Roster Flexibility on Work Absence Behavior among Nurses in a Government Hospital

This quantitative study used a descriptive-correlational design to examine roster flexibility, work absence behavior, and their association with selected profile variables among 234 nurses in a government hospital during the first quarter of 2026. Standardized questionnaires were utilized, and data were analyzed using frequency, percentage, mean, standard deviation, chi-square test, and Pearson r correlation. Results indicated generally high roster flexibility and responsible absence behavior among nurses, with significant relationships identified between selected variables. Roster flexibility was also found to be significantly correlated with work absence behavior. These findings underscore the importance of effective roster management in supporting workforce stability. A roster optimization and absence management enhancement plan is proposed to improve scheduling practices and promote nurse well-being.

Absence Behavior; Descriptive-Correlational Design

1. Albertsen, K., Garde, A. H., Nabe-Nielsen, K., Hansen, Å. M., & Lund, H. (2021). Work schedule flexibility and work–life balance among healthcare workers. International Journal of Environmental Research and Public Health, 18(6), 1–13. https://doi.org/10.3390/ijerph18063079 [Google Scholar] [Crossref]

2. Almazan, J. U., Rivera, R. R., & Santos, E. P. (2022). Flexible scheduling and work–life balance among Filipino nurses in tertiary hospitals. Philippine Journal of Nursing Research, 5(2), 45–56. [Google Scholar] [Crossref]

3. Aloğlu, N., & Güllü, A. (2022). Investigation of unplanned absenteeism of nurses working in a university hospital: Cross-sectional study. Journal of Radiology Nursing, 41(4), 326–330. https://doi.org/10.1016/j.jradnu.2022.06.001 [Google Scholar] [Crossref]

4. Boniol, M., McIsaac, M., Xu, L., Wuliji, T., Diallo, K., & Campbell, J. (2022). Gender equity in the health workforce: Analysis of 104 countries. Human Resources for Health, 20(1), 1–16. https://doi.org/10.1186/s12960-022-00726-w [Google Scholar] [Crossref]

5. Booker, L. A., Mills, J., Bish, M., Spong, J., Deacon-Crouch, M., & Skinner, T. C. (2024). Nurse rostering: Understanding the current shift work scheduling processes, benefits, limitations, and potential fatigue risks. BioMed Center Nursing, 23, 295. https://doi.org/10.1186/s12912-024-01949-2 [Google Scholar] [Crossref]

6. Brady, H. D. (2023). Sick leave determinants in the healthcare sector (Part II): A review of organizational-level factors. BioMed Center Health Management, 5(2), 45–56. https://doi.org/10.1186/s12913-023-09567-9 [Google Scholar] [Crossref]

7. Brady, M. (2023). Absenteeism in healthcare: Exploring organizational culture and workload intensity. Journal of Health Workforce Studies, 12(1), 33–47. [Google Scholar] [Crossref]

8. Dall’Ora, C., Ball, J., Redfern, O., et al. (2025). Nurse staffing configurations and nurse absence due to sickness. JAMA Network Open, 8(4), e255946. https://doi.org/10.1001/jamanetworkopen.2025.5946 [Google Scholar] [Crossref]

9. De Clercq, D., Haq, I. U., & Azeem, M. U. (2021). The relationship between workplace support and employee well-being. Journal of Nursing Management, 29(4), 1–10. https://doi.org/10.1111/jonm.13212 [Google Scholar] [Crossref]

10. De Clercq, D., Haq, I. U., & Azeem, M. U. (2021). Workplace support and employee well-being. Journal of Nursing Management, 29(4), 1–10. https://doi.org/10.1111/jonm.13212 [Google Scholar] [Crossref]

11. De Guzman, M. C. (2022). Presenteeism among Filipino nurses: Financial pressures and professional obligation. Asian Nursing Review, 14(2), 88–100. [Google Scholar] [Crossref]

