ABSTRACT

Little is known about covert trading behaviour in secure hospital settings. This study evaluated the nature, prevalence, and frequency of covert voluntary trading behaviour (VTB) and of coercive trading behaviour (CTB) between patients in secure psychiatric units. Ninety-six eligible patients in 18 low or medium secure wards across South London anonymously completed a questionnaire exploring their experiences of covert trading behaviour (including exchanging, lending, borrowing, or gifting personal property, money, or services) during their current hospital admission. About 70.2% reported engaging in some form of unauthorised VTB (38.3% ≥5 different behaviours). VTB was more commonly reported by male (74.7%) than female (36.3%) participants (odds ratio (OR) = 4.93, 95% confidence intervals (CI) = 1.28,19.05, p = 0.021). Engagement in any CTB behaviour was reported by fewer patients (31.9%). Participants were significantly more likely to report themselves as victims of coercive behaviours (8.6%–14.0% across different behaviours) rather than instigators (1.1%–5.5% across behaviours). Involvement in CTB was more common in patients reporting VTB (39.4%) compared to those not involved in VTB (14.3%; OR = 3.90, CI = 1.21,12.54). Covert patient trading appears commonplace in secure psychiatric inpatient settings and VTB participation may be linked with CTB engagement. Hospital policies to better monitor and regulate patient trading may help to reduce the incidence of CTB.

摘要

人们对安全医院环境中的秘密交易行为知之甚少。本研究评估了安全精神病院患者之间隐蔽自愿交易行为 (VTB) 和强制交易行为 (CTB) 的性质、普遍性和频率。伦敦南部 18 个低级或中级安全病房的 96 名符合条件的患者匿名填写了一份调查问卷，探讨他们在当前入院期间的秘密交易行为（包括交换、借贷、借用或赠送个人财产、金钱或服务）的经历。大约 70.2% 的人报告参与某种形式的未经授权的 VTB（38.3% ≥5 种不同行为）。男性 (74.7%) 比女性 (36.3%) 参与者更常报告 VTB（比值比 (OR) = 4.93，95% 置信区间 (CI) = 1.28,19.05，p = 0.021）。报告参与任何 CTB 行为的患者较少 (31.9%)。参与者更有可能将自己报告为胁迫行为的受害者（不同行为中的 8.6%–14.0%），而不是煽动者（不同行为中的 1.1%–5.5%）。与未参与 VTB 的患者 (14.3%；OR = 3.90，CI = 1.21,12.54) 相比，报告 VTB 的患者参与 CTB 的情况更为常见 (39.4%)。秘密患者交易在安全的精神病住院环境中似乎很常见，VTB 的参与可能与 CTB 的参与有关。医院更好地监控和规范患者交易的政策可能有助于降低 CTB 的发生率。