title: Total Joint Arthroplasty Patients' Education on Financial Issues and Its Connection to Reported Out-of-Pocket Costs-A European Study.
abstract: OBJECTIVE
  Total joint arthroplasty is accompanied by significant costs. In nursing, patient education on financial issues is considered important. Our purpose was to examine the possible association between the arthroplasty patients' financial knowledge and their out-of-pocket costs.
  
  
  METHODS
  Descriptive correlational study in five European countries. Patient data were collected preoperatively and at 6 months postoperatively, with structured, self-administered instruments, regarding their expected and received financial knowledge and out-of-pocket costs.
  
  
  RESULTS
  There were 1,288 patients preoperatively, and 352 at 6 months. Patients' financial knowledge expectations were higher than knowledge received. Patients with high financial knowledge expectations and lack of fulfillment of these expectations had lowest costs.
  
  
  CONCLUSIONS
  There is need to establish programs for improving the financial knowledge of patients. Patients with fulfilled expectations reported higher costs and may have followed and reported their costs in a more precise way. In the future, this association needs multimethod research.
authors.affiliation: Clinical Nurse, General Hospital of Piraeus Tzaneio, Piraeus, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Copanitsanou
authors.affiliation: Adjunct Professor, Department of Nursing Science, University of Turku, Turku, Finland and Lahti University of Applied Sciences, Lahti, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Valkeapää
authors.affiliation: Director of Health Science School, Tecno Campus, Matarό-Maresme, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Cabrera
authors.affiliation: Statistician, Department of Statistics, University of Turku, Turku, Finland.
authors.forename: Jouko
authors.initials: J
authors.lastname: Katajisto
authors.affiliation: Professor, Department of Nursing Science, University of Turku, Turku, Finland and Nurse Director, Turku University Hospital, Turku, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.affiliation: Professor, School of Health Sciences, University of Akureyri, Akureyri, Iceland.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Sigurdardottir
authors.affiliation: Professor, Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
authors.forename: Mitra
authors.initials: M
authors.lastname: Unosson
authors.affiliation: Director of Nursing, Hospital Clinic of Barcelona, Barcelona, Spain.
authors.forename: Adelaida
authors.initials: A
authors.lastname: Zabalegui
authors.affiliation: Professor, Faculty of Nursing, University of Athens, Athens, Greece.
authors.forename: Chryssoula
authors.initials: C
authors.lastname: Lemonidou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000191:economics* / Q000523:psychology / Q000592:standards; D005260:Female; D005387:Finland; D006115:Greece; D017048:Health Care Costs / Q000592:standards* / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007055:Iceland; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards* / Q000706:statistics & numerical data; D013030:Spain; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Costs; patient education; patient expectations; surgery; total joint arthroplasty