint pain or stiffness and pain in the back or neck. Absenteeism associated
with a chronic condition ranged from 0.9 to 5.9 hours in a period of four
weeks, and presenteeism ranged from 17.8% to 36.4%. The total cost of 10 major
chronic conditions was 10.7% of the total labor cost of the Dow in the United
States (Collins et al., 2005).
Checking
if sickness presenteeism results in later impacts in sickness absenteeism was the research goal of Bergstrom et al.
(2009). The result was that in the research on more than five occasions during
the base year 2000, presenteeism was a statistically significant risk factor
for the occurrence of medical licenses in 2002 and 2003. Thus, the authors
concluded that sickness presenteeism can lead to absenteeism due to illness in
the future.
Allen,
Hubbard and Sullivan (2005) investigated the impact of pain in employee
productivity, with a sample of 1,039 respondents. The findings of the research
were: 28.6% of workers reported some type of pain; workers with severe pain are
increased by five times in restricting work-induced health, pain control is
worse for those with severe pain; employees reported having pain miss about
three days of work (presenteeism) and two days (absenteeism) productivity in a
month, the best starting point of interventions should be derived from musculoskeletal
diseases pains.
The
Hertz et al. (2004) aimed to investigate the association between obesity,
cardiovascular risk factors and labor constraints. They found that obesity
increased 43.8% from 1988-1994 to 1999-2000 and now affects 29.4% of workers,
obese workers have higher prevalence of work limitations (6.9% versus 3.0%
among workers of normal weight), hypertension (35.3% versus 8.8%), dyslipidemia
(36.4% versus 22.1%), type 2 diabetes (11.9% versus. 3.2%) and the metabolic
syndrome (53.6% versus 5.7%). That is,
the impact of obesity on the work limitation is 4 times associated with
hypertension, 1.65 times associated with dyslipidemias, diabetes 3.7 times, 9.4
times greater metabolic syndrome.
6.
METHODS
This
study is characterized as an exploratory and quantitative approach. In the
design, the strategy case study was used. According to Marconi and Lakatos
(2002), the reason for conducting a quantitative research is to find out how
many people in a given population share a feature or group of features. According
to Marconi and Lakatos (2002), the reason for conducting a quantitative
research is to find out how many people in a given population share a feature
or group of features.
An
exploratory research can be defined according to Marconi and Lakatos (1993)
with the objective of strengthening the relationship with the problem studied,
in other words, providing familiarity with the problem, making it explicit or
allowing the development of hypotheses. It often takes the forms of
Bibliographic Research and Studies.
Based
on the technical procedures used, this research fits into a case study because,
according to Yin (2005, p. 32), "a case study is an empirical inquiry that
investigates a contemporary phenomenon within its real-life context especially
as the boundaries between phenomenon and context are not clearly defined".
The
case study was conducted in a private industry manufacturing branch, located in
the Paraíba Valley, with more than 500 employees (large company, ranking second
SEBRAE). The company currently has 5400 registered employees and 4900
employees in the plant.
The
sample consisted of 125 employees, to which a form containing closed questions
on health, quality of life and work was applied. The sample is defined by
accessibility, which, according to Vergara (2004) is meant as a sample in which
the researcher selects the elements that have access and is used in exploratory
or qualitative studies, mainly in case studies; Lwanga and Lemeshow (1991)
report that the researcher selects the elements that have access, assuming that
they may represent a universe. With regard to the sample, the limitation was
the impossibility to apply the forms to the night shift employees.
For
Marconi and Lakatos (1993), the form offers some alternatives, in which the
subject who is answering it chooses the one that best represents his/her
situation or point of view, but the filling is done by the researcher. Data
were tabulated in the Sphinx software (version 5.1.0.6).
7.
RESULTS
AND DISCUSSION
7.1. Characterization of the employees’ sample
It
is relevant to draw
a profile of the sample surveyed for
the interpretation of the data found
in relation to factors that affect
productivity. Therefore,
the public sample will be
characterized here.
