Awareness of Individuals with Chronic Lung Disease About Climate Change, Heat Waves, Air Pollution and Physical Activity

The air temperature of the province and district where the patients were located and lived one week before the assessment will be recorded from the open access website of the General Directorate of Meteorology of the Ministry of Environment and Urbanization (https://www.mgm.gov.tr/).

The humidity level of the province and district where the patients were located and lived one week before the assessment will be recorded from the open access website of the General Directorate of Meteorology of the Ministry of Environment and Urbanization (https://www.mgm.gov.tr/).

The wind speed of the province and district where the patients were located and lived one week before the assessment will be recorded from the open access website of the General Directorate of Meteorology of the Ministry of Environment and Urbanization (https://www.mgm.gov.tr/).

The province and district where the patients were located and lived in the last week before the assessment will be recorded and the air pollutant values of PM2.5, PM10, CO, NO2, SO2, NO, O3 in the settlement where they lived in the last week will be accessed from the open access website of the continuous monitoring center of the Ministry of Environment and Urbanization and will be recorded and used for analysis. (https://sim.csb.gov.tr/STN/STN_Report/StationDataDownloadNew).

Standardized Mini Mental Test. will be used for cognitive assessment. It provides assessment of cognitive activities such as understanding, reading, remembering and performing actions consisting of eleven questions. It is scored between 0-30. < 18 (quite a lot of cognitive impairment), 18-22 (moderate cognitive impairment), 23-26 (low cognitive impairment), 27-30 (no cognitive impairment).

Hospital Anxiety and Depression Scale (HADS) will be used to assess anxiety and depression. Seven out of a total of 14 questions measure anxiety and seven questions assess depression. The answers are scored in a four-point Likert format and between 0 and 3. The lowest score that patients can get from both subscales is 0, and the highest score is 21.

The St. George Respiratory Questionnaire (SGRQ) will be used to assess disease-specific quality of life. The SGRQ is a questionnaire consisting of three categories that patients answer themselves, assessing symptoms, activities and the impact of their disease on their daily lives. The questionnaire consists of a total of 76 questions and is scored between zero and 100, with high scores indicating poor health status.

The Rapid Assessment of Adult Health Literacy in Medicine (REALM) scale will be used for health literacy assessment. REALM tests people's word recognition and pronunciation skills. It is a word recognition test in which 66 health-related words are given, with the words becoming increasingly more difficult. Patients will be asked to read all of these words out loud in order.

Physical activity level will be assessed using the International Physical Activity Questionnaire (IPAQ) (Short Form). This questionnaire was designed as a short and long form to determine the physical activity and sedentary behavior levels of adults. The IPAQ short form consists of seven questions and provides information on the time spent in vigorous activity, moderate activity and walking activities, as well as the time spent sitting. Higher IPAQ scores reflect greater levels of physical activity. In addition, the step counts of the participants for the last week will be recorded from their smartphones.

Respiratory function test values will be recorded from patient records.

Body mass index value will be calculated.

Disease-related symptoms (shortness of breath, cough and sputum) will be questioned and recorded.

Socio-economic status will be recorded.

Education level will be recorded.

Modified Medical Research Council (mMRC) dyspnea scale will be used for dyspnea assessment. mMRC dyspnea scale is a scale in which individuals choose the expression that best describes their dyspnea levels from five expressions related to shortness of breath. It easily evaluates shortness of breath due to its simplicity and reliability. Higher mMRC dyspnea scale scores indicate more severe dyspnea (breathlessness).

Charlson Comorbidity Index (CCI) will be used to query accompanying comorbidities. Higher CCI scores indicate a greater burden of comorbid conditions.