Based on the stimulus-organism-response theory and cognitive-affective personality system theory, this paper explores how the theoretical model of the workplace safety climate (WSC) influences presenteeism. Affect-based trust and cognition-based trust are assessed, and the situational role of organization formalization is examined. Using a time-lagged research design, data from 396 healthcare employees were gathered and multiple regression and bootstrapping were used to test each hypothesis.

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... results show that: (1) WSC significantly reduces presenteeism. (2) Both affect-based trust and cognition-based trust mediate the relationship between WSC and presenteeism. Affect-based trust exerts a complete mediating role, while cognition-based trust exerts a partial mediating role. (3) Cognition-based trust completely mediates the relationship between affect-based trust and presenteeism. (4) Organization formalization exerts a positive moderating effect on the relationship between WSC and affect-based trust. However, it exerts no significant moderating effect on the relationship between WSC and cognition-based trust. This study overcame the single research perspective. Combined with organizational, work-related, and person-related factors, the internal logic of the impact of WSC on the decision-making process in presenteeism was identified. The research results provide practical information for enterprises to create a sustainable organizational environment, reduce risks related to human resources, and effectively manage organizational health.