Prevalence and Factors Associated with Sickness Presenteeism among Thai and Foreign Teachers Following the End of COVID-19 Public Health Emergency of International Concern

Article information

Korean J Fam Med. 2024;45(6):337-345
Publication date (electronic) : 2024 April 22
doi : https://doi.org/10.4082/kjfm.23.0224
1Science and Technology Learning Subject Group, Anuban Chonburi School, Chonburi, Thailand
2Occupational Health and Safety Program, Bansomdejchaopraya Rajabhat University, Bangkok, Thailand
*Corresponding Author: Chan Pattama Polyong Tel: +66-879953306, Fax: +66-2473-7000, E-mail: chanpattame.po@bsru.ac.th
Received 2023 October 16; Revised 2023 November 7; Accepted 2023 November 19.

Abstract

Background

Sickness presenteeism (SP) refers to the phenomenon where employees attend work while sick, a decision that impacts both their physical and mental well-being and can lead to burnout. This study aimed to determine the prevalence of and factors influencing SP among Thai and foreign teachers following the end of the coronavirus disease 2019 public health emergency of international concern (PHEIC).

Methods

A sample of 400 individuals was analyzed using chi-square tests and logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CI).

Results

Post-PHEIC, a significant proportion of teachers (51.9%) perceived an increase in their workload, and 62.1% reported having taken health-related leave of absence. The prevalence of SP was high (35.0%). Factors significantly associated with SP (P<0.05) included being younger than 37 years (OR, 1.825; 95% CI, 1.108–3.006), facing monthly financial challenges (OR, 1.627; 95% CI, 1.028–2.575), doing school-related work on holidays (OR, 1.920; 95% CI, 1.180–3.122), and experiencing sleep disturbances owing to work-related stress (OR, 1.910; 95% CI, 1.203– 3.033). No discernible difference existed in SP rates between Thai and foreign teachers.

Conclusion

As a course of action, we recommend the provision of appropriate financial planning resources for teachers. Policywise, school events and activities should be scheduled on working days to ensure that teachers maintain a work-life balance. Additionally, task allocation that caters to individual strengths and limitations can mitigate the effects of SP.

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on every continent. The spread of COVID-19 has resulted in increasing cases and fatalities, prompting the World Health Organization (WHO) to declare a public health emergency of international concern (PHEIC) on January 30, 2020 [1]. Thailand was among the first countries outside China to report infections. However, advances in medical science lead to a worldwide reduction in the number of infections by 2023. Subsequently, the WHO announced the conclusion of the PHEIC status on May 4, 2023 [2]. This announcement facilitated the easing of preventive measures against COVID-19, allowing educational institutions to resume conventional teaching practices.

The preceding COVID-19 landscape posed significant challenges to the education sector, affecting approximately 90% of both teachers and students [3]. An expansive Australian research study highlighted that students’ learning capacities diminished during the pandemic, primarily because of the shift to online teaching [4]. This sudden transition required educators to adapt swiftly by integrating technology and modifying their teaching methodologies [3]. A qualitative investigation into teachers’ experiences during the pandemic underscored primary concerns, which included adapting teaching strategies, facing various challenges, ensuring technological preparedness, and maintaining motivation [5]. Failure to adapt promptly to these changes had potential repercussions for educators’ physical and mental health.

The COVID-19 pandemic has led to changes in Thailand’s educational system for more than 2 years. Therefore, with the announcement of the end of the PHEIC, adjustments were made to the country’s educational and health policies. However, the spread of the infection continues; if teachers in a school are infected with COVID-19, they can be suspended for a short period of time. Furthermore, COVID-19 symptoms may have long-term consequences in certain individuals. A thorough systematic analysis indicated that the most common chronic symptoms are shortness of breath or dyspnea, weariness or exhaustion, and sleep disturbances or insomnia (frequencies were 36.0%, 40.0%, and 29.4%, respectively) [6]. However, teachers were unable to take an extended break as they did before the PHEIC announcement when they could either work from home or stay at home for up to 14 days [7]. Presently, the policy allows for a 5-day leave [8]. Consequently, this may be a contributing factor affecting their well-being, potentially leading to long-term physical and mental repercussions [9].

