Decoding the "Body Present, productivity Reduced " Phenomenon among Primary Health Care Workers: A Study on the Impact Mechanism of Role Overload on Presenteeism

Background Primary health care workers serve as a crucial human resource guarantee for the further improvement of the hierarchical medical system and constitute the backbone for forming a rational medical service pattern featuring "a slight illness be in the community, recovery be back to the community". This study aims to explore the impact mechanism of role overload on presenteeism in primary health care workers, and examine the mediating roles of occupational delay of gratification and work-family conflict in this relationship. Furthermore, by taking the occupation category of primary health care workers (doctors or non-doctors) as a moderating variable, the researchers constructed a mechanism mode. Methods Mature scales were adopted. Based on the Credamo data collection platform, 365 valid questionnaires from primary health care workers were collected through a two-wave questionnaire survey. Data analysis was conducted using SPSS 27.0 and Mplus 8.3 software. Results (1) Hindering mechanism: Role overload of primary health care workers exerted a significantly positive effect on work-family conflict (β = 0.569, p < 0.01); work-family conflict significantly increased presenteeism (β = 0.195, p < 0.01) and played a mediating role (β = 0.111, 95%CI = [0.431, 0.640]). (2) Facilitating mechanism: Role overload of primary health care workers had a significantly positive impact on occupational delay of gratification (β = 0.359, p < 0.01); occupational delay of gratification significantly reduced presenteeism (β = -0.854, p < 0.01), and played a mediating role (β = -0.307, 95%CI = [-0.287, -0.004]). (3) Boundary effect: Multi-group analysis results showed that the facilitating effect of occupational delay of gratification was more pronounced among non-doctors of primary health care workers (nurses, medical technicians, pharmacists) compared to doctors. Meanwhile, the hindering effect of work-family conflict is more pronounced in the doctors. Conclusion We confirmed the mediating roles of occupational delay of gratification and work-family conflict in the relationship between role overload and presenteeism, and the significant moderating role of the occupation category of primary health care workers (doctors or non-doctors). This study provides scientific evidence to reduce productivity loss among primary health care workers and offers a reference for managers of primary health institutions to formulate relevant intervention measures.