{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:21:01Z","timestamp":1784132461533,"version":"3.55.0"},"reference-count":42,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Carlos III Health Institute","doi-asserted-by":"crossref","award":["PI20\/01334"],"award-info":[{"award-number":["PI20\/01334"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ EBM"],"accepted":{"date-parts":[[2024,11,24]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to analyse the perspectives of screening candidates and healthcare professionals on shared decision-making (SDM) in prostate cancer (PCa) screening using the prostate-specific antigen (PSA) test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Descriptive qualitative study (May\u2013December 2022): six face-to-face focus groups and four semistructured interviews were conducted, transcribed verbatim and thematically analysed using ATLAS.ti software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were obtained as part of the project PROSHADE (Decision Aid for Promoting Shared Decision Making in Opportunistic Screening for Prostate Cancer) to develop a tool for SDM in PCa screening with PSA testing in Spain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 27 screening candidates (three groups of men: 40\u201350 years old; 51\u201360 years old and 61\u201380 years old), 25 primary care professionals (one group of eight nurses and two groups of physicians: one with more and one with less than 10 years of experience), and four urologists. Focus groups for patients and healthcare professionals were conducted separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Participants' perceptions of shared decision-making related to PSA opportunistic screening, including their understanding, preferences, and attitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three themes were generated: (1) perceptions of SDM, (2) perceptions of PSA testing and (3) perceptions of SDM regarding PCa screening. Theme 1: screening candidates valued SDM when it included clear information and empowered them. There was consensus with primary care health professionals on this point, although their knowledge and implementation of SDM varied. Theme 2: candidates were divided on PSA testing; some trusted it for early detection, while others expressed scepticism due to concerns about false positives and invasive procedures, reflecting gaps in accessible information. Theme 3: professionals across primary and specialised care stressed the need for standardised SDM protocols. Primary care physicians were particularly concerned that PSA decisions align with scientific evidence and urologists recognised SDM as valuable in PSA testing only if it was adequately explained to each patient. Barriers to implementing SDM included insufficient coordination across care levels, lack of consensus-driven protocols and limited clinical time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While patients expect comprehensive information, primarily based on practice to achieve empowerment, healthcare professionals face obstacles such as limited time and insufficient coordination between primary care and urology. All stakeholders agree on the importance of evidence-based tools to reinforce effective SDM and enhance collaboration across urologists and primary care in the context of PSA testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjebm-2024-113113","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T11:00:52Z","timestamp":1735210852000},"page":"163-172","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Perspectives of clinicians and screening candidates on shared decision-making in prostate cancer screening with the prostate-specific antigen (PSA) test: a qualitative study (PROSHADE study)"],"prefix":"10.1136","volume":"30","author":[{"given":"Mar\u00eda Jos\u00e9","family":"Sanchis","sequence":"first","affiliation":[{"name":"Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Guilabert","sequence":"additional","affiliation":[{"name":"Department of Health Psychology, Miguel Hernandez University of Elche, Elche, Comunidad Valenciana, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy A","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain"},{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Caballero-Romeu","sequence":"additional","affiliation":[{"name":"Urology Department, Dr Balmis General University Hospital. Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Chilet-Rosell","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain"},{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"G\u00f3mez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Urology, University General Hospital of Elche, Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Alonso-Coello","sequence":"additional","affiliation":[{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"},{"name":"Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Sant Pau Research Institute, Barcelona, Catalunya, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Cebri\u00e1n","sequence":"additional","affiliation":[{"name":"Cartagena Casco Healthcare Centre, Cartagena, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maite","family":"L\u00f3pez-Garrig\u00f3s","sequence":"additional","affiliation":[{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"},{"name":"Clinical Laboratory, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Moral","sequence":"additional","affiliation":[{"name":"Research Unit, EAP Sardenya, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ronda-P\u00e9rez","sequence":"additional","affiliation":[{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"},{"name":"Public Health Research group, Universidad de Alicante, San Vicente del Raspeig, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Canelo-Aybar","sequence":"additional","affiliation":[{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"},{"name":"Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau, Sant Pau Research Institute, Barcelona, Catalunya, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ildefonso","family":"Hern\u00e1ndez-Aguado","sequence":"additional","affiliation":[{"name":"Department of Public Health, History of Science, and Gynecology, Miguel Hernandez University of Elche Faculty of Medicine, Sant Joan D'Alacant, Comunidad Valenciana, Spain"},{"name":"CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"P\u00e1rraga","sequence":"additional","affiliation":[{"name":"Health Care Center Zone VIII, Servicio de Salud Castilla-La Mancha, Medical Sciences Department, Medicine Faculty, University of Castilla-La Mancha, Albacete, Spain. 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