Why do nurses work in the state of ill-health? Exploring the roles of nurse leader’s personality and cognitive preference

Purpose: Nurses are a representative occupational group experiencing high incidence of presenteeism. Based on social information processing theory and self-determination theory, this study examined the impact and underlying mechanisms of head nurses’ personality traits on the presenteeism among subordinate nurses. Specifically, this study examines the mediating role of head nurses' cognitive preferences towards presenteeism and the moderating effect of leader identification. Methods: A cross-sectional study design was employed, including 1,338 nurses from 232 nursing teams across six hospitals. Data were collected using the Nurse Presenteeism Questionnaire, Cognitive Preference Questionnaire, Chinese Adjectives Scale of Big-Five Factor Personality, and Leader Identification Questionnaire. Descriptive statistics, correlation analyses, and multilevel linear regressions were utilized for data analysis. Results: Head nurses’ neuroticism positively influenced subordinates’ presenteeism through head nurses’ cognitive preference. Conversely, extraversion, agreeableness, openness, and conscientiousness of head nurses negatively influenced nurses’ presenteeism through head nurses’ cognitive preference. Leader identification enhance the relationship between head nurses’ cognitive preference and subordinates’ presenteeism. Conclusion: This study integrates self-determination theory into the field of presenteeism, provides a more nuanced and stable understanding of how leaders influence followers’ presenteeism. Additionally, it explores the personal agency and individual motivation of nurses, offering valuable insights for future research.