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      Niveau socioéconomique et processus du recours aux soins par les familles de patients souffrant de troubles psychiques au Burkina Faso Translated title: Socioeconomic status and health-seeking process by the families of mentally ill patients in Burkina Faso

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          Abstract

          Introduction

          Le Burkina Faso a connu une amélioration constante depuis deux décennies de l'offre de soins en psychiatrie. De même, le taux d'alphabétisation sans cesse croissant s'accompagne d'une profonde modification des conceptions et des comportements. La présente étude visait à déterminer l′impact des déterminants socioéconomiques sur le processus du recours aux soins par les familles.

          Méthodes

          Il s'est agi d'une enquête transversale portant sur 200 familles, menée dans le service de psychiatrie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou. Variable à expliquer: premier recours aux soins par les familles (guérisseur traditionnel ou prières religieuses vs. consultations psychiatrique ou médicale). Variable explicative: catégorie socioprofessionnelle classée en suivant la nomenclature des professions et catégories socioprofessionnelles; niveau d’études. L'analyse statistique a été effectuée à l'aide du logiciel SAS version 9.2. Le test du Khi deux a été utilisé.

          Résultats

          Il existait une association entre le choix du premier recours et la Profession et la catégorie socioprofessionnelledu « décideur » (p = 0.0006) ainsi que leniveau d’études du « décideur » (p = 0.0001).

          Conclusion

          La Profession et Catégorie Sociale et le niveau d'instruction scolaire pourraient être un marqueur important dans les politiques visant à optimiser les processus de recours aux soins des patients dans le circuit de soins.

          Most cited references12

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          Lifecourse socioeconomic position and alcohol use in young adulthood: results from the French TEMPO cohort study.

          The aim of the study was to examine the relationship between lifetime socioeconomic position and alcohol use in young adults. The participants (n = 1103, age 22-35 years in 2009) were the French TEMPO cohort, offspring of employees (all French nationals) of the French national gas and electricity company (GAZEL) who were in a previous cohort study. Alcohol use was assessed by the WHO AUDIT questionnaire (none, low or intermediate alcohol use, alcohol abuse). Childhood socioeconomic position was measured using parental income documented in the GAZEL study in 1989 (low: ≤ 2592€/month vs. intermediate/high: >2592€/month). Adult socioeconomic position was measured by participants' educational level (≤ high school degree vs. >high school degree). Combining family income and educational attainment, we ascertained participants' social trajectory (stable high, upward, downward and stable low). Data were analyzed using multinomial regression analyses controlled for demographic, social, psychological and family characteristics. Compared with participants with a stable high social trajectory, those with an upward, downward or low social trajectory were more likely to abstain from alcohol (compared with a stable high social trajectory, sex and age-adjusted ORs: OR = 2.22, 95% CI 1.35-3.65 for an upward social trajectory; OR = 3.20, 95% CI 1.78-5.73 for a downward social trajectory; OR = 3.27, 95% CI 1.75-6.12 for a stable low social trajectory). Additionally, participants with a downward social trajectory were disproportionately likely to abuse alcohol (sex- and age-adjusted OR: 1.48, 95% CI 0.89-2.48). In multivariate analyses, social trajectory remained associated with alcohol use. Lifelong socioeconomic position may shape patterns of alcohol use early in life.
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            [Traditional concept of madness and therapeutic difficulties in the Moose of Kadiogo.].

            The practice of psychiatry in the south of the Sahara in Africa collides with many problems of acceptability of care for the ill and their families. The frequent rejection of the psychiatrist's therapeutic approach can often be explained by the inadaptation of the etiopathogenic approach. Indeed, in black Africa, responsibility of illness differs according to the fact that one has been schooled or not. The western world teaches minorities having the chance to live there or learn about it, that the human body can be assaulted by bacteria, viruses, mycoses or be self-assaulted by changes of its own physiology. Traditional education, for its part, regards the body as a mysterious entity susceptible of being penetrated or eaten by geniuses and anthrophagic sorcerers following a mystico-religious mechanism linked to beliefs and customs. In the majority of the Moose of the Moaga plateau in Burkina Faso, especially regarding madness, these assailants are ancestral geniuses or geniuses from the bush. Psychological suffering caused by a family, social or intrapsychic conflict independent of the invisible world is ultimately delirious for them thus provoking a resistance to give up complete charge of their mentally ill to psychiatric care. For us, an analysis of probable causes of this resistance appeared necessary. Interviews have shown that the psychiatric institution is experienced by the Moose of Kadiogo as a stage in the therapeutic itinerary of their mentally ill, a stage in the course of which their demand for care is reduced to the elimination of inconvenient symptoms. For them, the elimination of the cause derives from a knowledge that psychiatry does not possess, which renders the therapeutic relationship frustrating for both parties.
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              Occupational grade and depression course in a non-clinical setting: results from the French GAZEL cohort study

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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                16 March 2014
                2014
                : 17
                : 207
                Affiliations
                [1 ]Etablissement Public de Santé Ville Evrard- 202 Avenue Jean Jaurès 93332 Neuilly sur Marne- France
                [2 ]Conservatoire National des Arts et Métiers, Chaire d’économie et gestion des services de santé, 82 bld de sébastopol 75003 Paris, France
                Author notes
                [& ]Corresponding author: Ahmed Yaogo, Etablissement Public de Santé Ville Evrard, secteur 6- 202 Avenue Jean Jaurès 93330 Neuilly sur Marne- France.
                Article
                PAMJ-17-207
                10.11604/pamj.2014.17.207.3222
                4142635
                25161751
                10cb47f3-41fa-41d6-8523-34ad11b28677
                © Ahmed Yaogo et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 August 2013
                : 04 March 2014
                Categories
                Research

                Medicine
                profession,catégorie sociale,niveau d'instruction scolaire,processus de recours aux soins,social category,level of schooling,health care seeking process

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