Starting at age factor, one can see
that the average age of employees
who responded to the form is 31 years and 57.6%
are aged between 20
and 30 years of age, as shown in Figure 1:
Figure 1 – Graphical representation of age in the
sample studied.
Regarding gender, a sample composed predominantly
of males (93.6%) (Figure
2) was revealed:
Figure 2 – Graphical representation of the sample by
gender.
As
for education, one can see in
Figure 3 that more than half
of the sample has a high school degree:
Figure 3 – Graphical representation as to the
education of the sample
Regarding the shift, 85.6%
of the sample consisted of workers
of the first shift, since the third shift employees(night shift) was not possible (see
Figure 4):
Figure 4 – Graph as to sample shift
Analyzing the item referring to the time that employees have worked in the company,
it is clear that more than 60% of the sample have between
two to ten years of work in it, according to Figure
5:
Figure 5 – Graphical representation of the sample working
time in company (in years)
Figure 6 shows the response obtained for the stress
caused by work, in which 41.6% of the subjects reported
having some type of occupational
stress:
Figure
6 – Graphical representation of workers who reported stress
With respect to the population that has a body mass index higher than expected (BMI), the study sample consisted of 36% of subjects with weight change (Figure
7):
Figure 7 – Graphical representation
of the population with above-average weight
With respect to employees performing
some sort of physical activity or
those who have a sedentary lifestyle, as shown in Figure 8, over 60%
do not exercise:
Figure
8 – Graphical representation of the populations which do and do not do physical
activity
Under
the health aspect, more than 90% believe they have good health (Figure 9), but
in contrast, 51% reported having a chronic disease, among the chronic diseases
studied, allergy was the most recurrent, followed by back pain. During the
field research, anxiety and migraine were mentioned, but there is no way to
quantify such an account, since they were not entered in the search form
(Figure 10):
Figure
9 – Graphical representation with respect to health
Figure
10 – Graphical representation regarding chronic diseases
Depression
is highly relevant today, since this issue
has become a national concern because of its high prevalence,
8-25% (INNOCENT, 2005).
The most common symptoms are: depressed mood, loss of interest and pleasure, increased fatigue and reduced activity, and other symptoms
- reduced concentration
and attention, reduced self-esteem
and self-confidence, ideas of guilt and worthlessness; bleak and pessimistic views
of the future; ideas or act that harm or lead to suicide, disturbed sleep and decreased
appetite. The World Health
Organization (HARNOIS 1996
apud SILVA et al.,
2009) signals depression as the leading cause of lost work in the world, projecting that by the year 2020,
it appears as the leading cause of disability for employees at work.
When
asked about the quality of sleep, 33.6% consider not
having a good one. But at the time of listing
the characteristics that
influence the quality of sleep, only
7% did not report any item,
and over 90% reported having one or more of the characteristics
investigated in the act that
interferes with sleep (Figures
11 and 12):
Figure
11 – Graphical representation as to the classification of sleep
Figure
12 – Graphical representation as to the items that affect the quality of sleep
able 1, shows company time versus quality of sleep:
Table
1 – Company time x Sleep Quality
|
Time working in the company (years) |
Sleep good and very good |
Regular
sleep and bad |
|
0-1 |
21,7% |
19,1% |
|
2-5 |
33,7% |
28,6% |
|
6-10 |
30,1% |
35,7% |
|
11-20 |
10,8% |
11,9% |
|
>20 |
3,6% |
4,8% |
7.2. Factors
that affect productivity
Those who missed work due to
illness in the previous year were also researched,
and 47% reported having missed work, as shown in Figure 13:
Figure
13 – Graphical representation on absenteeism due to illness in the previous year
Confirming the importance of this information, Reis (2001) conducted a
study in a large company in the
metallurgy field, having as its basis the total data of
6,366 medical certificates. In this research, he came to the following data:
Table 2 – Distribution of sickness up to 15 days
|
Registered
Cause |
Consolidated
(1991 to 1998) |
|
|
(Large Group) |
N |
% |
|
Infectious
diseases |
268 |
4,2 |
|
Neoplasms |
18 |
0,3 |
|
Endocrine and
