Éducation thérapeutique du patient et clinique transculturelle

The experience of chronic disease takes a particular heavy toll on immigrants. Therapeutic patient education (TPE) programs rarely address this population category specifically. How to reach out to these vulnerable groups? Can a transcultural clinic contribute to opening avenues for reflection? This approach aims at promoting healthcare professionals' cultural competences. It is rooted in the empowerment perspective and thus directly relates to TPE's efforts to make patients actors and share responsibilities in the management of chronic disease. But in order to achieve this, patients need to acquire knowledge not only on care techniques, but also on medical theories of their disease. In return, medical professionals must be able to access patients' representations of his/her disease and the ways it transformed his/her life. This exchange is dependent upon the necessary articulation between lay knowledge and expert knowledge. By having scientific theories of disease intersect with lay discourses without one disqualifying the other, the transcultural clinic opens up a new avenue, especially by establishing mediation technical units. It shows how cultural diversity -which is usually construed as an obstacle to care- may in fact play a catalytic role in improving the healthcare relationship. Pioneering experiments in the context of TPE should be led by associating patient groups sharing the same language. Such actions must be associated to training programs for TPE professionals.