The concept of sickness presenteeism (SP) refers to situations in which employees come to work despite being unwell, even if they qualify for sick leave [10,11]. This phenomenon appears to be particularly pronounced among educators. A study comparing teachers, nurses, and private-sector workers found that teachers are more likely to experience SP-related challenges than their counterparts in other professions [12]. This is especially true for elementary school educators who are expected to consistently monitor and engage with their students. In instances of illness, unless a substitute is available, they often feel compelled to work [13]. Additionally, interactions with supervisors, colleagues, and broader school administrations can exacerbate feelings of exhaustion among teachers [14]. The pandemic further heightened psychosocial risks for educators, resulting in increased conflict with colleagues, students, or even family [15]. Moreover, the rise of cyberbullying during online teaching sessions has been linked to diminished teacher performance, potentially leading to both SP and teacher burnout [13].

In Thailand, the term “SP” has recently gained significant attention [16]. It presents both economic and health implications, manifesting in reduced work productivity, decreased quality of output, and diminished motivation. Over prolonged periods, this can escalate into stress, culminating in employee resignation. In the past, research on SP in Thailand was confined primarily to medical personnel. One study revealed an SP prevalence rate of 48.1% among this group. Consequently, this led to a 5.12-fold decline in work efficiency, and hospital office staff exhibited elevated stress and burnout levels at 3.89 and 2.66 times the norm, respectively [17]. However, limited research exists on SP prevalence in other occupational sectors within the country.

As part of Thailand’s strategic vision for 2023–2037 AD, the 13th Sustainable Development Goals agenda emphasizes enhancing the health and well-being of the Thai population. Correspondingly, the National Education Reform Plan mandates the safeguarding of educators and educational staff from all potential threats [18]. Furthermore, the Safety Master Plan of Office of the National Economic and Social Development Council of Thailand has been formulated to advocate for a secure and healthy work setting for all employees [19]. Historically, there has been scant mention of SP. In Thailand, there have been no studies on SP among teachers. To the best of our knowledge, this is the first study to report these findings. However, labor studies in Spain have indicated that domestic and foreign workers exhibit different SP [20]. This difference might be attributed to disparities in welfare, including the cost of living away from family, working far from home, and cultural variations, among other factors. This study investigated the occurrence of and factors influencing SP among Thai and foreign educators. The hypothesis is that work-related elements following the recent COVID situation impact teachers’ SP with Thai and foreign teachers experiencing distinct SP. Such insights can pave the way for the identification of risk factors and formulation of guidelines for illness prevention and health promotion. This not only benefits educators, but also extends their professional output. Well-equipped and healthy educators should be better poised to effectively instruct students who represent the nation’s future.

METHODS

1. Study Population and Design

This study employed a cross-sectional design. The sample size was calculated using the G*Power program (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; http://www.gpower.hhu.de/) [21]. Data were analyzed using regression models, and the odds ratio (OR) derived from Kabito and Wami [22] was 1.61 (95% confidence interval [CI], 1.29–3.74). With an α value of 0.05 and a power (1–β) of 0.95, the minimum sample size was estimated to be 367 individuals. The final sample size was adjusted to 400 to account for a 10% non-response rate, and simple random sampling was employed.

The researcher explained to the school director that they would like to collect data using a questionnaire and use public relations to recruit sample groups. The researcher officially obtained permission from the directors of schools in the research area. The research team explained the objectives of the research project, its benefits, and the collection of information and answered various questions on the day of the schoolwide teacher meeting. The details were publicized in the form of infographics through school boards and online channels. After publicizing the overall group, if the sample wished to participate in the research, the researcher provided individual communication channels to answer any questions that might arise during data collection.

Using a sampling method, the researcher selected schools that offered bilingual instruction in Chonburi Province. To provide a similar environmental setting, the ratio of Thai to foreign teachers was maintained at approximately 3:1. Subsequently, a simple random sampling approach based on probability was applied to select educational professionals randomly from a list until the sample size was calculated.

