{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:44:58Z","timestamp":1791963898272,"version":"4.3.4"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The interrelationships between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention remain insufficiently understood in nursing populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined the associations between presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted involving 511 nurses. Composite scores from the Work Productivity and Activity Impairment (WPAI) questionnaire, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), the Quality of Nursing Care Tool, and the Nurse Retention Intention Scale were analyzed using an observed-composite path structural equation modeling (SEM) approach. Indirect effects were estimated using 5,000 bootstrap resamples with percentile-based 95% confidence intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Presenteeism was positively associated with burnout (\u03b2\u202f=\u202f0.262,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and negatively associated with the quality of nursing care (\u03b2\u202f=\u202f\u22120.250,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and retention intention (\u03b2\u202f=\u202f\u22120.334,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Burnout was negatively associated with the quality of nursing care (\u03b2\u202f=\u202f\u22120.177,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and retention intention (\u03b2\u202f=\u202f\u22120.179,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Bootstrap analyses indicated indirect associations between presenteeism and productivity loss and both outcomes through burnout. The model showed an acceptable but imperfect fit: \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (4)\u202f=\u202f13.151, CFI\u202f=\u202f0.959, TLI\u202f=\u202f0.877, RMSEA\u202f=\u202f0.067, and SRMR\u202f=\u202f0.043.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher presenteeism was statistically associated with lower retention intention and poorer nursing care quality, both directly and indirectly, through burnout. Health-related productivity loss showed indirect associations with both outcomes through burnout.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1962028","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:48:17Z","timestamp":1791960497000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Presenteeism, health-related productivity loss, burnout, quality of nursing care, and retention intention among nurses: a structural equation modeling study"],"prefix":"10.3389","volume":"14","author":[{"given":"Mengyun","family":"Peng","sequence":"first","affiliation":[{"name":"School of Nursing, Suzhou Medical College, Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiqin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Nursing, First Affiliated Hospital of Dali University","place":["Dali, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Shi","sequence":"additional","affiliation":[{"name":"School of Nursing, Suzhou Medical College, Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyan","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Suzhou Medical College, Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing, Suzhou Medical College, Soochow University","place":["Suzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nursing, First Affiliated Hospital of Dali University","place":["Dali, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e2443059","DOI":"10.1001\/jamanetworkopen.2024.43059","article-title":"Nurse burnout and patient safety, satisfaction, and quality of care: a systematic review and meta-analysis","volume":"7","author":"Li","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1002\/job.2727","article-title":"Sick and working: current challenges and emerging directions for future presenteeism research","volume":"44","author":"Patel","year":"2023","journal-title":"J Organ Behav"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1080\/10803548.2022.2108660","article-title":"Presenteeism and productivity loss among nurses","volume":"29","author":"Shdaifat","year":"2023","journal-title":"Int J Occup Saf 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