*4.3.8 Symptom perception*

Symptom perception is related to signs observed and listening to the body to determine physical sensations allowing the patient to identify, interpret, and label symptoms. Symptom awareness, with measurement and taking rapid action through evaluation, is defined as one of the basic elements in the self-care process of patients with advanced heart failure [39].

Symptom evaluation by the patient is assessed under the headings of frequency, intensity [e.g., on a scale of 1–10], rate [how many times in a time interval], duration, model [mornings, after activity, etc.], symptom specificity [in the whole body, in the arms, etc.], and pain [20]. In addition to clinical evaluation, symptoms can be evaluated using the Numerical Grading Scale, the Edmonton Symptom Assessment Scale [ESAS], the ESAS-HF, or the Integrated Palliative Care Outcome Scale.
