Sciences sociales et santé


Quand les pratiques des soignants « calment » ou « stressent » les malades : l’accompagnement psychosocial des malades infectés par le SARS-CoV-2 à Bamako Volume 41, numéro 3, Septembre 2023


* Anthropologue, Faculté de Médecine et d’Odontostomatologie, Mali ; IRL 3189 Santé, Environnement, Société, Bamako, Mali ;
** Anthropologue, Agence de recherche MISELI, Bamako, Mali ;
*** Sociologue, Université Paris Cité, IRD, Inserm, Ceped, 75006 Paris, France ;
**** Epidémiologue, École de Santé Publique de l’Université de Montréal, Montréal, Canada ; Centre de recherche en santé publique, Montréal, Canada ;
***** Directeur de recherche, Université de Paris, IRD, Inserm, Ceped, 75006 Paris, France ; Institut de Santé et Développement, Université Cheikh Anta Diop, Dakar, Sénégal ;

The Covid-19 epidemic highlighted the need for psychological care of hospitalized patients infected with SARS-CoV-2. However, few studies have explored this need from an anthropological point of view. Our study aims to understand how the psychosocial support of infected patients was carried out in a referral hospital in the capital of Mali. Our ethnographic survey took place during the first two waves of the epidemic, from April to June 2020 (wave 1) and from December 2020 to January 2021 (wave 2), during which 47 semi-structured interviews and 106 observations of situations were conducted. Following the coding and transcription of the data, an inductive approach was used to analyze the material collected. We found multiple psychological difficulties among the patients, which could be cumulative. Fear of the disease is often linked to a lack of information, a feeling of abandonment by the staff and a poor quality of nursing. During the second wave, the massive arrival of dependent patients (cases of respiratory distress) increased the need for support. Psychosocial support was limited to rare attempts by caregivers to calm patients’ fears. The attitudes and practices of health care personnel (doctors, nurses, social workers) also often tended to aggravate rather than alleviate the psychological difficulties of patients. In the context of an epidemic, in order to achieve therapeutic efficacy and to help patients better cope with isolation, which is a source of recurrent stress, it is important to create the conditions to reduce the negative influence of caregivers on the mental health of patients.