Approche culturelle dans l'annonce du diagnostic en ophtalmologie

There are important differences in the way cultures conceive diseases. The intercultural approach of diseases can enhance the ability of the medical staff to understand the patients' problems within their culture, to communicate medical explanations to the patients for better mutual comprehension, to alleviate patient's sufferings, to ensure compliance to follow up and treatment. We report the case of a multicultural approach for the announcement of a diagnosis of blindness for a baby with multiple diseases, in the course of visual electrophysiology clinics. This case shows the different possibilities of intercultural approach of diseases, with three levels of implication. At the first level we may acquire the knowledge of ethnologic tools to understand disease representations, types and causes that can be very different from the Western ones, in the patient's community. At the second level we may integrate cultural consciousness in the management of clinics. At the third level we may proceed to the cultural mediation of diseases. Practicing this intercultural approach of the patient develops the ethical part of the therapeutic relationship, it also provides the patients and the physicians better comfort, and better efficiency for prevention campaigns.