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Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital. [ABSTRACT FROM AUTHOR]

Occupational health and safety management systems (OHSMS) promote healthy workplace environments through regulating hazards and health promotion activities. Abuse within elite sports is one hazard that threatens the health and safety of elite adult athletes. Despite the widespread existence of evidence-informed guidelines to safeguard youth athletes, few safeguards have been developed for elite adult athletes, despite sport being their primary occupation. Through a critical realist lens, we used a thematic meta-synthesis to search, appraise and synthesize 20 articles conducted with elite adult athletes who have experienced abuse. We present three themes to highlight: (a) how abuse types (sexual, psychology, physical, and financial) are fluid and expand over time, (b) the contextual factors that influence abuse (individual, relational, structural, cultural), and (c) temporal impacts of abuse throughout athletes' early, late, and post-sport careers. The present work is discussed in relation to perceived advancement of OHSMS and safe sport through protecting athletes from the hazards present within their occupational environments. [ABSTRACT FROM AUTHOR]