AcknowledgmentsThe study has required contribution by many people in the participating countries. We wish to thank all those who took part in this study. This study was financially supported by the following: Finland-University of Turku; A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTEmpowering 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 AcknowledgmentsThe study has required contribution by many people in the participating countries. We wish to thank all those who took part in this study. Abbreviations EK hpExpected knowledge (hospital patients) EQ-5DEuroQoL 5-dimensional classification component scores (www.euroqol.org) HRQoLHealth-related quality of life OA Osteoarthritis RK hpReceived knowledge (hospital patients) THA Total hip arthroplasty TKA Total knee arthroplasty A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT AbstractAims: 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.Method: 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 healthrelated 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 healthrelated 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.
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