The inclusion criteria were being employed as a teacher for at least 6 months and, for foreign teachers, the ability to teach in English or understand an English-language questionnaire. Voluntary participation in the study was required. Exclusion criteria included absence from work on the day of data collection. Ethical approval was obtained from the Human Ethics Committee of Bansomdejchaopraya Rajabhat University and followed the principles of the Declaration of Helsinki, Council for International Organizations of Medical Sciences, and International Conference on Harmonization-Good Clinical Practice with a certificate of approval number BSRU-REC 660802.

2. Research Tool

The research utilized a questionnaire tailored to the linguistic preferences of the respondents: Thai for Thai teachers and English for foreign teachers. The questionnaire, obtained from literature reviews and standardized assessment forms, was divided into three sections: demographic information, work history, and SP. The sections are outlined as follows:

Part 1: This section contained ten questions capturing data on sex, age, height, weight, overall health status, congenital diseases, number of children in care, financial status, exercise habits, and alcohol consumption. Quantitative data such as age, weight, and height required respondents to fill in specific numbers. For others, the participants chose multiple options. For instance, in the exercise question, options were “no” or “yes,” with those selecting “yes” indicating the frequency. Similarly, for the congenital disease question, options were “no” and “yes,” with “yes” respondents providing details of their condition.

Part 2: This section included six questions focusing on previous work history, duration of work associated with schooling, whether the COVID-19 situation affected work hours or workload, instances of coming to school despite illness, taking leave owing to health concerns, and losing sleep because of work-related stress. Respondents provided numeric answers or selected from multiple-choice options. For instance, concerning leaves taken owing to health reasons, the options were “never” and “ever.” If “ever” was chosen, respondents indicated the number of days taken off in the past month.

Part 3: The Stanford Presenteeism Scale (SPS-6) assessment form was employed, which consisted of six questions probing health concerns, the ability to meet work objectives, feelings of empowerment, stress management skills, concentration levels at work, and feelings of hopelessness [23]. Responses were measured on a Likert scale, providing five choices: “extremely low,” “low,” “moderate,” “high,” and “extremely high.”

3. Research Tool Quality

The questionnaire underwent a thorough assessment based on the Index of Item Objective Congruence (IOC) by three domain experts. The IOC scores ranged from 0.67 to 1.00. For clarity and comprehension, the English version of the questionnaire was translated by a Thai English teacher. Subsequently, foreign educators reviewed and refined the linguistic aspects. Before the final deployment, a trial was conducted with 30 elementary school educators. The reliability coefficient of the SPS-6 section of the questionnaire was 0.89, ensuring consistency and validity in line with standard measurement and evaluation benchmarks.

4. Interpretation of SPS-6

The SPS-6 comprises six questions, each rated on a Likert scale ranging from 1 to 5. A score of 1 corresponds to the response “extremely low,” while a score of 5 signifies “extremely high.” Thus, the possible scores for respondents ranged from a minimum of 6 to a maximum of 30 points. Notably, the scoring pattern was reversed for questions framed negatively. The established threshold score, based on several referenced studies [23-25], is 18 points. Scores below 18 indicated low SP levels, whereas scores above 18 indicated high SP levels.

5. Statistical Analysis

The primary variable, SP, was assessed using the Kolmogorov-Smirnov test to gauge data distribution. Normally distributed data were subjected to the inferential statistical tests. This study employed descriptive and inferential statistical methods. Descriptive statistics included frequency, percentage, mean, and standard deviation. For inferential statistics, a comparison of demographic characteristics and work histories between Thai and foreign teachers was performed using a chi-square test. Additionally, factors influencing SP were analyzed using logistic regression in conjunction with univariate analysis. Subsequently, variables exhibiting a P-value less than 0.25 were incorporated into a multivariate analysis, with a statistical significance threshold set at a P-value of less than 0.05 [26].

RESULTS

1. Participant Characteristics

Of the 400 participating teachers, a significant majority were female, accounting for 85.8%. Approximately two-thirds (68.3%), were under the age of 37. Regarding body weight, 63.9% of the participants were either thin or obese. More than half (51.5%) reported not engaging in regular exercise, whereas a significant percentage (81.0%) abstained from alcohol consumption. Regarding health and financial stability, 83.8% indicated having no underlying health conditions and 94.0% rated their health status as satisfactory. A minority (36.7%) highlighted the monthly responsibility of sending money to dependents, such as children or relatives. Furthermore, 38.3% of the respondents faced recurring financial challenges each month.

