title: Empowering knowledge and its connection to health-related quality of life: A cross-cultural study: A concise and informative title: Empowering knowledge and its connection to health-related quality of life.
abstract: OBJECTIVE
  Assess the association between patient education (i.e. empowering knowledge) and preoperative health-related quality of life, 6 months postoperative health-related quality of life, and the increase in health-related quality of life in osteoarthritis patients who underwent total hip or total knee arthroplasty.
  
  
  METHODS
  This is a cross-cultural comparative follow-up study using structured instruments to measure the difference between expected and received patient education and self-reported health-related quality of life (EQ-5D) in Finland, Greece, Iceland, Spain and Sweden.
  
  
  RESULTS
  The health-related quality of life was significantly increased 6 months postoperatively in all countries due to the arthroplasties. In the total sample, higher levels of empowering knowledge were associated with a higher health-related quality of life, both pre- and postoperatively, but not with a higher increase in health-related quality of life. On the national level, postoperative health-related quality of life was associated with higher levels of empowering knowledge in Finland, Iceland and Sweden. The increase in health-related quality of life was associated with levels of empowering knowledge for Greece.
  
  
  CONCLUSIONS
  Overall, it can be concluded that the level of empowering knowledge was associated with high postoperative health-related quality of life in the total sample, even though there is some variation in the results per country.
authors: Department of Nursing science, University of Turku, FI-20014 Turun yliopisto, Finland.
authors: Krista
authors: K
authors: Koekenbier
authors: Department of Nursing science, University of Turku, FI-20014 Turun yliopisto, Finland; Hospital district of Southwest Finland, 20521 Turku, Finland.
authors: Helena
authors: H
authors: Leino-Kilpi
authors: Tecnocampus Mataro, School of Health Sciences de la Mercè, 10-12, Barcelona.
authors: Esther
authors: E
authors: Cabrera
authors: Department of Nursing, Klaipeda University, Lt-92294, Klaipėda, Lithuania.
authors: Natalia
authors: N
authors: Istomina
authors: Department of Social and Welfare studies, Faculty of Health sciences, Linköping University, Campus Norrköping, Medicinska fakulteten, 581 83 Linköping, Sweden.
authors: Åsa
authors: Å
authors: Johansson Stark
authors: Department of Mathematics and Statistics, University of Turku, FI-20014, Turun yliopisto, Finland.
authors: Jouko
authors: J
authors: Katajisto
authors: Faculty of Nursing, University of Athens, Greece.
authors: Chryssoula
authors: C
authors: Lemonidou
authors: Cyprus University of Technology, P.O. Box 50329, 3603, Limassol, Cyprus.
authors: Evridiki
authors: E
authors: Papastavrou
authors: Department of Nursing science, University of Turku, FI-20014 Turun yliopisto, Finland; Hospital district of Southwest Finland, 20521 Turku, Finland.
authors: Sanna
authors: S
authors: Salanterä
authors: School of Health sciences, University of Akureyri Akureyi, Norðurslóð, Akureyri, Iceland.
authors: Arun
authors: A
authors: Sigurdardottir
authors: Department of Nursing science, University of Turku, FI-20014 Turun yliopisto, Finland; Lahti University of Applied Sciences, FI-15101, Lahti, Finland.
authors: Kirsi
authors: K
authors: Valkeapää
authors: Department of Nursing science, University of Turku, FI-20014 Turun yliopisto, Finland; Hospital district of Southwest Finland, 20521 Turku, Finland. Electronic address: sinelo@utu.fi.
authors: Sini
authors: S
authors: Eloranta
mesh_terms: D003431:Cross-Cultural Comparison; D005387:Finland; D006115:Greece; D007055:Iceland; D010003:Osteoarthritis / Q000601:surgery; D010358:Patient Participation; D011788:Quality of Life; D013030:Spain; D013548:Sweden
keywords: Cross-cultural; Empowering knowledge; Empowerment; Health-related quality of life; Osteoarthritis; Patient-centered education