The Bidirectional Relationship Between Workplace Bullying and Presenteeism: A Systematic Review and Meta-Analysis

Background: Although previous studies suggest a link between workplace bullying and presenteeism, uncertainties persist regarding the direction, strength, and influencing factors. Understanding the potential mediators and moderators is crucial to addressing these issues in workplace settings. Objective: This study aims to clarify the bidirectional relationship between workplace bullying and presenteeism, assess the strength and direction of this association, and identify individual and work-related factors that mediate or moderate these interactions. Methods: A systematic search of nine databases (PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PsycINFO, CNKI, WANFANG, and Chinese Biomedical) was conducted from inception through March 30, 2023, with an update on September 8, 2024. Independent reviewers screened the literature, extracted data, and evaluated methodological quality using the Risk Of Bias In Non-randomized Studies of Exposure tool. Odds ratios, relative risks, and 95% confidence intervals were calculated to assess effect sizes. Results: After adjusting for confounders, workers exposed to workplace bullying had 1.74 times higher odds of reporting presenteeism compared to non-exposed individuals (95% CI [1.02, 2.46]). Workers reporting presenteeism also had increased odds of later workplace bullying exposure ( OR = 2.29, 95% CI [1.23, 3.36]). Various individual and work-related factors were identified as potential mediators and moderators influencing these associations. Conclusion: This study establishes a bidirectional relationship between workplace bullying and presenteeism. Both individual and work-related factors play a critical role as mediators and moderators, potentially mitigating or amplifying the workplace bullying-presenteeism cycle. Future interventions should target these factors to disrupt this harmful dynamic and improve employee well-being.