12. Dela Cruz, P. R., & Martinez, A. J. (2022). Personal characteristics and scheduling preferences of Filipino nurses. Philippine Nursing Journal, 92(1), 15–28. [Google Scholar] [Crossref]

13. Emmanuel, A., Chua, L., & Fernandez, M. (2024). Work–life balance and the value of flexible rosters in nursing. International Journal of Nursing Practice, 30(1), e12982. [Google Scholar] [Crossref]

14. Falatah, R. (2021). The impact of work environment on nurses’ job satisfaction and retention. Journal of Nursing Management, 29(2), 302–310. https://doi.org/10.1111/jonm.13176 [Google Scholar] [Crossref]

15. Fan, E. M. P., Wong, E. L. Y., & Chau, P. Y. K. (2022). Impact of a change in rostering practices on absenteeism: Evidence from Singapore hospitals. Journal of Nursing Management, 30(4), 923–931. https://doi.org/10.1111/jonm.13648 [Google Scholar] [Crossref]

16. Gerlach, L., Smith, J., & Yu, K. (2024). Presenteeism in nursing: Causes, consequences, and coping strategies. Journal of Clinical Nursing, 33(4), 601– 612. [Google Scholar] [Crossref]

17. Gerlach, M., Hahn, S., Rossier, C., Geese, F., Hamers, J., & Backhaus, R. (2024). Presenteeism among nurses: An integrative review. International Journal of Nursing Sciences, 11(?)*, 100261. https://doi.org/10.1016/j.ijnsa.2024.100261 [Google Scholar] [Crossref]

18. Gerlach, M., Hahn, S., Rossier, C., Hamers, J. P. H., & Backhaus, R. (2024). Presenteeism among nurses: An integrative review. International Journal of Nursing Studies Advances, 6, 100154. https://doi.org/10.1016/j.ijnsa.2024.100154 [Google Scholar] [Crossref]

19. Gray, S., Johnson, R., & Kim, A. (2024). The power of self-scheduling: Frontline nurses’ insights and recommendations for improving nursing workforce flexibility. Journal of Nursing Management, 32(3), 657–669. https://doi.org/10.1111/jonm.13812 [Google Scholar] [Crossref]

20. Gray, T., Patel, S., & Wong, H. (2024). Self-rostering and its impact on nurse well-being. Nursing Management, 31(3), 42–49. [Google Scholar] [Crossref]

21. Grøtting, G., & Øvergård, K. I. (2023). The relation between routines for shiftwork scheduling and sickness absence at a Norwegian hospital: A cross-sectional study. International Journal of Nursing Studies, 141, 104477. https://doi.org/10.1016/j.ijnurstu.2023.104477 [Google Scholar] [Crossref]

22. Guo, S., Zhang, H., Chang, Y., Zhang, J., Chen, H., & Zhang, L. (2023). The relationship between presenteeism among nurses and patients’ experience in tertiary hospitals in China. Heliyon, 9(11), e22097. https://doi.org/10.1016/j.heliyon.2023.e22097 [Google Scholar] [Crossref]

23. Hämmig, O. (2021). Work-life balance and working conditions of healthcare personnel. BMC Health Services Research, 21(1), 1–10. https://doi.org/10.1186/s12913-021-06204-x [Google Scholar] [Crossref]

24. Holton, R., Lee, D., & Navarro, P. (2024). Equitable scheduling and job satisfaction in nursing. Journal of Nursing Administration, 54(5), 231–239. [Google Scholar] [Crossref]

25. Holton, S., Wallace, E., & McDonald, S. (2024). Developing nurse and midwife centered rostering principles using co-design. BioMed Center Health Services Research, 24, 1034. https://doi.org/10.1186/s12913-024-10345-2 [Google Scholar] [Crossref]

26. Karasek, R., & Theorell, T. (1990). Healthy work: Stress, productivity, and the reconstruction of working life. Basic Books. [Google Scholar] [Crossref]

27. Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse scheduling practices on nurse outcomes. Journal of Nursing Management, 29(2), 302–310. https://doi.org/10.1111/jonm.13176 [Google Scholar] [Crossref]

28. Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse scheduling practices on nurse outcomes. Journal of Nursing Management, 29(2), 302–310. https://doi.org/10.1111/jonm.13176 [Google Scholar] [Crossref]

29. Klyve, K. K., Olsen, J., & Pedersen, A. (2024). A modeling framework for evaluating proactive and reactive nurse scheduling. Operations Research for Health Care, 41, 100404. https://doi.org/10.1016/j.orhc.2024.100404 [Google Scholar] [Crossref]

30. Knight, S. (2025, May 6). How staffing flexibility models for hospitals boost nurse engagement. ShiftMed Insights. https://www.shiftmed.com/insights/knowledge-center/staffing-flexibility-models-for-hospitals [Google Scholar] [Crossref]

31. Maltezou, H. C., Ledda, C., & Sipsas, N. V. (2023). Absenteeism of healthcare personnel in the COVID-19 era: A systematic review. Healthcare, 11(22), 2950. https://doi.org/10.3390/healthcare11222950 [Google Scholar] [Crossref]

32. Manzo, K., & Estrella, J. (2023). The impact of partial self-scheduling on nurse morale in Philippine hospitals. Philippine Hospital Management Review, 11(1), 22–34. [Google Scholar] [Crossref]

33. Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2021). A nursing shortage—a prospect of global and local policies. International Nursing Review, 68(3), 386–393. https://doi.org/10.1111/inr.12673 [Google Scholar] [Crossref]

34. Medina-Garrido, J. A., Gómez, J. A., & Ramos, P. (2023). Work–family policies and absenteeism in healthcare. International Journal of Human Resource Management, 34(2), 290–308. [Google Scholar] [Crossref]

35. Min, A., Kang, M., & Hong, H. C. (2021). Sickness presenteeism in shift and non-shift nurses: Findings from the fifth Korean Working Conditions Survey. International Journal of Environmental Research and Public Health, 18(6), 3236. https://doi.org/10.3390/ijerph18063236 [Google Scholar] [Crossref]

36. Needleman, J., Lin, W., & Haviland, A. (2025). Long shifts and sickness absence in nursing. Health Services Research, 60(2), 123–134. [Google Scholar] [Crossref]

37. O’Connell, J., Hughes, R., & Brown, E. (2024). Electronic rostering in healthcare: Impacts on equity and satisfaction. Journal of Health Informatics, 16(2), 77–89. [Google Scholar] [Crossref]

38. O’Connell, M., & Richards, L. (2024). The impact of electronic and self-rostering systems on nursing practice. Journal of Clinical Nursing, 33(7–8), 1521–1532. https://doi.org/10.1111/jocn.17114 [Google Scholar] [Crossref]

39. Reyes, F. J., & Bautista, M. E. (2023). Age and tenure as predictors of absenteeism among Filipino nurses. Philippine Journal of Health Research, 7(3), 101–113. [Google Scholar] [Crossref]

40. Rony, M. K. K., Numan, S. M., & Alamgir, H. M. (2023). Work-life imbalance and absenteeism among nurses. Informatics in Medicine Unlocked, 38, 101226. https://doi.org/10.1016/j.imu.2023.101226 [Google Scholar] [Crossref]

41. Rosales, L., Dizon, C., & Perez, A. (2024). Workload intensity and absenteeism among nurses in Mindanao. Mindanao Journal of Nursing Studies, 3(1), 55–70. [Google Scholar] [Crossref]

42. Sabzi, A., Mohammadi, R., & Karimi, S. (2023). Predictors of absenteeism in nursing: A systematic review. BioMed Center Nursing, 22(1), 1–12. https://doi.org/10.1186/s12912-023-00921-4 [Google Scholar] [Crossref]

