These findings suggest there is a disconnect between the perceived severity of AHF by ED physicians and the severity defined by BNP levels.
Three papers highlighted an association between the perceived severity of symptoms and seeking assistance, with patients and relatives often explaining symptoms as being due to a less serious condition [ 35- 37].
At a group level, there was evidence for a robust association between the perceived severity of the different problems domains and the expectations for outcome, with all patients expecting improvement or, at worse, no change.
Based upon Protection Motivation Theory we distinguish between the perceived severity of a disease, described by Brewer et al. as the extent of harm a hazard would cause, and the perceived vulnerability (often also described as perceived likelihood or risk perception as such), described as the probability that one will be harmed by the hazard [ 15, 23, 24].
Similar to our data, a multicenter study reported a large disconnect between the perceived severity of heart failure (as assessed by initial disposition and New York Heart Association functional class) and the BNP level, emphasizing the biomarker-guided therapeutic and monitoring strategies involving BNP in the patients with heart failure [ 9].
This positive relationship between perceived severity and disease representativeness, which together show an inverse relationship with estimates of prevalence, is consistent with previous findings [19] [20].
Within domains, significant associations were found between perceived severity and expectations for therapy in each domain, with higher severity associated with higher expected improvement (Table 2).
On the contrary we observed a strong positive association between perceived severity and mitigation, β = 0.479, p < 0.001.
To assess the association between demographic and lifestyle parameters and perceived severity of the climacteric syndrome in perimenopausal women.
Marked differences were found in the perceived severity of health system bottlenecks between Asian and African countries, with the former reporting more significant or very major bottlenecks for KMC with respect to all the health system building blocks.