When comparing the characteristics of Thai and foreign teachers, most showed no significant divergence. However, Thai teachers exhibited a higher proportion of females and those aged above 37 years than their foreign counterparts, with this difference being statistically significant (P<0.05) (Table 1).

Participant characteristics of Thai and foreign teachers

2. Work History

The work history results revealed that the majority of the teachers had less than 10 years of teaching experience (67.7%). Furthermore, 66.2% of the teachers reported working more than 8 hours per day on school-related activities, with 66.5% indicating that they worked during holidays. In relation to the past COVID-19 situation, the working period remained consistent for 56.4% of the teachers. However, following the end of the PHEIC due to COVID-19, 51.9% of teachers experienced an increase in their workload.

Over the past year, a significant proportion (60.4%) of the teachers came to work despite being ill. Additionally, 62.1% had taken leave owing to health issues and 42.5% had faced sleepless nights in the last 2 months because of school-related concerns. Interestingly, Thai and foreign teachers exhibited similar trends in their work histories (Table 2).

Work history of Thai and foreign teachers

3. Comparison of SP among Thai and Foreign Teachers

This comparative study revealed no significant differences in SP between Thai and foreign teachers. Thai teachers registered a high SP rate of 34.2%, while foreign teachers registered a slightly higher SP rate of 37.8%. The details of this comparison are presented in Table 3.

Comparison of SP among Thai and foreign teachers

4. Factors Influencing SP among Thai and Foreign Teachers

The analysis revealed that both participant characteristics and work history significantly influenced the SP. Notably, participant factors such as being younger than 37 years (OR, 1.825; 95% CI, 1.108–3.006) and experiencing monthly financial difficulties (OR, 1.627; 95% CI, 1.028–2.575) emerged as significant predictors. On the work front, teachers who engaged in schoolwork during holidays (OR, 1.920; 95% CI, 1.180–3.122) and those who experienced sleeplessness over the past 2 months due to concerns about schoolwork (OR, 1.910; 95% CI, 1.203–3.033) were more likely to exhibit higher SP (Table 4). However, the other factors did not show any correlation with SP.

Factors influencing SP among Thai and foreign teachers

DISCUSSION

The current study on SP is the first research initiative addressing educators in Thailand. Historically, SP research has primarily focused on medical professionals [16,17]. Both educators and healthcare practitioners have been designated as occupational groups with heightened susceptibility to SP, as highlighted in previous literature [27]. The inherent nature of these professions necessitates unwavering dedication to their respective roles, often compelling individuals to persist despite potential health issues. Consistent presence is indispensable to ensure the uninterrupted execution of daily responsibilities. Although international academic contributions have documented SP among educators [12,14,28], disparities in educational infrastructure, welfare programs, and sociocultural environments between countries underscore the importance of specialized research paradigms. This study aimed to elucidate the prevalence and associated risk factors of SP, positing it as an antecedent to increased work-related stress, subsequent burnout, and potential resignation. An element distinguishing this study is its examination of foreign educators within Thailand, a demographic overlooked in earlier studies, thus amplifying a comprehensive understanding of SP within the Thai context.

When comparing Thai and foreign teachers, we observed many similarities in demographic characteristics. However, Thai teachers are predominantly female and generally older than foreign teachers. Many foreign teachers teaching English, especially in the Chonburi region, come from the Philippines, where English is the official language. These Filipino teachers are typically younger than their Thai counterparts. The study also highlighted that a large majority (84.0%) of Thai teachers were part of the bureaucratic system, with only 16.0% on temporary contracts. This structure leads to fewer Thai teachers changing jobs or leaving their roles, which explains why they tend to be older than foreign teachers.

