Sickness absence, when in excess, lead to enormous social and economic costs (1). There are several economic factors affecting sickness absence rates. For instance, we know that sickness benefits have a significant effect on sickness absence and that sickness absence declines when financial costs are shifted to the employer. Therefore, policy changes where the employer is responsible for covering the economic costs of sickness absence is suggested to reduce sickness absence (1). On the other hand, less is known about cultural factors affecting sickness absence.
Seeing as sickness absence occurs in the context of a workplace, our use of the term culture will therefore refer to organizational culture. Organizational culture is defined by Andrew Brown as: “…the pattern of beliefs, values and learned ways of coping with experience that have developed during the course of an organization’s history, and which tend to be manifested in its material arrangements and in the behaviours of its members.” (2 p.9).
Absence culture as a phenomenon has been described by Johns and Nicholson as: “the set of shared understandings about absence legitimacy in a given organization and the established ‘custom and practice’ of employee absence behavior and its control…” (3 p.136). Absence culture is here described as a social phenomenon that employees affect and is affected by. It entails norms and beliefs about the perceived legitimacy of various reasons not to attend work. Sub-groups of an organization may develop differing absence cultures from the organization as a whole (4–6). Since smaller working groups and teams have become a more common way to organize work (7), it is important to consider the possibility of several absence cultures within a single organization. A more recent definition by Gellatly and Luchak takes this into account by defining absence culture as: “the set of absence-related beliefs, values, and behavioral patterns that are shared among the members of a work group or organizational unit...shown to account for the different pattern of absences within and between organizational settings…” (8 p.1086). In this review, we apply Gellatly and Luchak’s understanding of absence culture.
According to Stuart Whitaker, sickness absence can be defined as: "...absence from work that is attributed to sickness by the employee and accepted as such by the employer…" (9 p.420). Drawing on this definition, sickness absence it not just medically certified absence due to sickness, but all absence reported as sickness by the employee. The threshold for reporting in sick from work is thought to be affected by the workgroup. Several studies show that the absence behavior of co-workers’ influence the absence rates of individual group members so that an employee is more likely to be absent when co-workers are often absent (10–13). This effect can partly be explained by norms and social interactions regarding sickness absence (14). Individual sickness absence seems to be moderated by factors like group cohesion, group absence norms, and task interdependency within a working group (15–17). These types of effects are not restricted to a certain field of work as we for instance see similar results when comparing blue-collar workers and white-collar workers. In addition, there have been studies done on employees in countries with different working policies, for instance Finland, USA, and China (15–18).
When looking at the preexisting literature are several different conceptualizations of sickness absence culture. These include absenteeism, absence culture, unit- and cross-level absence culture, and sick leave culture, to name a few. After a preliminary literature search, we discovered that the term absenteeism is widely used. Absenteeism refers to an employee's failure to report for scheduled work (12). As per this definition absenteeism does not exclusively refer to an individual being absent from work due to illness. Absenteeism can refer to an employee being absent due to a family funeral, a dentist appointment, having a sick child, etc. Due to the nature of our review, literature that make a clear distinction between the reasons why employees are absent will be of great interest, considering we are mainly interested in absence due to reported employee sickness. In addition, the designs used to investigate these conceptualizations also varied (e.g., in-depth interviews, field studies and survey studies, in addition to use of objective measures, self-reports and co-worker reports).
The objective of this review is to identify and map existing literature on sickness absence culture. We will also investigate what methods and designs are used.
A preliminary search of PROSPERO International prospective register of systematic reviews and JBI Evidence Synthesis was conducted and no current or underway systematic reviews or scoping reviews on the topic were identified.
Review question
The objective of this review is to identify and map existing literature on sickness absence culture.
Eligibility criteria
Participants
Not applicable.
Concept
This review will include studies that focus on the concept of sickness absence culture. We will consider sickness absence culture as a broad concept and will therefore include studies that report on absenteeism, organizational culture and concepts associated with culture such as norms and beliefs.
Context
We will identify the differing contexts and academic disciplines in which sickness absence culture has been investigated. In addition, we will identify which research questions has been asked regarding sickness absence culture, and what their findings are.
Types of Sources
This scoping review will consider any publication on sickness absence culture in the field of human sciences, including also reviews, original research, and opinion pieces.