{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:55:36Z","timestamp":1791406536130,"version":"4.3.3"},"reference-count":35,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014840","name":"Gemeinsame Bundesausschuss","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014840","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Patient Education and Counseling"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1016\/j.pec.2026.109482","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T16:25:49Z","timestamp":1768580749000},"page":"109482","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Improving diagnosis-specific knowledge of people with differences of sex development (DSD): Evaluation of the two-day Empower-DSD training course in Germany"],"prefix":"10.1016","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0222-3369","authenticated-orcid":false,"given":"Ralph","family":"Schilling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Wiegmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirja","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5494-3328","authenticated-orcid":false,"given":"Katja","family":"Wechsung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Kalender","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"St\u00f6ckigt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Richter-Unruh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Hiort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1259-2029","authenticated-orcid":false,"given":"Ulla","family":"D\u00f6hnert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Rohayem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus-Peter","family":"Liesenk\u00f6tter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6795-8430","authenticated-orcid":false,"given":"Martin","family":"Wabitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gundula","family":"Ernst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Roll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9108-3360","authenticated-orcid":false,"given":"Thomas","family":"Keil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3892-0577","authenticated-orcid":false,"given":"Uta","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.pec.2026.109482_bib1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41443-022-00606-z","article-title":"Differences in sex development (DSD) and related conditions: mechanisms, prevalences and changing practice","volume":"35","author":"Conway","year":"2023","journal-title":"Int J Impot Res"},{"key":"10.1016\/j.pec.2026.109482_bib2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1038\/s41574-018-0010-8","article-title":"Caring for individuals with a difference of sex development (DSD): a consensus statement","volume":"14","author":"Cools","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"10.1016\/j.pec.2026.109482_bib3","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jpurol.2006.03.004","article-title":"Consensus statement on management of intersex disorders","volume":"2","author":"Hughes","year":"2006","journal-title":"J Pediatr Urol"},{"key":"10.1016\/j.pec.2026.109482_bib4","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1159\/000442975","article-title":"Global disorders of sex development update since 2006: perceptions, approach and care","volume":"85","author":"Lee","year":"2016","journal-title":"Horm Res Paediatr"},{"key":"10.1016\/j.pec.2026.109482_bib5","unstructured":"S1-Leitlinie Adrenogenitales Syndrom (AGS) im Kindes- und Jugendalter 2.0. [S1-Guideline: Congenital adrenal hyperplasia (CAH) in childhood and adolescence. Version 2.0]: Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e. V.; 2021. \u3008https:\/\/register.awmf.org\/de\/leitlinien\/detail\/174-003\u3009."},{"key":"10.1016\/j.pec.2026.109482_bib6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/jpepsy\/jsaa089","article-title":"Psychosocial functioning among children with and without differences of sex development","volume":"46","author":"Hansen-Moore","year":"2021","journal-title":"J Pediatr Psychol"},{"key":"10.1016\/j.pec.2026.109482_bib7","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/s41443-021-00422-x","article-title":"Psychosocial care and support in the field of intersex\/diverse sex development (dsd): counselling experiences, localisation and needed improvements","volume":"33","author":"Lampalzer","year":"2021","journal-title":"Int J Impot Res"},{"key":"10.1016\/j.pec.2026.109482_bib8","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1007\/s00103-013-1850-y","article-title":"Intersex and differences of sex development: background, diagnostics, and concepts of care","volume":"56","author":"Holterhus","year":"2013","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"10.1016\/j.pec.2026.109482_bib9","first-page":"586","article-title":"Intersex condition and the construction of gender identity","volume":"2","author":"Miano","year":"2015","journal-title":"Int J Humanit Cult Stud"},{"key":"10.1016\/j.pec.2026.109482_bib10","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s11154-008-9084-2","article-title":"Disorders of sex development (DSDs), their presentation and management in different cultures","volume":"9","author":"Warne","year":"2008","journal-title":"Rev Endocr Metab Disord"},{"key":"10.1016\/j.pec.2026.109482_bib11","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1086\/JCE199809409","article-title":"Pediatric ethics and the surgical assignment of sex","volume":"9","author":"Kipnis","year":"1998","journal-title":"J Clin Ethics"},{"key":"10.1016\/j.pec.2026.109482_bib12","article-title":"Intersexuality. Opinion","author":"Council","year":"2013","journal-title":"German Ethics Council"},{"key":"10.1016\/j.pec.2026.109482_bib13","unstructured":"S2k-Leitlinie Varianten der Geschlechtsentwicklung 2.0 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e. V.; 2016. \u3008https:\/\/register.awmf.org\/de\/leitlinien\/detail\/174-001\u3009."},{"key":"10.1016\/j.pec.2026.109482_bib14","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1007\/s00120-024-02326-2","article-title":"Differences in sexual development-S2k guideline update","volume":"63","author":"Krege","year":"2024","journal-title":"Urologie"},{"key":"10.1016\/j.pec.2026.109482_bib15","unstructured":"Gesetz zum Schutz von Kindern mit Varianten der Geschlechtsentwicklung [Law on the Protection of Children with Varieties in Sex Development]: Bundesgesetzblatt Jahrgang 2021 Teil I Nr. 24, ausgegeben zu Bonn am 21. Mai 2021; 2021. \u3008https:\/\/www.bmjv.de\/SharedDocs\/Downloads\/DE\/Gesetzgebung\/BGBl\/Bgbl_Varianten_der_Geschlechtsentwicklung.pdf?