In the present study, the prevalence of SP was 35.0%. Interestingly, no discernible difference existed between Thai and foreign teachers in this regard. Internationally, the incidence of SP among teachers has been documented in several studies. For instance, Dudenhöffer et al. [14] reported an SP rate of 57.1% among German teachers, while a separate study indicated a prevalence of 65.2% in Nicaragua [25]. Such statistics could potentially be attributed to the systemic operations of the teaching profession. Both aforementioned studies identified improper managerial support and oversight as key contributors to the occurrence of SP [9,14]. Notably, in this study, 66.5% of the respondents reported working during holidays. Furthermore, during the COVID-19 pandemic, 56.4% reported no change in their working hours, whereas 51.9% reported an increase in their workload. The pandemic has accelerated the adoption of technology in teaching, which, given the rapidity of the shift, may have caused discomfort for educators.

Several demographic variables influenced the SP. Teachers younger than 37 years exhibited a higher likelihood of experiencing SP. Monthly financial distress is also identified as a risk factor. Notably, the age threshold of 37 years in this study separated the Generation X and Y cohorts. The results indicate that those under 37 years (Generation Y) were more prone to SP than their older (Generation X) counterparts. This disparity may be rooted in generational behavioral and attitudinal differences. A survey by the Thailand Ministry of Public Health highlighted distinct lifestyle patterns for Generation Y, characterizing them as ambitious, highly committed to career success, tech-savvy, and frequently multitasking online [29]. Such differences in outlook and work habits between generations may result in diverging acceptance levels of institutional norms and practices, potentially causing psychological stress for younger educators.

Regarding compensation, teachers facing monthly financial constraints were 1.627 times more susceptible to SP than those without such financial challenges. This finding aligns with research from Poland, which identified financial hardships and challenges in accessing medical care during illnesses as significant predictors of SP among teachers [12]. In a local context, a survey conducted across 22 elementary schools in Thailand revealed a concerning level of indebtedness among educators. Notably, a substantial number of these teachers were in debt, with figures surpassing one million baht. Of this group, 46.2% had secured loans from teacher savings cooperatives, with a staggering 76.6% reporting their income as insufficient to meet monthly expenditures. The issue of teachers’ mounting debts has been a persistent concern for the Thai government [30]. Furthermore, this study highlights that one in every three teachers bears monthly financial responsibilities for the upbringing or care of children, grandchildren, or other relatives. As a result, 38.3% of the respondents reported facing consistent monthly financial challenges.

Work-related factors associated with SP include teachers undertaking school-related tasks during holidays and experiencing sleeplessness owing to contemplation of schoolwork. On typical working days, primary school educators are primarily tasked with teaching responsibilities that require their constant presence in the classroom to supervise students. This is particularly evident in schools located in the city of Chonburi, the central hub of the Eastern Economic Corridor. In this region, a significant proportion of parents are employed in the industrial sector. Given the work context, students often drop off at school earlier than the usual time observed in other districts, and are picked up later, aligning with the end of industrial workdays. Consequently, urban schools in these areas frequently offer supplementary evening classes to accommodate students waiting for their parents. This arrangement contributes to extended working hours for teachers, with 66.2% reportedly working more than 8 hours daily. Owing to constraints such as official paperwork and meetings during regular office hours, teachers often resort to fulfilling their responsibilities during holidays. Another concerning finding of this study was the notable percentage (42.5%) of teachers who reported sleeplessness induced by persistent thoughts about their school duties. Such mental preoccupations not only disrupt sleep, but can also lead to physical ailments. Previous research indicates that teachers who experience inadequate rest are 1.28 times more susceptible to SP (95% CI, 1.03–1.59) [28].

The results of this study are consistent with organizational behavior theory. Newstrom and Davis [31] stated that organizational behavior consists of behavior at three levels: individual, group, and organizational. In this study, SP conditions were found at the individual (age and financial status), group (coming to work on holidays), and organizational levels. Schools receive government policies that consider scheduling time off due to illness. In particular, if a teacher is infected with COVID-19, the length of stay will decrease. Even in the presence of chronic symptoms, teachers must work. If teachers take a break, they must complete a sick leave form, which is also a loss of leave. However, if all individuals are treated fairly when carrying out the same tasks, particularly at the organizational level, this can foster positive organizational behavioral interactions and mitigate work-related boredom and anxiety [32].

