الفهرس 
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Abstract
Nursing is considered a strenuous profession associated with work-related stress, time pressure, a heavy workload, long working hours, understaffing, work on holidays, health hazards, low wages, and benefits losses that increase nurses9 vulnerability to sickness presenteeism, which consequently may affect nurses’ job performance. Sickness presenteeism in workplaces is a much more costly problem than other direct or indirect social and economic burdens, especially among nurses, who are considered a major portion and significant key of the human resources of hospital service providers. The prevalence of sickness presenteeism phenomenon among nurses in healthcare organizations has many negative consequences for their job performance, including health impairment and the potential for exposing others to communicable disease, dissatisfaction, decreased work productivity, the risk of errors, and decreasing quality of patient care. Job performance is a multifaceted indicator with many variables, including meeting the increasing work demands, improving satisfaction levels, maintaining personal health, decreasing stress, and preserving the reputation of nursing care quality in healthcare settings. It reflects the overall predictable value of compliance with standards while doing the job over a set period. A successful health organization should customize the experience of healthcare around the staff’s job performance and patients’ needs. Aim of the study: This study aimed to assess sickness presenteeism and job performance among nurses at Tanta University Emergency Hospital., Subject and method: The descriptive-correlational research design was used in the present study. The study9s subjects included 256nurses at various departments at Tanta University Emergency Hospital. To achieve the study9s aim, two tools were applied for data collection including: the Sickness Presenteeism Structured Questionnaire and Nurses9 Performance Observation Checklist. Tools of data collection - Tool I: Sickness Presenteeism Structured Questionnaire: It comprised four parts: Part (1): Socio-demographic characteristics of nurses: It included nurses, sex, age, years of experience, educational qualification, department, marital status, number of children, working shift, number of working hours per week, and method of delivering care. Moreover, there are two additional questions asked about working overtime or working in another hospital. Part (2): Frequency of Sickness Presenteeism: It involved closed-end questions that were developed by the researcher to assess the frequency of sickness presenteeism among nurses. Part (3): Predisposing Factors of Sickness Presenteeism: it included (19 items) classified into four factors; job demand, locus of control, social support and health problems. The nurses’ responses was measured on five points Likert Scale ranging from (5) = strongly agree to (1) = strongly disagree. Part (4): Stanford Presenteeism Scale (SPS-6). It has (6 items) classified into two dimensions: avoiding distractions and completing work. The nurses’ responses were measured on five points Likert Scale ranging from (5) = strongly agree to (1) = strongly disagree. - Tool II: Nurses’ Performance Observation Checklist: It included (71 items) classified into nine dimensions as follows: work habits, staff relations and communication, communication with patients, nursing care plan activities, material planning and coordination, safety measures and patient safety, innovation, documentation and keeping up to date technically. Nurses’ performance was assessed using a three-point Likert scale ranging from 2 to 0, (0) for not done, (1) for incompletely done and (2) for completely done. A questionnaire was submitted to a jury of five experts for testing the content and face validity. The content validity value for sickness presenteeism frequency was 100%, predisposing factors of sickness presenteeism was 95.5%, and Stanford Presenteeism Scale (SPS-6) was 95.0%, whereas nurses9 performance observation checklistwas98.5%. A pilot study was carried out on a sample (10%) of nurses to test clarity, sequence of items and applicability. Results of the present study revealed that: • The majority (84.8%) of nurses were females, and around half (46.1%) of them were in the age group >30 with a mean age of 31.31 ±6.78, as well as about two thirds (71.5%) of them having<10 years of experience in nursing, while (13.7%) of them had 10320 years of experience with a mean score of 9.70 ± 7.54. More than half of nurses (53.5%) graduated from the Nursing Technical Institute, and 30.1% of them worked in intensive care units. The majority (87.1%) of nurses were married and had children, with a mean score of 1.88 ±1.22. • Additionally, more than half (54.3%) worked during the night shift, and 91.8% of them worked for 36 hours, with a mean score of 31.31±6.78. Around two thirds (72.3%) of nurses used the case method for delivering care, and slightly more than three quarters of them (77%) perceived an average salary 2000-<3000 per month with a mean score of 2357.4 ± 433.2. The majority of nurses (83.2%) didn’t receive overtime, and 73% of them didn’t work in other hospitals. • The majority of nurses (84.0%) experienced sickness presenteeism and 44.9% experienced health problems while attending their work in the frequency group 2-3 times during the last six months. • The job demand factor had the highest mean score (92.48±14.33) followed by social support (73.40±15.53) then health problems (32.01±15.62) and finally locus of control (23.63±21.85) as predisposing factors for sickness presenteeism. • Regarding Stanford presenteeism dimensions perception, it highlighted that 58.6% of nurses had a low level of avoiding distraction, while 60.2% of them had a high level in completing their work. Therefore, 65.2% of nurses had a moderate level of overall nurses9 perception regarding Stanford presenteeism. The total mean score percent of completing work dimension was 10.57±3.52 while the total mean score percent for avoiding distractions was 7.82±3.58. The total mean score percent for the overall presenteeism scale dimension was 18.39±3.71. Job performance • Regarding job performance dimensions, the dimensions of keeping up to date technically, documentation and safety measures had the highest score (96.97%, 89.70%, 89.70%) respectively, followed by staff relation and staff relations and communication, innovation, material planning and coordination, nursing care activities and finally work habits with scores (83.92%, 83.20%, 81.02%, 79.61, 78.98%, 52.7%) respectively. Correlation between Study Variables • There were a statistically significant relations between Stanford presenteeism levels and nurses9 gender, age, years of experience, marital status, method of delivering care and average salary per month at p <0.05. • There wasn’t statistically significant difference between all items of nurse9s sociodemographic characteristics and the nurses’ job performance at p <0.05. • Results indicated a significant negative statistical correlation was found between nurses’ job performance and predisposing factors of sickness presenteeism • Results showed a negative statistical contribution to the prediction of the explained variance between overall nurses9 job performance and predisposing factors of sickness presenteeism, as well as Stanford presenteeism with a regression coefficient value of R2 =0.06 and F test =8.080 at high significant levels of p<0.001. Conclusion and recommendations Based on the results of this study it was concluded that there was a significant negative statistical correlation was found between nurses’ job performance and predisposing factors of sickness presenteeism. It was recommended that hospital management develop policies and practices with clearer guidelines to avoid vagueness regarding what nursing professionals should do while sick, arrange workplace ergonomic elements that reduce the sickness presenteeism propensity and provide flexible scheduling that allows balance between work and family as well as monitoring performance, and providing frequent feedback for nurses. Also, involve the sickness presenteeism phenomenon in nursing students9 curriculums about definition, causes, drivers, vulnerable groups, consequences, management and its outcomes on job performance.