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

Abstract

Background Differences in sexual development (DSD) are rare diseases, which affect the chromosomal, anatomical or gonadal sex differentiation. Although patient education is recommended as essential in a holistic care approach, standardised programmes are still lacking. The present protocol describes the aims, study design and methods of the Empower-DSD project, which developed an age-adapted multidisciplinary education programme to improve the diagnosis-specific knowledge, skills and empowerment of patients and their parents. Methods The new patient education programme was developed for children, adolescents and young adults with congenital adrenal hyperplasia, Turner syndrome, Klinefelter syndrome or XX-/or XY-DSD and their parents. The quantitative and qualitative evaluation methods include standardised questionnaires, semi-structured interviews, and participatory observation. The main outcomes (assessed three and six months after the end of the programme) are health-related quality of life, disease burden, coping, and diagnosis-specific knowledge. The qualitative evaluation examines individual expectations and perceptions of the programme. The results of the quantitative and qualitative evaluation will be triangulated. Discussion The study Empower-DSD was designed to reduce knowledge gaps regarding the feasibility, acceptance and effects of standardised patient education programmes for children and youth with DSD and their parents. A modular structured patient education programme with four generic and three diagnosis-specific modules based on the ModuS concept previously established for other chronic diseases was developed. The topics, learning objectives and recommended teaching methods are summarised in the structured curricula, one for each diagnosis and age group. At five study centres, 56 trainers were qualified for the implementation of the training programmes. A total of 336 subjects have been already enrolled in the study. The recruitment will go on until August 2022, the last follow-up survey is scheduled for February 2023. The results will help improve multidisciplinary and integrated care for children and youth with DSD and their families. Trial registration German Clinical Trials Register, DRKS00023096. Registered 8 October 2020 – Retrospectively registered.

Facilitating the transition from paediatric to adult care in endocrinology: a focus on growth disorders

“…Disease-specific education and skill-building interventions strengthen knowledge and self-management skills for patients with chronic endocrine disorders, such as T1D [13,14], Klinefelter syndrome [15 ▪ ,16] and Turner syndrome [16]. These interventions can be integrated into transition clinics, focus groups, workshops, classes and camps, and may be led by clinicians, trained educators, social workers or psychologists.…”

“…Patel et al [39] reported that increased patient age, higher level of education, more life skills, and greater Turner syndrome knowledge, confidence and social/emotional skills were associated with higher transition readiness. Education programmes have been designed to improve Turner syndrome-specific knowledge, skills and empowerment of patients and their parents [16]. Transition tools specific to Turner syndrome are noted in Table 1.…”

Long-term outcomes in non-CAH 46,XX DSD

“…To date, it collected information from 1,040 persons with DSD conditions in six countries (Germany, France, the Netherlands, Poland, Sweden, and the UK). Another example is the Empower-DSD project, which is a prospective, longitudinal, and noncontrolled multicenter study led in Germany with the main aim of developing, implementing, and evaluating an age-appropriate educational program for 700 children and young people with DSD ( 3 ).…”