1. Highlights and Limitations

This study marks a significant milestone as it is the first in Thailand to explore the prevalence of SP among education professionals. The underlying motivation for this study stems from the desire to identify the root causes of SP and devise potential preventive measures. The persistent issue of teacher resignations in Thai education underscores the importance of this study. This study responded to the pertinent cross-sectional research questions with a substantial sample size of 400 participants. Furthermore, the inclusion of both Thai and foreign teachers enriches the scope of this study, allowing for a more comprehensive understanding of the challenges faced.

2. Conclusions

In the study, it was observed that teachers demonstrated a significant SP prevalence of 35.0%. Interestingly, no discernible differences in SP rates were observed between Thai and foreign teachers. Several factors were found to correlate with SP, including being under the age of 37, monthly financial challenges, working on school tasks during holidays, and disrupted sleep due to work-related concerns. Based on these findings, we offer several recommendations for future research. From a policy perspective, it is vital that schools schedule learning and related activities during standard office hours. This approach would help ensure that teachers align their holidays more harmoniously with their personal lives. Moreover, establishing a straightforward leave substitution system is essential. Notedly, it is crucial that teachers adopt prudent financial planning. To aid this, the human resources departments can play an active role by either promoting or arranging financial planning sessions. Future research should explore programs that enhance and bolster teachers’ positive energies and well-being.

Notes

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

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Article information Continued

Table 1.

Participant characteristics of Thai and foreign teachers

Characteristic Teachers
Total χ2 P-value
Thai Foreign
Sex
 Male 36 (11.6) 21 (23.3) 57 (14.3) 6.911 0.009*
 Female 274 (88.4) 69 (76.7) 343 (85.8)
Age (y)
 <37 196 (63.8) 75 (83.3) 271 (68.3) 11.319 0.001*
 ≥37 111 (36.2) 15 (16.7) 126 (31.7)
Body mass index
 Normal 104 (34.2) 38 (42.7) 142 (36.1) 1.796 0.180
 Thin/obese 200 (65.8) 51 (57.3) 251 (63.9)
Health status
 Optimal 290 (94.5) 83 (92.2) 373 (94.0) 0.284 0.594
 Suboptimal 17 (5.5) 7 (7.8) 24 (6.0)
Congenital disease
 Absent 258 (77.0) 77 (85.6) 335 (83.8) 0.133 0.715
 Present 52 (16.8) 13 (14.4) 65 (16.3)
Exercise habits
 Does not exercise 165 (53.2) 41 (45.6) 206 (51.5) 1.350 0.245
 Exercises 145 (46.8) 49 (54.4) 194 (48.5)
Alcohol consumption
 Abstains 251 (81.0) 70 (77.8) 321 (80.3) 0.269 0.604
 Consumes 59 (19.0) 20 (22.2) 79 (19.8)
Responsibility for dependents
 Does not have dependents 207 (66.8) 46 (51.1) 253 (63.3) 6.703 0.010*
 Has dependents 103 (33.2) 44 (48.9) 147 (36.7)
Monthly financial issues
 No financial issues 188 (60.8) 58 (64.4) 246 (61.7) 0.245 0.620
 Has financial issues 121 (39.2) 32 (35.6) 153 (38.3)

Values are presented as number (%).

*

P<0.05 (statistical significance).

Table 2.

Work history of Thai and foreign teachers

Work history Teachers
Total χ2 P-value
Thai Foreign
Years of teaching experience (y)
 <10 204 (69.2) 52 (62.7) 256 (67.7) 0.973 0.324
 ≥10 91 (30.8) 31 (37.3) 122 (32.3)
Average daily working hours (h)
 ≤8 93 (34.1) 27 (32.9) 120 (33.8) 0.003 0.954
 >8 180 (65.9) 55 (67.1) 235 (66.2)
Work during holidays
 No 107 (35.4) 24 (27.0) 131 (33.5) 2.270 0.174
 Yes 195 (64.6) 65 (73.0) 260 (66.5)
The COVID-19 pandemic has increased the duration of work
 No 174 (56.7) 50 (55.6) 224 (56.4) 0.005 0.946
 Yes 133 (43.3) 40 (44.4) 173 (43.6)
The COVID-19 pandemic has increased the workload
 No 150 (49.5) 39 (43.3) 189 (48.1) 0.826 0.363
 Yes 153 (50.5) 51 (56.7) 204 (51.9)
Continued to work when ill (past year)
 No 124 (40.5) 33 (21.0) 157 (39.6) 0.286 0.593
 Yes 182 (59.5) 57 (63.3) 239 (60.4)
Taken leave due to health issues (past year)
 No 110 (35.7) 41 (45.6) 151 (37.9) 2.462 0.117
 Yes 198 (64.3) 49 (54.4) 247 (62.1)
Sleeplessness from work-related concerns (past 2 months)
 No 184 (59.7) 45 (50.0) 229 (57.5) 2.321 0.128
 Yes 124 (40.3) 45 (50.0) 169 (42.5)

