出勤主义行为是指尽管员工感到身体不适，应该请假休息，但是仍坚持工作的行为，是一种工作场所中普遍存在的现象。但由于其影响带有隐性与滞后性的特点，出勤主义行为很容易被管理者所忽视，进而导致员工健康水平下降、工作倦怠、工作绩效下降等负面影响的涌现，为组织带来更大的损失。有研究表明，护士是出勤主义行为高发的职业之一。由于护理工作的专业性与特殊性，护士的出勤主义行为还会降低护理质量，甚至影响到患者的治疗与生命安全。目前我国关于出勤主义行为的研究数量相对较少，我国护士出勤主义行为的水平、特点、后果与影响因素值得进一步深入探究。

本研究以北京市某三甲医院的284名护士为研究对象，通过自陈式问卷的方式进行调查，在了解该医院护士出勤主义行为现况的基础上，探究出勤主义行为产生的顾虑与原因，并分析出勤主义行为对工作倦怠的影响，最后从团队的视角切入，验证领导-成员交换关系、同事支持与感知凝聚力能否降低出勤主义行为的发生。

结果显示，在全部样本中有170名（59.86%）护士表示在过去6个月内有过出勤主义行为，平均出勤主义行为的累计次数为1.60次，平均累计天数为3.57天，表明出勤主义行为在护士中具有一定普遍性。差异性分析结果显示不同婚姻状况与不同聘用形式的护士在出勤主义行为累计次数方面存在显著差异。相关性分析结果显示出勤主义行为的累计次数与年龄、平均每白班负责病床数量、因病缺勤累计次数、加班累计小时数、职称与工作年限均存在显著的正相关。在选择带病坚持工作的原因方面，最主要的顾虑是担心影响团队与组织的工作进度，而对于自身薪酬、晋升等个人因素的顾虑相对较少，但仍为产生出勤主义行为的重要原因之一。

通过对出勤主义行为累计次数与工作倦怠进行层次回归分析发现，出勤主义行为的累计次数对工作倦怠总分、情感耗竭维度与人格解体维度均存在正向影响，表明出勤主义行为会使护士的工作倦怠水平提高。在团队视角下的影响因素方面，层次回归分析结果显示领导-成员交换关系与同事支持对出勤主义行为有着显著的负向影响，感知凝聚力对出勤主义行为具有着一定负向影响，三者均能够在一定程度上降低出勤主义行为的产生。

最后，通过对研究结果的分析，并结合医院临床护理管理的实际需要，从医院管理者与护理管理者的角度出发，对如何减少出勤主义行为及其负面影响提出了相应建议。

Presenteeism refers to the behavior that employees persisting in work even though they feel unwell and should take rest. It is a common phenomenon in the workplace. However, due to its concealment and lagging characteristics, presenteeism is easy to be ignored by managers, which leads to some negative effects such as declining health condition, job burnout and declining work performance, bringing greater losses to the organization. Other studies have shown that nurse is one of the professions with a high incidence of presenteeism. Due to the specialty and professionalism of nursing work, nurses' presenteeism will reduce the quality of nursing, even impact the treatment and life safety of patients. At present, the researches on presenteeism in China are relatively few. Therefore, the level, characteristics, consequences and influencing factors of presenteeism behavior of nurse groups in China deserve further exploration.

This study chose a third-level grade-A hospital, 284 nurses in Beijing as the research object and conducted a self-report questionnaire to investigate the concerns and causes of presenteeism based on the current level of nurse presenteeism. Then analyzed the impact of presenteeism on job burnout, and verified whether the leader-member exchange, coworker support and perceived cohesion could reduce the occurrence of presenteeism from team perspective.

The results showed that in all samples, 170 nurses (59.86%) reported that they had experienced presenteeism in the past 6 months, the mean of presenteeism cumulative number was 1.60 times. and the mean of presenteeism cumulative days was 3.57 days, indicating that presenteeism was common among nurses. The results of difference analysis showed that nurses with different marital status and different employment forms had significant differences in presenteeism. The results of correlation analysis showed that the presenteeism behaviors number had significant positive correlation with age, average number of patients to nurse per day, cumulative number of absentee due to illness, cumulative number of extra work hours, professional title and working years. In terms of the work reasons that nurses insisted on working when they were sick, the most important concern of nurses was that it would affect the work progress of the team and organization, while the concern level for personal factors such as salary and promotion was relatively low, but it was still one of the reasons for presenteeism.

Through hierarchical regression analysis of thecumulative number of presenteeism and job burnout, it was found that the cumulative number of presenteeism behaviors had positive effects on the total score of job burnout, emotional exhaustion dimension and depersonalization dimension, indicating that presenteeism would increase the level of job burnout. From the team perspective, the exchange relationship between leaders and members and support from coworkers  has a significant negative impact on presenteeism, and perceived cohesion has a negative impact on presenteeism, all of three indicators could reduce presenteeism.

Finally, based on the analysis of the research and the actual requirement of clinical nursing management, this study made suggestions to reduce presenteeism behavior and its negative effects from nurses' management and hospital management perspective.