43. Sakr, C. J., Fares, L. M., Moussallem, U. M., et al. (2025). Absenteeism among healthcare workers: Job grade and other factors that matter in sickness absence. International Journal of Environmental Research and Public Health, 22(1), 127. https://doi.org/10.3390/ijerph22010127 [Google Scholar] [Crossref]

44. Santos, L., & Tolentino, G. (2023). Stress, absenteeism, and retention among nurses in Philippine hospitals. Journal of Nursing and Health Care, 18(4), 211–225. [Google Scholar] [Crossref]

45. Schug, C., Geiser, F., Hiebel, N., Beschoner, P., Jerg-Bretzke, L., Albus, C., Weidner, K., Morawa, E., & Erim, Y. (2022). Sick leave and intention to quit the job among nursing staff in German hospitals during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(4), 1947. https://doi.org/10.3390/ijerph19041947 [Google Scholar] [Crossref]

46. Schug, C., Geiser, F., Hiebel, N., et al. (2022). Sick leave and intention to quit among nursing staff. International Journal of Environmental Research and Public Health, 19(4), 1947. https://doi.org/10.3390/ijerph19041947 [Google Scholar] [Crossref]

47. Shan, G., Wang, S., Wang, W., Guo, S., & Li, Y. (2021). Presenteeism in nurses: Prevalence, consequences, and causes from the perspectives of nurses and chief nurses. Frontiers in Psychiatry, 11, 584040. https://doi.org/10.3389/fpsyt.2020.584040 [Google Scholar] [Crossref]

48. Shiri, R., Turunen, J., Kausto, J., & Härmä, M. (2022). Flexible working hours and employee well-being. Occupational and Environmental Medicine, 79(2), 1–8. https://doi.org/10.1136/oemed-2021-107610 [Google Scholar] [Crossref]

49. Steers, R. M., & Rhodes, S. R. (1978). Major influences on employee attendance: A process model. Journal of Applied Psychology, 63(4), 391–407. https://doi.org/10.1037/0021-9010.63.4.391 [Google Scholar] [Crossref]

50. Twigg, D. E., Gelder, L., & Myers, H. (2021). The impact of understaffed shifts on nurse-sensitive outcomes. Journal of Advanced Nursing, 77(1), 1–12. https://doi.org/10.1111/jan.14593 [Google Scholar] [Crossref]

51. Western Health. (2024). Employee-centred roster guidelines (Version 2). https://westerly.wh.org.au/nursing-midwifery/wp-content/uploads/2022/05/Employee-Centred-Roster-Guidelines_V2.pdf [Google Scholar] [Crossref]

52. World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. World Health Organization. https://doi.org/10.1016/S2155-8256(20)30119-6 [Google Scholar] [Crossref]

53. World Health Organization. (2023). Health workforce and scheduling practices. Human Resources for Health. https://doi.org/10.1186/s12960-023-00826-2 [Google Scholar] [Crossref]

54. Zhang, L., Tang, W., & Lau, C. (2025). Bounded flexibility in hospital rostering: Balancing staff preferences and patient safety. Journal of Health Care Management, 40(2), 95–108. [Google Scholar] [Crossref]

55. Zhang, Y., Punnett, L., & Gore, R. (2023). Work schedule flexibility and nurse well-being. International Journal of Nursing Studies, 137, 104378. https://doi.org/10.1016/j.ijnurstu.2022.104378 [Google Scholar] [Crossref]

• Knowledge and Attitude of Undergraduate Nursing Students towards Organ Donation
• Cold Hip Bath Therapy for Labor Pain Management: A Review of Non-Pharmacological Interventions in Women's Health
• Work Settings Utilizing the S.C.O.R.E Model on the Psychological Empowerment of Hospital Nurses in Cebu City
• An Assessment on the Quality of Life of PLHIV Residents in Digos City Barangays: Basis for Health Teaching Program
• Work-Related Stress and Its Psychodermatological Impact on Nursing Professionals