Validation of Risk Perception Cut-Offs in Italian Brief PRHDS (PRHDS-BI): Implications for Primary Cardiovascular...

Area of Science:

• Cardiology
• Psychometrics
• Preventive Medicine

Background:

• Effective cardiovascular (CV) prevention hinges on accurate risk estimation and patient engagement, influenced by perceived risk.
• The Perception of Risk of Heart Disease Scale (PRHDS) is validated, but clinical thresholds for its brief Italian version were previously unavailable.

Purpose of the Study:

• To further validate the Brief Italian version of the PRHDS (PRHDS-BI) in a new cohort.
• To examine convergent and divergent validity, establish clinical thresholds, and create a discrepancy index comparing perceived and objective CV risk.

Main Methods:

• A multicentre cross-sectional study involving 285 adults (40-69 years) without prior CV disease.
• Participants completed the PRHDS-BI and Patient Health Questionnaire-4 (PHQ-4).
• Objective CV risk was assessed using the Systematic Coronary Risk Evaluation 2 (SCORE2); Confirmatory Factor Analysis (CFA) and correlation analyses were employed.

Main Results:

• The PRHDS-BI demonstrated good internal consistency and strong convergent validity.
• Clinical thresholds were established: low/moderate (6-12), high (13-17), and very high (18-24).
• A significant perception-reality gap was observed: 63.5% of low/moderate actual risk individuals overestimated, while 80% of very high actual risk individuals underestimated their risk.

Conclusions:

• The PRHDS-BI is a valid instrument for assessing cardiovascular risk perception.
• Defined thresholds facilitate tailored risk communication and patient-centered interventions.
• Nursing professionals can utilize this tool in primary prevention settings to address risk perception discrepancies.