Perceived Impact of Extreme Temperatures, Severe Weather and Air Pollution on Health and Daily Life Among Patients with Cardiovascular Disease: Protocol for a Cross-Sectional Questionnaire-Based Study

Background: Extreme temperatures, severe weather events, and air pollution pose important challenges to cardiovascular health. However, patients’ perceptions of environmental risks, symptom-related experiences, adaptive behaviours, and information needs remain insufficiently characterized. This study aims to develop and describe the methodology of a patient-centred questionnaire assessing these dimensions in adults with cardiovascular disease. Methods: An anonymous, self-administered, 37-item questionnaire was developed for adult patients with at least one cardiovascular diagnosis. The instrument comprises five sections addressing sociodemographic and clinical characteristics; perceived health effects of heat, cold, and air pollution; psychological and quality-of-life impacts; protective behaviours and healthcare utilization; and knowledge and information sources. Most closed-ended items use five-point Likert-type or frequency scales, alongside one open-ended question. Content validity was assessed by an independent panel of three experts in cardiology, psychology, and meteorology/climatology. A pilot study involving 39 patients with cardiovascular disease recruited from a clinical research database was conducted to assess questionnaire feasibility and internal consistency. Pilot participants were excluded from the main study. The target sample size for the main study was calculated as 385 participants, increased to 428 to account for non-submission. Eligible patients will be recruited consecutively during hospitalization in our cardiology department. Conclusions: This questionnaire provides a structured framework for investigating perceived environmental cardiovascular vulnerability, psychological impact, adaptive responses, healthcare-related consequences, and information needs. Its application may help identify gaps in patient awareness and protective practices and inform the development of targeted educational and preventive interventions addressing climate-related cardiovascular risks.