title: Work-related Stress and Employee Absenteeism: Development and Empirical Test of a Process Model
Creators: name: Melling, Kathryn
Publisher: name: University of Liverpool Repository
Year: 2024

description: Work-related stress has been widely considered as strongly related to absenteeism but comprehensive understanding of this relationship and conditions under which stress results in absence is not well developed. This is especially the case in mental health nursing staff who are generally found to have higher rates of both stress and stress-related absences. This issue is compounded by a lack of empirical focus on this population as compared to nursing in general healthcare. The goal of this thesis was to further explore and evaluate the causes, mechanisms and conditions under which work-related stress and stress-related absences are most likely to occur in a population of mental health nursing staff in a UK National Health Service (NHS) mental health foundation Trust. An exploratory sequential mixed method research design was used and two empirical studies were conducted; a qualitative classic grounded theory followed by a quantitative survey. This design was selected based on reviews of the literature that revealed limitations and shortcomings in existing theories of work-related stress and specifically, in their ability to extract the process underlying the stress-absence relationship. A grounded theory method allowed for a data driven exploration of the specific contextual issues faced by this population as opposed to applying existing theoretical frameworks to understanding the nuances present within this setting. Results of the grounded theory study were integrated to form a comprehensive yet parsimonious theoretical model of the work stress-absence relationship; the Resource-Drain model. Results from this study were integrated into the development of a novel quantitative measure (the Stress-Related Absence Questionnaire (SRA-Q)) and statistically validated within a large sample of staff (n=309). The questionnaire was found to have sound psychometric properties. Analyses of these quantitative data, collected via the SRA-Q, allowed for an empirical test of the Resource-Drain model’s predictions using structural equation modelling and mediation analyses. Integrated findings from both studies suggest that the causes of work-related stress are perceptions of an inconsistent workplace alongside feelings of uncertainty and relationships with colleagues and managers. Mediators within the stress-absence process were found to be perceptions of value, fairness at work and supportive relationship with colleagues and managers. Outcomes of these sources of stress were strongly associated with psychological strain and negative evaluations of the work environment. This was in turn found to be a significant predictor of absence taking behaviours alongside reductions in productivity. The methods used within this research allowed for a combination of detail and complexity to be uncovered, alongside verification of a simplified version of this within a large sample of participants. This supported the Resource Drain model’s predictions and confirmed these relationships as being evident across the workforce. The utility of the Resource-Drain model, the SRA-Q and the methods used in the thesis are discussed along with implications for further research.