immune diseases |
31 |
0,5 |
|
Blood
diseases |
9 |
0,1 |
|
Mental
disorders |
149 |
2,3 |
|
Diseases of the nervous system |
244 |
3,8 |
|
Diseases of the circulatory system |
195 |
3,1 |
|
Respiratory
Diseasess |
1124 |
17,7 |
|
Digestive
diseases |
562 |
8,8 |
|
Diseases of the genitourinary system |
174 |
2,7 |
|
Complications
of pregnancy |
6 |
0,1 |
|
Diseases f the skin and subcutaneous tissue |
183 |
2,9 |
|
Diseases of the musculoskeletal system |
1190 |
18,7 |
|
Deformations
and chromosomal abnormalities |
6 |
0,1 |
|
Signs and symptoms and ill-defined conditions |
509 |
8,0 |
|
Injuries
and traumas |
444 |
7,0 |
|
Other contacts with health services |
1254 |
19,7 |
|
TOTAL |
6366 |
100 |
Source:
Reis (2001, p. 2)
Based
on the data presented on the table, the author reached the following values:
Direct costs involving medical certificates within 15 days was of approximately
U.S. $ 905,807.90. The biggest cost was related to the group of diseases of the
musculoskeletal system with U.S. $ 203,925.00, followed by respiratory diseases
with U.S. $ 150,865.00 and other contacts with health services with U.S. $
139,615.70. (REIS, 2001).
For examining
the factors that impact on productivity and the frequency with which they
interfere, workers were asked to give a grade on the frequency of a particular
item that interfere with their work. Calculating an average of the responses to
each item, inferring weights '1.5', '5,5' and '9' to the tracks of grades, the
highest average for the interference of sleep was obtained (4.2), followed by
desktop (3.9) and health problems (3.8), with the lowest average item for emotional
problems (2.8). The factor that had the highest percentage of grade 8-10 is
sleep. The range of
responses can be seen in Figure 14:
74,4%
Figure 14 – Graphical representation of the factors
that interfere with worker productivity x grade (quantification)
Although emotional problems have been the factor that showed less
interference in productivity among those surveyed, it is known that the change in emotional state can result in bodily
symptoms, called psychosomatic illnesses. Rangel (2009, p.
01) addresses the issue:
The emotions that affect the individual in the workplace arising from the clash with the organization of work and can cause disease, comes to
be defined as psychosomatic
illnesses. The word psychosomatic
is a term taken from psyche (denoting the
mind, mental processes, and
emotional activities) and somatic (soma, meaning something
distinct from body and mind).
Study
by ISMA-BR (2008) reported that among the main causes of presenteeism, health problems that reduce the productivity
of Brazilian workers are: muscle pain (86%), sleep problems (35%),
gastrointestinal pain (26%).
8.
FINAL
CONSIDERATIONS
From
the historical perspective of the workers themselves, this work analyzes some
interference factors in the performance of work activity. It can be concluded that sleep among the factors studied, is what
most interferes with work. This result was
obtained, taking into account
that most of the research population is male and
it was not possible to include the
night shift employees, which would probably demonstrate this finding
further.
In
spite of the results found, few companies give due attention to presenteeism
and recognize the interference of sleep in productivity. Yet there is a reality
that companies worry and invest in the quality of sleep of their employees.
After
exposure of the findings, some questions arise:
·
How to maximize the productivity of human capital reporting tiring waking up and improper sleeping?
·
Population overweight, with sleep
impairment, sedentary life and
may be considered young: what is the influence of these four characteristics
on worker health and,
consequently, on their productivity
in the near future?
Thus, studies of presenteeism and health management, ways of measuring and obtaining indicators of presenteeism,
productivity and quality
of sleep in the night shift employees will come to add, synergistically toward
the improvement of effective
productivity management and health employees.
Therefore,
this study aims at encouraging discussion in the field of productivity, presenteeism and quality of sleep in
organizations, besides encouraging researchers to discuss such topics so that improvements in this field can
be made and knowledge in this area
can be expanded. Emphasis is also placed on the attention
companies should give to such problems.
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