Values are presented as number (%).

Table 3.

Comparison of SP among Thai and foreign teachers

SP Teachers
Total χ2 P-value
Thai Foreign
Low (score <18) 204 (65.8) 56 (62.2) 260 (62.2) 0.252 0.616
High (score ≥18) 104 (34.2) 34 (37.8) 140 (35.0)
Mean±SD 16.57±2.11 16.64±2.01 16.58±2.09

Values are presented as number (%) or mean±standard deviation.

SP, sickness presenteeism; SD, standard deviation.

Table 4.

Factors influencing SP among Thai and foreign teachers

Factors SP
Univariate analysis
Multivariate analysis
Low High OR P-value OR (95% CI)
Age (y)
 <37 170 (62.7) 101 (37.3) 1.485 0.091 1.825* (1.108–3.006)
 ≥37 90 (71.4) 36 (28.6) Ref Ref
Congenital disease
 Absent 213 (63.6) 122 (36.4) Ref Ref
 Present 47 (72.3) 18 (27.7) 0.669 0.179 0.584 (0.311–1.096)
Monthly financial issues
 No financial issues 171 (69.5) 75 (30.5) Ref Ref
 Has financial issues 89 (58.2) 64 (41.8) 1.640 0.021 1.627* (1.028–2.575)
Alcohol consumption
 Abstains 218 (67.9) 103 (32.1) Ref Ref
 Consumes 42 (53.2) 37 (48.4) 1.865 0.015 1.444 (0.839–2.485)
Work during holidays
 No 78 (59.5) 53 (40.5) Ref Ref
 Yes 176 (67.7) 84 (32.2) 1.424 0.112 1.920* (1.180–3.122)
Taken leave due to health issues (past year)
 No 104 (68.9) 47 (31.1) Ref Ref
 Yes 155 (62.8) 92 (37.2) 1.313 0.214 1.196 (0.753–1.899)
Sleeplessness from work-related concerns (past 2 months)
 No 161 (70.3) 68 (29.7) Ref Ref
 Yes 98 (58.0) 71 (42.0) 1.715 0.011 1.910* (1.203–3.033)
Nationality
 Thai 204 (65.8) 104 (34.2) Ref
 Foreign 56 (62.2) 34 (37.8) 1.168 0.530 -
Responsibility for dependents
 Does not have dependents 169 (66.8) 84 (33.2) Ref
 Has dependents 91 (61.9) 56 (38.1) 1.238 0.323 -
Years of teaching experience (y)
 <10 164 (64.1) 92 (70.2) Ref
 ≥10 83 (68.6) 39 (32.0) 0.838 0.448 -
Average daily working hours (h)
 ≤8 81 (67.5) 39 (32.5) Ref
 >8 152 (64.7) 83 (35.3) 1.134 0.597 -
The COVID-19 pandemic has increased the duration of work
 No 143 (63.8) 81 (36.2) Ref
 Yes 116 (67.1) 57 (32.9) 0.867 0.505 -
The COVID-19 pandemic has increased the workload
 No 126 (66.7) 63 (33.3) Ref
 Yes 132 (64.7) 72 (35.3) 0.917 0.683 -
Continued to work when ill (past year)
 No 102 (65.0) 55 (35.0) Ref
 Yes 155 (64.5) 84 (35.1) 1.005 0.981 -

Values are presented as number (%) unless otherwise stated.

SP, sickness presenteeism; OR, odds ratio; CI, confidence interval; Ref, reference; COVID-19, coronavirus disease 2019.

*

P<0.05 (statistical significance).