Extended Parallel Processing Model

1. Persuading Rico to abandon his long-held beliefs about family structure, end of life and palliative care is a difficult task. As I discussed in the above prompt, the most immediate and effective action to take is “meeting Rico where he is.” In PMH we learned of three different theoretical models that could be implemented to help sway Rico’s decision: The Theory of Plan Behavior (TPB), The Health Belief Model (HBM) and the Extended Parallel Processing Model (EPPM). The Theory of Plan Behavior examines a patient’s behavioral beliefs, normative expectations and their locus of control in health decisions. The HBM expands on the TPB and includes variables of patient self-efficacy; this model also examines the perceived risk and severity the patient

I would address Rico’s lack of perceived susceptibility, which may be difficult with his stroke; his deficits in understanding will make this a more difficult conversation. I would explain to Rico that his susceptibility of death is near, and that the severity (which he understands) is not avoidable. The most important aspect of this conversation would be explaining to Rico the benefits of palliative care. I would explain to Rico that palliative care would undertake a multidisciplinary approach to help relieve his pain, anxiety and health management concerns. I would explain to Rico that the palliative care team I am recommending would be capable of providing him round the clock care, which his son could not. I would further emphasize that we could find him a Spanish speaking team, so his customs and language could be maintained. To reveal the barriers in his approach I would have the interpreter engage Rico’s son in Spanish; I would have his son explain the stress, anxiety and unpreparedness that he feels in managing his father’s care. I would then use the “Cues to Action” aspect of the HBM to motivate Rico to enter palliative care. I would provide him names, numbers and costs of palliative care teams with Spanish speaking capabilities. Moreover, I would give him the contact information of others in his situation and have them describe to him their experiences within the palliative care system. I would lastly engage his self-efficacy; Rico feels confident in himself and his son for the care he needs, but it frankly would not be sufficient. I would explain to Rico that he and his son could take an active role in helping the palliative care team, which allows Rico to feel he and his family are still the primary caretakers. By taking this approach, Rico would feel more