Understanding prolonged work absence in Canadian nurses

In brief

  • Both personal health factors and workplace factors are associated with prolonged work absences among Canadian nurses.
  • Key personal health factors associated with prolonged work absence include pain-related work interference (difficulty in performing work activities because of pain), depression, pain severity and having a greater number of chronic pain-related conditions.
  • Key workplace factors associated with prolonged work absence include patient and co-worker hostility at work, low respect and support at work, and poor organizational culture.

Why was this study done?

In the past 10 years, the duration and cost of work absenteeism have increased. The length of work absences is of particular importance in health care, the sector with the highest rate of lost-time workers’ compensation claims and work absence in Canada. This study was done to examine the impact of worker and workplace factors on work absence duration among Canadian nurses.

How was the study done?

The study examined information from a representative sample of 11,762 female, nurses providing direct patient care from the Statistics Canada’s 2005 National Survey of the Work and Health of Nurses. Factors related to nurses’ personal health and to their workplaces were examined relative to three categories of self-reported cumulative work absence over one year: none, short-term (one to 10 work days) and prolonged (11 or more work days).

What did the researchers find?

Worker health factors—namely pain that interfered with the ability to work, more severe pain, depression, and having a higher number of chronic pain-related health conditions (arthritis, migraine and back pain)—had the biggest effect on the duration of nurses’ work absences. Although workplace factors had a smaller effect overall, those that had the most impact on absence duration were emotional or physical hostility by a patient, visitor and/or co-worker, and low respect and low support at work.

What did the researchers conclude?

The study’s findings suggest a number of ways in which health-care organizations might help decrease time away from work among nurses. They include:

  • implementing or augmenting violence prevention programs;
  • creating respectful and supportive workplaces for nurses (e.g. improving their relationships with doctors and co-workers, giving them more autonomy at work); and
  • offering work-focused self-management programs that address pain and depression.

What are some strengths and weaknesses of the study?

The strengths of this study include its large sample size and breadth of worker and workplace factors analyzed. Its weaknesses include the cross-sectional design of the Statistics Canada survey, which limits the ability to infer causal relationships. As well, the possibility of measurement error exists because information on worker health and workplace factors was self-reported by nurses. Finally, this study’s focus on understanding worker and workplace factors does not mean that other factors, such as insurance and health-care system factors, are not also important in driving the duration of work absences.  

Publication Information


Examining the impact of worker and workplace factors on prolonged work absences among Canadian nurses


Franche R-L, Ibrahim S, Smith P, Carnide N, Côté P, Gibson J, Koehoorn M


Journal of Occupational and Environmental Medicine, 2011: vol. 53, no. 8, pp. 919-927