__blob=publicationFile&v=3\u3009."},{"key":"10.1016\/j.pec.2026.109482_bib16","unstructured":"United Nations. Convention on the Rights of the Child 1577 ed: United Nations; Nov. 20, 1989. p. 3."},{"key":"10.1016\/j.pec.2026.109482_bib17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0738-3991(02)00032-0","article-title":"Self-management approaches for people with chronic conditions: a review","volume":"48","author":"Barlow","year":"2002","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.pec.2026.109482_bib18","first-page":"18","article-title":"Patient education programs for children, adolescents and parents - survey on the current status of concepts and education requirements in Germany. Pravention und Rehabilitation","volume":"25","author":"Ernst","year":"2013"},{"key":"10.1016\/j.pec.2026.109482_bib19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1207\/S15324796ABM2601_01","article-title":"Self-management education: history, definition, outcomes, and mechanisms","volume":"26","author":"Lorig","year":"2003","journal-title":"Ann Behav Med"},{"key":"10.1016\/j.pec.2026.109482_bib20","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11133859","article-title":"On Behalf Of The Empower-Dsd Study G. Diagnosis of DSD in children-development of new tools for a structured diagnostic and information management program within the empower-DSD study","volume":"11","author":"Wechsung","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.pec.2026.109482_bib21","article-title":"Structured care after a DSD diagnosis in childhood: a mixed methods evaluation of the Empower-DSD program","volume":"13","author":"Wechsung","year":"2025","journal-title":"Front Pedia"},{"key":"10.1016\/j.pec.2026.109482_bib22","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12902-022-01079-3","article-title":"Development and evaluation of a patient education programme for children, adolescents, and young adults with differences of sex development (DSD) and their parents: study protocol of Empower-DSD","volume":"22","author":"Wiegmann","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"10.1016\/j.pec.2026.109482_bib23","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.pec.2017.01.001","article-title":"Development and evaluation of a generic education program for chronic diseases in childhood","volume":"100","author":"Ernst","year":"2017","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.pec.2026.109482_bib24","author":"Ernst","year":"2020"},{"key":"10.1016\/j.pec.2026.109482_bib25","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1093\/her\/cyy045","article-title":"Evaluation of a generic patient education program in children with different chronic conditions","volume":"34","author":"Menrath","year":"2019","journal-title":"Health Educ Res"},{"key":"10.1016\/j.pec.2026.109482_bib26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.pec.2004.05.008","article-title":"Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm","volume":"57","author":"Anderson","year":"2005","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.pec.2026.109482_bib27","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1007\/s00431-010-1173-z","article-title":"Preschoolers' and parents' asthma education trial (P2AET)--a randomized controlled study","volume":"169","author":"Szczepanski","year":"2010","journal-title":"Eur J Pedia"},{"key":"10.1016\/j.pec.2026.109482_bib28","doi-asserted-by":"crossref","unstructured":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Amer Med Assoc 2013;310:2191\u20132194. https:\/\/doi.org\/10.1001\/jama.2013.281053.","DOI":"10.1001\/jama.2013.281053"},{"key":"10.1016\/j.pec.2026.109482_bib29","doi-asserted-by":"crossref","DOI":"10.1016\/j.pecinn.2024.100321","article-title":"Satisfaction with a new patient education program for children, adolescents, and young adults with differences of sex development (DSD) and their parents","volume":"5","author":"Wiegmann","year":"2024","journal-title":"PEC Innov"},{"key":"10.1016\/j.pec.2026.109482_bib30","unstructured":"UNESCO. International Standard Classification of Education - ISCED 2011. \u3008https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/index.php?title=International_Standard_Classification_of_Education_(ISCED)\u3009."},{"key":"10.1016\/j.pec.2026.109482_bib31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jpag.2013.09.004","article-title":"Improving self-esteem in women diagnosed with turner syndrome: results of a pilot intervention","volume":"27","author":"Chadwick","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"10.1016\/j.pec.2026.109482_bib32","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1093\/humrep\/dem167","article-title":"A randomized controlled trial of a cognitive-behavioural group intervention versus waiting-list control for women with uterovaginal agenesis (Mayer-Rokitansky-K\u00fcster-Hauser syndrome: MRKH)","volume":"22","author":"Heller-Boersma","year":"2007","journal-title":"Hum Reprod"},{"key":"10.1016\/j.pec.2026.109482_bib33","unstructured":"Kompetenznetz Patientenschulung im Kindes- und Jugendalter e.V. (KomPaS). \u3008https:\/\/www.kompetenznetz-patientenschulung.de\/\u3009."},{"key":"10.1016\/j.pec.2026.109482_bib34","author":"Ernst","year":"2020"},{"key":"10.1016\/j.pec.2026.109482_bib35","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.pec.2006.09.008","article-title":"Patient empowerment in theory and practice: polysemy or cacophony?","volume":"66","author":"Aujoulat","year":"2007","journal-title":"Patient Educ Couns"}],"container-title":["Patient Education and Counseling"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399126000157?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399126000157?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:24:48Z","timestamp":1791404688000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0738399126000157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":35,"alternative-id":["S0738399126000157"],"URL":"https:\/\/doi.org\/10.1016\/j.pec.2026.109482","relation":{},"ISSN":["0738-3991"],"issn-type":[{"value":"0738-3991","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Improving diagnosis-specific knowledge of people with differences of sex development (DSD): Evaluation of the two-day Empower-DSD training course in Germany","name":"articletitle","label":"Article Title"},{"value":"Patient Education and Counseling","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.pec.2026.109482","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"109482"}}